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https://www.readbyqxmd.com/read/29792393/outcomes-of-transcatheter-aortic-valve-implantation-compared-with-surgical-aortic-valve-replacement-in-geriatric-patients-with-chronic-kidney-disease
#1
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a less invasive treatment modality for patients with severe aortic valve stenosis (AS) who are at a higher risk if they have surgery. Preoperative chronic kidney disease (CKD) influences outcomes of cardiac surgery and is associated with a higher mortality and more complicated hospital course. The aims of our study were to evaluate the comparative outcomes of TAVI versus surgical aortic valve replacement (SAVR) in geriatric patients with preoperative CKD...
May 24, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29789153/adjunct-retrograde-cerebral-perfusion-provides-superior-outcomes-compared-with-hypothermic-circulatory-arrest-alone-a-meta-analysis
#2
David H Tian, Justin Weller, Shaheen Hasmat, Aung Oo, Paul Forrest, Hosen Kiat, Tristan D Yan
OBJECTIVE: Retrograde cerebral perfusion is becoming less frequently used as a method of neuroprotection during aortic surgery. The present meta-analysis aims to compare outcomes after arch surgery with hypothermic circulatory arrest versus hypothermic circulatory arrest + retrograde cerebral perfusion. METHODS: Electronic searches were performed using 7 databases from their inception to September 2016. Relevant comparative studies that included patient groups who underwent aortic arch surgery using hypothermic circulatory arrest with continuous retrograde cerebral perfusion or hypothermic circulatory arrest alone were identified, and data were extracted by 2 independent researchers...
April 21, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29788958/langerhans-cell-histiocytosis-at-l5-vertebra-treated-with-en-bloc-vertebral-resection-a-case-report
#3
Lunhao Chen, Zhong Chen, Yue Wang
BACKGROUND: Langerhans cell histiocytosis (LCH) in adult lumbar spine is extremely rare, and optimal treatments remain unclear. In literature, only a few cases of lumbar spine LCH were treated using surgery but en bloc vertebral resection has not been used. CASE PRESENTATION: A 50-year-old man presented with unbearable radiating pain at his right leg. Radiological studies revealed a solitary osteolytic lesion, which was moderately enhanced on contrast MR imaging and hyper-metabolic on PET/CT, at the right L5 vertebral body and arch...
May 22, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29788370/large-traumatic-skull-base-internal-carotid-artery-pseudoaneurysm-managed-with-endovascular-flow-diversion-2-dimensional-operative-video
#4
Gary Rajah, Richard Justin Garling, Leonardo Rangel-Castilla
We present a case of a traumatic skull base internal carotid artery (ICA) pseudoaneurysm treated with endovascular flow diversion stenting. The patient was a 27-year-old male who was involved in a motorcycle accident suffering multiple traumatic injuries including a large skull base fracture that extended through the carotid canal. Computed tomography angiography revealed a 2-cm right ICA pseudoaneurysm. Once the patient was stable, a digital subtraction angiography demonstrated enlargement of the pseudoaneurysm...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29788139/microsurgical-resection-of-spinal-cord-hemangioblastoma-2-dimensional-operative-video
#5
Mirza Pojskic, Kenan I Arnautovic
This video demonstrates microsurgical resection of spinal cord hemangioblastoma. Hemangioblastomas are rare, benign, highly vascularized tumors classified as grade I according to World Health Organization classification systems. About 3% of all intramedullary tumors are hemangioblastomas.1,2 Spinal cord hemangioblastomas are either sporadic3,4 or manifestations of von Hippel-Lindau (VHL) disease in 20% to 45% of patients.5,6 A 30-year-old male presented with sudden onset urinary incontinence. Magnetic resonance imaging showed contrast enhancing intramedullary tumor with adjacent cyst in T11, and syringomyelia extending to C1...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29787402/a-pilot-study-of-a-novel-automated-somatosensory-evoked-potential-ssep-monitoring-device-for-detection-and-prevention-of-intraoperative-peripheral-nerve-injury-in-total-shoulder-arthroplasty-surgery
#6
Jason Chui, John M Murkin, Darren Drosdowech
INTRODUCTION: Peripheral nerve injury is a potentially devastating complication after total shoulder arthroplasty (TSA) surgery. This pilot study aimed to assess the feasibility of using an automated somatosensory evoked potential (SSEP) device to provide a timely alert/intervention to minimize intraoperative nerve insults during TSA surgery. METHODS: A prospective, single-arm, observational study was conducted in a single university hospital. The attending anesthesiologist monitored the study participants using the EPAD automated SSEP device and an intervention was made if there was an alert during TSA surgery...
May 21, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29787357/prophylactic-cranial-irradiation-versus-observation-in-radically-treated-stage-iii-non-small-cell-lung-cancer-a-randomized-phase-iii-nvalt-11-dlcrg-02-study
#7
Dirk De Ruysscher, Anne-Marie C Dingemans, John Praag, Jose Belderbos, Caroline Tissing-Tan, Judith Herder, Tjeerd Haitjema, Fred Ubbels, Frank Lagerwaard, Sherif Y El Sharouni, Jos A Stigt, Egbert Smit, Harm van Tinteren, Vincent van der Noort, Harry J M Groen
Purpose The purpose of the current study was to investigate whether prophylactic cranial irradiation (PCI) reduces the incidence of symptomatic brain metastases in patients with stage III non-small-cell lung cancer (NSCLC) treated with curative intention. Patients and Methods Patients with stage III NSCLC-staged with a contrast-enhanced brain computed tomography or magnetic resonance imaging-were randomly assigned to either observation or PCI after concurrent/sequential chemoradiotherapy with or without surgery...
May 22, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29786852/evolution-of-lobar-abnormalities-of-cerebral-glucose-metabolism-in-41-children-with-drug-resistant-epilepsy
#8
Tuhina Govil-Dalela, Ajay Kumar, Michael E Behen, Harry T Chugani, Csaba Juhász
OBJECTIVE: We analyzed long-term changes of lobar glucose metabolic abnormalities in relation to clinical seizure variables and development in a large group of children with medically refractory epilepsy. METHODS: Forty-one children (25 males) with drug-resistant epilepsy had a baseline positron emission tomography (PET) scan at a median age of 4.7 years; the scans were repeated after a median of 4.3 years. Children with progressive neurological disorders or space-occupying lesion-related epilepsy and those who had undergone epilepsy surgery were excluded...
May 22, 2018: Epilepsia
https://www.readbyqxmd.com/read/29783695/application-of-a-novel-anti-adhesive-membrane-e8002-in-a-rat-laminectomy-model
#9
Kiyoshi Kikuchi, Kentaro Setoyama, Takuto Terashi, Megumi Sumizono, Salunya Tancharoen, Shotaro Otsuka, Seiya Takada, Kazuki Nakanishi, Koki Ueda, Harutoshi Sakakima, Ko-Ichi Kawahara, Ikuro Maruyama, Gohsuke Hattori, Motohiro Morioka, Eiichiro Tanaka, Hisaaki Uchikado
Neuropathic pain after spinal surgery, so-called failed back surgery syndrome, is a frequently observed common complication. One cause of the pain is scar tissue formation, observed as post-surgical epidural adhesions. These adhesions may compress surrounding spinal nerves, resulting in pain, even after successful spinal surgery. E8002 is an anti-adhesive membrane. In Japan, a clinical trial of E8002 is currently ongoing in patients undergoing abdominal surgery. However, animal experiments have not been performed for E8002 in spinal surgery...
May 18, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29782395/pull-out-of-upper-thoracic-pedicle-screws-can-cause-spinal-canal-encroachment-in-growing-rod-treatment
#10
Senol Bekmez, Aykut Kocyigit, Zeynep Deniz Olgun, Mehmet Ayvaz, Halil Gokhan Demirkiran, Ergun Karaagaoglu, Muharrem Yazici
BACKGROUND: Proximal foundation failure is a common complication of growing rod (GR) treatment for early-onset scoliosis. Spinal canal encroachment due to pull-out of pedicle screw used as proximal foundation has been anecdotally reported in GR patients. The aim of this study is to report the prevalence of spinal canal encroachment of pedicle screws in GR treatment and determine risk factors using a single-center cohort. METHODS: Inclusion criteria were: (1) GR for early-onset scoliosis and (2) pull-out of at least 1 proximal anchor pedicle screw...
May 4, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29781783/clinical-and-radiological-outcome-of-non-surgical-management-of-thoracic-and-lumbar-spinal-fracture-dislocations-a-historical-analysis-in-the-era-of-modern-spinal-surgery
#11
Andrei Fernandes Joaquim, Gregory D Schroeder, Alpesh A Patel, Alexander R Vaccaro
CONTEXT: It is well established that traumatic spinal dislocations (AO Type C injuries) should be surgically treated. However, no recent comparative study of surgical versus non-surgical management of type C injuries was found attesting the superiority of surgical treatment. OBJECTIVE: Due to the lack of information about the natural history of non-surgical management of type C injuries, we evaluated the outcome of historical conservative treatment of type C injuries...
May 21, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#12
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29780723/cerebral-perfusion-issues-in-type-a-aortic-dissection
#13
REVIEW
Davide Pacini, Giacomo Murana, Luca Di Marco, Marianna Berardi, Carlo Mariani, Giuditta Coppola, Mariafrancesca Fiorentino, Alessandro Leone, Roberto Di Bartolomeo
Stroke events are very common in acute type A aortic dissection. Cerebral malperfusion could manifest at presentation due to prolonged arch vessels hypoperfusion or develop after surgery for inadequate cerebral protection during arch repair. To reduce this detrimental complication there are several adjuncts that can be adopted for cerebral protection such as direct antegrade or retrograde cerebral perfusion (RCP) and use period of deep to moderate hypothermic circulatory arrest time; however, they are often insufficient as preoperative malperfusion already caused irreversible ischemic damages...
2018: Journal of visualized surgery
https://www.readbyqxmd.com/read/29779968/one-stage-posterior-debridement-and-fusion-combined-with-irrigation-and-drainage-for-the-treatment-of-postoperative-lumbar-spondylodiscitis
#14
Tao Zhang, Jianzhong Hu, Jianhuang Wu, Jinyang Liu, Shuangfei Ni, Chunyue Duan
OBJECTIVE: The aim of this study was to evaluate the clinical outcomes of one-stage posterior debridement, interbody fusion, and instrumentation, combined with irrigation and drainage, for treating lumbar spondylodiscitis. METHODS: The study included 23 patients (13 male and 10 female, mean age: 45 years) who had posterior debridement, interbody fusion, and instrumentation, followed by continuous closed irrigation and drainage for lumbar postoperative spondylodiscitis...
May 17, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29779840/hand-involvement-in-gout
#15
G Meyer Zu Reckendorf, A Dahmam
Damage to the hand in patients suffering from gout is rare and is often detected at an advanced stage. The main clinical manifestations are the appearance of subcutaneous tophi at the finger joints. Other clinical manifestations of osteoarticular, tendinous or neurological lesions have been described in the hand and are often difficult to diagnose. In the majority of cases, surgery and adequate medical care with a suitable anti-gout treatment will allow the patient to recover normal hand function. However, surgical treatment is rare and is only performed after several months of carefully adapted medical treatment...
May 17, 2018: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/29779783/readmission-to-the-intensive-care-unit-following-cardiac-surgery-a-derived-and-validated-risk-prediction-model-in-4-869-patients
#16
Rebekah Thomson, Nick Fletcher, Oswaldo Valencia, Vivek Sharma
OBJECTIVE: To derive and validate a clinical risk index that can predict readmission to the intensive care unit (ICU) after cardiac surgery. DESIGN: Retrospective nonrandomized study to determine the perioperative variables associated with risk of readmission to the ICU after cardiac surgery. SETTING: The study was carried out in a single university hospital. PARTICIPANTS: This was an analysis of 4,869 consecutive adult patients...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29778441/hypoxic-postconditioning-enhances-functional-recovery-following-endothelin-1-induced-middle-cerebral-artery-occlusion-in-conscious-rats
#17
Hong L Nguyen, Alexander M Ruhoff, Thomas Fath, Nicole M Jones
Stroke is a leading cause of death and a major contributor to neurological disability in adults. Tissue plasminogen activator is the only approved treatment. However, due to its narrow therapeutic window, <5% of patients receive treatment. Recently, hypoxic postconditioning (HPC) was shown to reduce stroke induced-injury in mice, but the mechanisms and functional outcomes are still unknown. In the current study, male Sprague Dawley rats were subjected to endothelin-1 induced stroke. HPC (8% O2 , 1 h/d for 5d) or normoxia treatments were started 24 h after stroke...
May 17, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29775977/-rehabilitation-after-traumatic-fracture-of-thoracic-and-lumbar-spine
#18
Hartmut Bork, Stefan Simmel, Eckhardt Böhle, Ulrich Ernst, Klaus Fischer, Bernd Fromm, Jean-Jacques Glaesener, Bernhard Greitemann, P Krause, S Panning, V Pullwitt, J Schmidt, Andreas Veihelmann, Lutz Vogt
On the basis of the S2-k guideline "Rehabilitation after traumatic fractures of the thoracic und lumbar spine without neurologic disorder", this article gives an overview of target-oriented rehabilitation of patients with minor fractures or those with column stability and unstable spinal fractures which are stabilised by surgery. To obtain early social and job related reintegration, outpatient or inpatient rehabilitation has to start immediately after treatment in hospital. Rehabilitation must be orientated towards the biopsychosocial model of ICF and has to be adapted for the patient...
May 18, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29775155/long-term-surgical-outcomes-following-transsphenoidal-surgery-in-patients-with-rathke-s-cleft-cysts
#19
Michelle Lin, Michelle A Wedemeyer, Daniel Bradley, Daniel A Donoho, Vance L Fredrickson, Martin H Weiss, John D Carmichael, Gabriel Zada
OBJECTIVE Rathke's cleft cysts (RCCs) are benign epithelial lesions of the sellar region typically treated via a transsphenoidal approach with cyst fenestration and drainage. At present, there is limited evidence to guide patient selection for operative treatment. Furthermore, there is minimal literature describing factors contributing to cyst recurrence. METHODS The authors conducted a retrospective analysis of 109 consecutive cases of pathology-confirmed RCCs treated via a transsphenoidal approach at a single center from 1995 to 2016...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29774497/safety-of-commercial-airflight-in-patients-with-brain-tumors-a-case-series
#20
Michelle Phillips, Marlon Saria, Amy Eisenberg, Daniel F Kelly, Garni Barkhoudarian
INTRODUCTION: Patients with intracranial masses are often advised to avoid airflight due to concerns of worsening neurological symptoms or deterioration. However, many patients often travel cross-country or internationally to tertiary care centers for definitive care. This study assesses the safety of commercial airflight for brain and skull base tumor patients without severe or progressive neurological deficits. METHODS: Patients that had traveled to our institution for surgery via commercial airflight from 2014 to 2017 were identified...
May 17, 2018: Journal of Neuro-oncology
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