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https://www.readbyqxmd.com/read/29454483/postoperative-opioid-prescribing-getting-it-rightt
#1
REVIEW
Brian K Yorkgitis, Gabriel A Brat
BACKGROUND: Prescription opioid medications account for a large number of fatal and non-fatal overdoses. Many opioid prescription medications after surgery go unused, with the potential for diversion and misuse. As surgeons become increasingly aware of their role in opioid misuse, better tools are needed to guide behavior. DATA SOURCES: There has recently been a plethora of research into opioid prescribing after surgery. A review of this literature was performed using a search for manuscripts written in the English language...
February 6, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29454226/dysphagia-and-laryngeal-pathology-in-post-surgical-cardiothoracic-patients
#2
Anna Miles, Naomi McLellan, Rochelle Machan, David Vokes, Alexandra Hunting, Mary McFarlane, Jennifer Holmes, Kelly Lynn
PURPOSE: Cardiothoracic surgery is known to result in dysphagia and laryngeal injury. While prevalence has been explored, extent, trajectory and longevity of symptoms are poorly understood. This retrospective, observational study explored dysphagia and laryngeal injury in patients following cardiothoracic surgery referred for instrumental swallowing assessment. METHODS: Clinical notes and endoscopic recordings of 106 patients (age range 18-87yrs; mean 63yrs; SD 15yrs) (including 190 endoscopes) at one large tertiary centre were reviewed by two speech-language pathologists and a laryngologist...
February 9, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29451989/all-done-procedure-by-laser-in-free-gingival-graft-treatment-a-case-series-study
#3
Reza Fekrazad, Nasim Chiniforush, Katayoun Kalhori
AIM: This case series study evaluated the application of Er;Cr:YSGG laser for a free gingival graft procedure and the effect of low level laser therapy on post surgical pain and wound healing. CASES: 6 cases with mucogingival problems needing free gingival grafts were selected. First, the recipient site was anesthetized and de-epithelialization was done with a Er;Cr:YSGG laser. After tracing the palatal donor site with the laser, the graft was harvested. For root modification of the recipient tooth, conditioning of the dentin was done by the same laser...
February 16, 2018: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
https://www.readbyqxmd.com/read/29451522/-management-of-benign-esophageal-strictures-a-literature-review
#4
Leonardo Frazzoni, Marina La Marca, Amedeo Montale, Lorenzo Fuccio
The management of benign esophageal strictures is challenging. The first strategy includes endoscopic dilation using bougies or balloons. Although the immediate success rate of these is up to 90%, about 30-40% of patients experience recurrent dysphagia within the first year of follow-up. The management of refractory stenosis involves repeated sessions of endoscopic dilation. In order to obtain long-lasting functional results, alternative treatments have been developed, such as the use of self-expanding stents, particularly indicated in subgroups of patients with post-surgical stenosis or post-radiation therapy...
January 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29448301/histological-expression-of-methionine-adenosyl-transferase-mat-2a-as-a-post-surgical-prognostic-surrogate-in-patients-with-hepatocellular-carcinoma
#5
Jihyun An, Seong Kyun Na, Ju Hyun Shim, Yang Soon Park, Mi Jung Jun, Joo Ho Lee, Gi-Won Song, Hac Chu Lee, Eunsil Yu
BACKGROUND AND OBJECTIVES: Deregulation of methionine adenosyltransferase (MAT) is involved in hepatocarcinogenesis. This study aimed to investigate the prognostic implications of the level of histological MAT1A and MAT2A in patients with resected hepatocellular carcinoma (HCC). METHODS: A total of 210 patients with HCC who underwent curative resection between 2004 and 2011 were included. The levels of MAT proteins were immunohistochemically measured. RESULTS: MAT1A and MAT2A were over-expressed in 134 (63...
February 15, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29447368/venovenous-malformation-developed-prior-to-a-kawashima-operation-in-a-patient-with-an-interrupted-inferior-vena-cava
#6
Hideto Ozawa, Takaya Hoashi, Kazuto Fujimoto, Hajime Ichikawa
An 11-month-old girl with an unbalanced atrioventricular septal defect, coarctation of the aorta and an interrupted inferior vena cava with hemiazygos continuation post-surgical status of coarctation repair and pulmonary artery banding underwent a Kawashima operation. Severe hypoxia occurred immediately after she was weaned from cardiopulmonary bypass, which was successfully resolved by the ligation of the hemiazygos vein. Postoperative enhanced computed tomography detected significant venovenous malformation from the hemiazygos vein to the left renal vein...
February 13, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29436655/effects-of-dexmedetomidine-post%C3%A2-treatment-on-bdnf-and-vegf-expression-following-cerebral-ischemia-reperfusion-injury-in-rats
#7
Zheng-Chen Li, Ying-Ping Jia, Yuan Wang, Jin-Lian Qi, Xue-Ping Han
Brain‑derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) serves a significant role in neural protection by activating the phosphatidylinositol 3‑kinase (PI3K)/Akt signaling pathway, which also was associated with the neuroprotective the treatment with dexmedetomidine (DEX). The present study aimed to further explore whether treatment with DEX post‑IR increased the expression level of BDNF and VEGF in the rat brain. A total of 30 healthy, clean male Wistar rats were randomly divided into 3 experimental groups: Control group, ischemia/reperfusion (I/R) group and DEX treatment group...
February 13, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29435826/efficacy-of-bovine-lactoferrin-in-the-post-surgical-treatment-of-patients-suffering-from-bisphosphonate-related-osteonecrosis-of-the-jaws-an-open-label-study
#8
Francesco Calvani, Antimo Cutone, Maria Stefania Lepanto, Luigi Rosa, Valentino Valentini, Piera Valenti
Osteonecrosis of the jaws is an emerging pathological condition characterized by un-exposure or exposure of the necrotic bone, independently from the etiology. This term is usually referred to medication-related osteonecrosis of the jaws due to severe adverse reaction to certain medicines, as bisphosphonates, used for the treatment of cancer and osteoporosis. The management of patients with Bisphosphonate-Related Osteonecrosis of the Jaws (BRONJ) remains challenging because surgical and medical interventions may not eradicate this pathology...
February 12, 2018: Biometals: An International Journal on the Role of Metal Ions in Biology, Biochemistry, and Medicine
https://www.readbyqxmd.com/read/29435604/influence-of-body-mass-index-on-short-term-subjective-improvement-and-risk-of-reoperation-after-mid-urethral-sling-surgery
#9
Vibeke Weltz, Rikke Guldberg, Michael D Larsen, Bjarne Magnussen, Gunnar Lose
INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the impact of body mass index (BMI) on the subjective improvement and risk of reoperation after first-time mid-urethral sling surgery. METHODS: Data were retrieved from the national Danish Urogynaecological Database, including women with first-time surgery with mid-urethral polypropylene slings from 2011 to 2016. The subjective improvement was assessed by the difference in symptoms based on the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) completed pre- and 3 months postoperatively...
February 12, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29434959/retrospective-observational-cohort-study-on-cosmetic-outcome-of-using-ti-ni-memory-alloy-wire-for-intradermal-suture-following-mastectomy-in-patients-with-breast-cancer
#10
Gang Li, Sida Qin, Xin Sun, Jiansheng Wang, Yunfeng Zhang, Jia Zhang, Jing Zhang, Shou-Ching Tang, Hong Ren
The method of suturing for incisions is crucial for the comprehensive treatment of clinical patients with breast cancer. Suturing is considered a major part of post-surgical recovery and may serve as a marker for evaluation of surgical outcome. The present study aimed to establish an effective means of suturing for patients who received modified radical surgery that helps to improve the cosmetic outcome of the incision. Enrolled patients were divided into an active and a control group. Ti-Ni memory alloy wire for intradermal suture in the active group and silk for interruption suture in the control group were applied to assess the different prognosis-associated factors...
February 2018: Oncology Letters
https://www.readbyqxmd.com/read/29433350/a-review-of-post-caesarean-infectious-morbidity-how-to-prevent-and-treat
#11
Rebecca C Pierson, Nicole P Scott, Kristin E Briscoe, David M Haas
Post-caesarean infectious complications result in significant maternal morbidity and mortality as well as increased readmissions and increased health care cost worldwide. This review provides a discussion of several risk factors that have been identified which predispose women to post-surgical infection. We also provide an overview of strategies for infection prevention including antibiotics, surgical techniques and negative pressure wound therapy. Criteria for diagnosis of wound infection are provided, as well as appropriate treatment regimens...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29430505/role-of-radical-cystectomy-in-non-organ-confined-bladder-cancer-a-systematic-review
#12
Roger Li, Michael Metcalfe, Janet Kukreja, Neema Navai
Background: Currently, a diagnosis of non-organ confined bladder cancer (NOCBCa) confers a grave prognosis. The mainstay of treatment consists of systemic chemotherapy. However, it must be recognized that NOCBCa is a heterogeneous disease state with important clinical distinctions. While surgical extirpation has traditionally been regarded as overly aggressive for all NOCBCa patients, its utility as part of a multimodal treatment strategy in various clinical scenarios has not been thoroughly investigated...
January 20, 2018: Bladder Cancer
https://www.readbyqxmd.com/read/29429066/outcomes-following-surgical-management-of-femoral-neck-fractures-in-elderly-dialysis-dependent-patients
#13
Varun Puvanesarajah, Raj Amin, Rabia Qureshi, Babar Shafiq, Ben Stein, Hamid Hassanzadeh, Seth Yarboro
INTRODUCTION: Proximal femur fractures are one of the most common fractures observed in dialysis-dependent patients. Given the large comorbidity burden present in this patient population, more information is needed regarding post-operative outcomes. The goal of this study was to assess morbidity and mortality following operative fixation of femoral neck fractures in the dialysis-dependent elderly. METHODS: The full set of medicare data from 2005 to 2014 was retrospectively analyzed...
February 10, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29428691/short-term-changes-in-affective-behavioral-and-cognitive-components-of-body-image-after-bariatric-surgery
#14
Gail A Williams, Danae L Hudson, Brooke L Whisenhunt, Megan Stone, Leslie J Heinberg, Janis H Crowther
BACKGROUND: Many bariatric surgery candidates report body image concerns before surgery. Research has reported post-surgical improvements in body satisfaction, which may be associated with weight loss. However, research has failed to comprehensively examine changes in affective, behavioral, and cognitive body image. OBJECTIVES: This research examined (1) short-term changes in affective, behavioral, and cognitive components of body image from pre-surgery to 1- and 6-months after bariatric surgery, and (2) the association between percent weight loss and these changes...
January 6, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29421412/right-subclavian-artery-aneurysms-with-fibromuscular-dysplasia
#15
Daisuke Kaneyuki, Hideki Ueda, Goro Matsumiya
Subclavian artery aneurysms are rare and even more uncommon in patients with fibromuscular dysplasia. A 20-year-old man with a past medical history of moyamoya disease, presented with an abnormal mass shadow in the apex of the right lung on chest x-ray. Based on computed tomography imaging, a diagnosis of right subclavian artery aneurysm was established and an excision of the aneurysm was performed. Since the left vertebral artery is dominant, the proximal and distal right subclavian artery and right vertebral artery were clamped...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29420144/complications-of-optic-nerve-sheath-fenestration-as-a-treatment-for-idiopathic-intracranial-hypertension
#16
Aubrey L Gilbert, Bart Chwalisz, Robert Mallery
There are a number of surgical options for treatment of idiopathic intracranial hypertension (IIH) when it is refractory to medical treatment and weight loss. Optic nerve sheath fenestration (ONSF) is one of these options. Use of this procedure varies among centers due to experience with the procedure and concern for associated complications that can result in severe loss of vision. This review summarizes the literature concerning post-surgical complications of ONSF for IIH.
2018: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/29419656/psychological-factors-predict-an-unfavorable-pain-trajectory-after-hysterectomy-a-prospective-cohort-study-on-chronic-post-surgical-pain
#17
Patrícia R Pinto, Teresa McIntyre, Vera Araújo-Soares, Armando Almeida, Patrício Costa
Chronic post-surgical pain (CPSP) is a well-recognized potential complication with negative personal, social and healthcare consequences. However, limited data exists on CPSP and on the course of pain over time after hysterectomy. Using data from a prospective cohort study on a consecutive sample assessed at 4 time points, pre-surgery (T1), 48 hours (T2), 4 months (T3), and 5 years post-surgery (T4), we sought to examine women's post-surgical pain trajectories using assessments of pain at T3 and T4. Additionally, this study aimed to investigate pre-surgical and post-surgical risk factors associated with an unfavourable pain trajectory (PT)...
February 5, 2018: Pain
https://www.readbyqxmd.com/read/29417284/biologic-meshes-and-synthetic-meshes-in-cancer-patients-a-double-edged-sword-differences-in-production-of-il-6-and-il-12-caused-by-acellular-dermal-matrices-in-human-immune-cells
#18
Maria Margarete Karsten, Sabine Enders, Julia Knabl, Verena Kirn, Peter Düwell, Brigitte Rack, Jens-Uwe Blohmer, Doris Mayr, Darius Dian
PURPOSE: In 2005, Breuing et al. first described the use of acellular dermal matrices (ADMs) in breast cancer patients. ADMs are assumed to be safe to use in an oncologic setting, but data from controlled studies are still needed. Here, we investigate the effects of ADMs on the production of interleukin (IL)-6 and IL-12, key regulators of immune suppression and activation. METHODS: Strattice (ST), CollaMend (CM), and Biodesign (BD) biologic meshes and TiLoop, a synthetic mesh (TL), were used in this study...
February 7, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29416155/erector-spinae-plane-block-as-an-alternative-to-epidural-analgesia-for-post-operative-analgesia-following-video-assisted-thoracoscopic-surgery-a-case-study-and-a-literature-review-on-the-spread-of-local-anaesthetic-in-the-erector-spinae-plane
#19
Sanjib Das Adhikary, Ashlee Pruett, Mauricio Forero, Venkatesan Thiruvenkatarajan
Post-operative pain after minimally invasive video-assisted thoracoscopic surgery (VATS) in adults is commonly managed with oral and parenteral opioids and invasive regional techniques such as thoracic epidural blockade. Emerging research has shown that the novel erector spinae plane (ESP) block, can be employed as a simple and safe alternative analgesic technique for acute post-surgical, post-traumatic and chronic neuropathic thoracic pain in adults. We illustrate this by presenting a paediatric case of VATS, in which an ESP block provided better analgesia, due to greater dermatomal coverage, as well as reduced side-effects when compared with a thoracic epidural that had previously been employed on the same patient for a similar procedure on the opposite side...
January 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29411331/association-of-pre-operative-medication-use-with-post-surgery-mortality-and-morbidity-in-oncology-patients-receiving-comprehensive-geriatric-assessment
#20
Kyung Suk Choi, Young Mi Jeong, Eunsook Lee, Kwang Ill Kim, Jeong Yee, Byung Koo Lee, Jee Eun Chung, Sandy Jeong Rhie, Hye Sun Gwak
BACKGROUND: Comprehensive geriatric assessment (CGA) has become a predictor for elderly cancer patients in post-surgical complications, including post-discharge institutionalization and mortality. AIMS: To determine whether pre-operative medication use is associated with post-operative morbidity and mortality in oncology patients receiving CGA. METHODS: Patients aged 65 years or older who were scheduled for cancer surgery and presented for CGA were included in the present study...
February 6, 2018: Aging Clinical and Experimental Research
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