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https://www.readbyqxmd.com/read/29232273/practice-bulletin-no-191-tubal-ectopic-pregnancy
#1
(no author information available yet)
Ectopic pregnancy is defined as a pregnancy that occurs outside of the uterine cavity. The most common extrauterine site of ectopic pregnancy is the fallopian tube. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical emergency that requires prompt surgical intervention. The purpose of this document is to review information on the current understanding of tubal ectopic pregnancy and to provide guidelines for timely diagnosis and management that are consistent with the best available scientific evidence...
December 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29231488/-clinical-data-analysis-of-279-inpatients-with-acupuncture-consultation-in-a-comprehensive-hospital
#2
Yamin Zhang, Hua Sun, Suhui Chen, Hong Xu, Fei Bao
OBJECTIVE: To analyze the current status of acupuncture consultation in Peking Union Medical College Hospital, which could provide references and suggestions for the development of acupuncture at comprehensive hospitals and the treatment of diseases. METHODS: The source of departments, the number of patients, the number of consultation, treatment frequency, consultation reasons and western medicine diagnosis of 279 inpatients who received acupuncture consultation were analyzed...
February 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29230341/pancreatic-laceration-in-a-pediatric-patient-an-unexpected-diagnosis
#3
Michelle J Hong, Lauren M Porter, Debra D Esernio-Jenssen, Andrew C Miller, Marna Rayl Greenberg
Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29229157/long-term-outcomes-of-sigmoid-diverticulitis-a-single-center-experience
#4
Ido Mizrahi, Abbas Al-Kurd, Katya Chapchay, Yael Ag-Rejuan, Natalia Simanovsky, Ahmed Eid, Haggi Mazeh
BACKGROUND: During the last decade, guidelines for the treatment of sigmoid diverticulitis have dramatically changed. The aim of this study is to report the long-term outcomes of patients treated for diverticulitis at a nonspecialized single center. MATERIALS AND METHODS: After obtaining institutional review board approval, medical records of all patients admitted to our institution with the diagnosis of sigmoid diverticulitis between 1998 and 2008 were reviewed...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229153/prophylactic-retention-suture-for-surgical-site-infection-a-retrospective-cohort-study
#5
Eisaku Ito, Masashi Yoshida, Norihiko Suzuki, Tomonori Imakita, Nobuhiro Tsutsui, Hironori Ohdaira, Masaki Kitajima, Yutaka Suzuki
BACKGROUND: Surgical site infection (SSI) is a common complication of gastrointestinal surgery. Because retention suture is known to prevent abdominal wound dehiscence, it is only considered indicated in high-risk patients. At present, there are no clear indications for retention suture. The purpose of this study was to analyze the effect of prophylactic retention suture and to determine what situations indicate prophylactic retention suture against SSI. MATERIAL AND METHODS: Between January 2014 and January 2016, 135 patients who underwent midline laparotomy in our hospital were analyzed...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229128/thirty-day-readmission-and-mortality-among-medicare-beneficiaries-discharged-to-skilled-nursing-facilities-after-vascular-surgery
#6
Sara Fernandes-Taylor, Stephen Berg, Rebecca Gunter, Kyla Bennett, Maureen A Smith, Paul J Rathouz, Caprice C Greenberg, K Craig Kent
BACKGROUND: Readmission within 30 d of an acute hospital stay is frequent, costly, and increasingly subject to penalties. Early readmission is most common after vascular surgery; these patients are often discharged to skilled nursing facilities (SNFs), making postacute care an essential partner in reducing readmissions. We characterize 30-day readmissions among vascular surgery patients discharged to SNF to provide evidence for this understudied segment of readmission after specialty surgery...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229124/mortality-after-emergency-hartmann-s-procedure-in-octogenarians-a-propensity-score-matched-analysis
#7
Ian C Bostock, Maureen V Hill, Timothy C Counihan, Srinivas Joga Ivatury
BACKGROUND: Complicated diverticulitis is associated with a postoperative mortality rate of 20%. We hypothesized that age ≥80 was an independent risk factor for mortality after Hartmann's procedure for diverticular disease when controlling for baseline comorbidities. METHODS: Patients who underwent an urgent or emergent Hartmann's procedure (Current Procedural Terminology codes 44143 and 44206) for diverticular disease (International Classification of Diseases-9:562...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229057/functional-limitations-in-adults-who-utilize-chiropractic-or-osteopathic-manipulation-in-the-united-states-analysis-of-the-2012-national-health-interview-survey
#8
Mary L Forte, Michele Maiers
OBJECTIVES: The goals of this study were to identify self-reported differences in function, comorbidities, and medical service utilization among adults who reported using chiropractic and/or osteopathic manipulation in the 2012 National Health Interview Survey, and to compare these between older and younger adults. METHODS: We conducted a descriptive study of adults aged 18 or older who were included in the 2012 National Health Interview Survey and the Alternative Medicine Questionnaire...
November 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/29227054/auditing-surgical-service-provision-at-a-south-african-tertiary-institution-implications-for-the-development-of-district-services
#9
G L Laing, D L Skinner, J L Bruce, C Aldous, V Govindasamy, S R Thomson, D L Clarke
BACKGROUND: The optimal management of resources within South African state hospitals has been hampered by a paucity of data due to a lack of robust auditing information systems. This study reviews the use of a Hybrid Electronic Medical Record (HEMR) system to capture and aggregate data pertaining to the inpatient service demands on a South African tertiary surgical service. This dataset was used to analyse the appropriateness of tertiary surgical resource utilisation. METHOD: The HEMR system was implemented at Greys Hospital, in the city of Pietermaritzburg, Kwa-Zulu Natal, South Africa on 1 January 2013...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29226994/demographic-and-clinical-correlates-of-accelerometer-assessed-physical-activity-and-sedentary-time-in-lung-cancer-survivors
#10
Adrijana D'Silva, Gwyn D Bebb, Terry Boyle, Steven T Johnson, Jeff K Vallance
OBJECTIVE: To determine demographic and clinical correlates of accelerometer assessed physical activity and sedentary time among a population-based sample of lung cancer survivors. METHODS: Lung cancer survivors in Southern Alberta, Canada (N=527) were invited to complete a mailed survey assessing socio-demographics and wear an Actigraph® GT3X+ accelerometer for seven days. Average daily minutes of physical activity and sedentary time were derived from the accelerometer data...
December 11, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/29226123/open-repair-of-a-12-cm-posttraumatic-aneurysm-of-right-subclavian-artery
#11
Konstantinos Tigkiropoulos, Omiros Chalvatzoulis, Eleftherios Chalvatzoulis, Kyriakos Stavridis, Dimitrios Karamanos, Ioannis Lazaridis, Andreas Efstathiou, Nikolaos Saratzis
Purpose: To present a rare case of a patient with a 12-cm posttraumatic right subclavian artery aneurysm successfully treated with aneurysmectomy and innominate-axillary bypass. Case report: A 54-year-old man presented to the emergency department due to progressive dyspnea and hoarseness of voice. His medical record was unremarkable except that he had right-sided pneumothorax and multiple rib fractures from a car accident 16 years ago. A chest X-ray showed a mass in the upper lobe of the right lung, and the patient was hospitalized for further investigation...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/29225814/perioperative-plasma-lyte-use-reduces-the-incidence-of-renal-replacement-therapy-and-hyperkalaemia-following-renal-transplantation-when-compared-with-0-9-saline-a-retrospective-cohort-study
#12
Anamika Adwaney, David W Randall, Mark J Blunden, John R Prowle, Christopher J Kirwan
Background: Kidney transplant recipients often receive large volumes of intravenous fluid replacement in the peri-operative period. Administration of 0.9% saline has previously been associated with acidosis, hyperkalaemia and acute kidney injury. The perioperative use of physiologically balanced replacement fluids may reduce the incidence of post-operative renal replacement therapy and hyperkalaemia. Methods: A retrospective review of consecutive renal transplants before and after a change in perioperative fluid prescription from 0...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29225747/a-prospective-randomized-controlled-double-blind-trial-to-assess-the-effects-of-dexmedetomidine-during-cleft-palate-surgery
#13
Priyanka Surana, Devangi A Parikh, Geeta A Patkar, Bharati A Tendolkar
Background: We investigated whether the intraoperative administration of dexmedetomidine would attenuate the profound sympathoadrenal response associated with cleft palate (CP) surgery. Methods: Sixty children aged 6 months to 12 years undergoing CP surgery under general anesthesia were randomly assigned to the control (C) or dexmedetomidine (D) groups. Group C received benzodiazepine (0.05 mg/kg midazolam followed by infusion of normal saline) fentanyl isoflurane anesthesia, and Group D received dexmedetomidine (loading 1 µg/kg followed by infusion of 0...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29225618/influence-of-enhanced-recovery-pathway-on-surgical-site-infection-after-colonic-surgery
#14
Caroline Gronnier, Fabian Grass, Christiane Petignat, Basile Pache, Dieter Hahnloser, Giorgio Zanetti, Nicolas Demartines, Martin Hübner
Background: The present study aimed to evaluate a potential effect of ERAS on surgical site infections (SSI). Methods: Colonic surgical patients operated between May 2011 and September 2015 constituted the cohort for this retrospective analysis. Over 100 items related to demographics, surgical details, compliance, and outcome were retrieved from a prospectively maintained database. SSI were traced by an independent National surveillance program. Risk factors for SSI were identified by univariate and multinomial logistic regression...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29224794/external-validation-of-the-european-hernia-society-classification-for-postoperative-complications-after-incisional-hernia-repair-a-cohort-study-of-2-191-patients
#15
Leonard F Kroese, Gert-Jan Kleinrensink, Johan F Lange, Jean-Francois Gillion
BACKGROUND: Incisional hernia is a frequent complication after midline laparotomy. Surgical hernia repair is associated with complications, but no clear predictive risk factors are identified. The European Hernia Society (EHS) classification offers a structured framework to describe hernias and to analyze postoperative complications. Because of its structured nature, it might prove to be useful for preoperative patient or treatment classification. The objective of this study was to investigate the EHS classification as a predictor for postoperative complications after incisional hernia surgery...
December 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29224789/pediatric-surgical-capacity-building-a-pathway-to-improving-access-to-pediatric-surgical-care-in-haiti
#16
Neema Kaseje, Hillary Jenny, Andre Patrick Jeudy, Jean Louis MacLee, John G Meara, Henri R Ford
PURPOSE: Lack of human resources is a major barrier to accessing pediatric surgical care globally. Our aim was to establish a model for pediatric surgical training of general surgery residents in a resource constrained region. MATERIALS/METHODS: A pediatric surgical program with a pediatric surgical rotation for general surgery residents in a tertiary hospital in Haiti in 2015 was established. We conducted twice daily patient rounds, ran an outpatient clinic, and provided emergent and elective pediatric surgical care, with tasks progressively given to residents until they could run clinic and perform the most common elective and emergent procedures...
November 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29224711/-risk-factors-associated-with-anesthesia-emergence-delirium-in-children-undergoing-outpatient-surgery
#17
Ana Carolina Tavares Paes Barreto, Ana Carolina Rangel da Rocha Paschoal, Carolina Barbosa Farias, Paulo Sérgio Gomes Nogueira Borges, Rebeca Gonelli Albanez da Cunha Andrade, Flávia Augusta de Orange
INTRODUCTION: Anesthesia emergence delirium (AED) is a self-limiting clinical phenomenon very common in children. Although pathophysiology is still uncertain, some factors seem to be involved, such as rapid awakening in an unknown environment, agitation during anesthetic induction, preoperative anxiety, environmental disorders, use of preanesthetic medication, use of inhalational anesthetics, and postoperative pain. OBJECTIVE: To determine the prevalence and risk factors associated with AED in children undergoing outpatient surgery...
December 7, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29224652/primary-percutaneous-coronary-intervention-at-centers-with-and-without-on-site-surgical-support-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2
#18
Majed Afana, Hitinder S Gurm, Milan Seth, Kathleen M Frazier, Sheryl Fielding, Gerald C Koenig
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is being increasingly performed nationally at sites without on-site cardiac surgery; however, recent guidelines only provide a Class IIa recommendation for this practice. The state of Michigan has permitted PPCI without on-site surgery under a closely monitored system that mandates auditing of all procedures and quarterly feedback on quality and outcomes. This study sought to compare outcomes of patients undergoing PPCI at centers with and without on-site surgery in the state of Michigan...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29224568/internal-herniation-through-lesser-omentum-hiatus-and-gastrocolic-ligament%C3%A2-with-malrotation-a-case-report
#19
Ang Li, Renwang Hu, Dong Zhou, Senmao Li, Dan Huang, Xin Wei, Zhixin Cao
BACKGROUND: Internal herniation through lesser omentum hiatus and gastrocolic ligament with malrotation is extremely rare. This type of internal hernia has rarely been described before. Preoperative diagnosis is difficult and prone to misdiagnosis. CASE PRESENTATION: A 38-year-old Chinese woman was an emergency admission to our hospital with a sudden onset of acute epigastralgia for the past 14 hours. We made a presumptive diagnosis of gastrointestinal perforation and septic shock...
December 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29224414/using-photovoice-to-explore-quality-of-life-factors-of-adults-with-crouzon-syndrome
#20
Kelly J Wheeler, Jody O Early
In the United States, one in 60,000 adults live with Crouzon Syndrome (CS) and facial malformations. Phenomenological studies about their lived experiences and quality of life are lacking. The purpose of this participatory action research study was to gain a richer understanding of the perceived biopsychosocial and socioecological factors that impact quality of life for adults living with CS using Photovoice. Another aim was to develop a conceptual framework of quality of life for those experiencing CS to enhance tailored health education and services...
December 1, 2017: Qualitative Health Research
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