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https://www.readbyqxmd.com/read/28631835/suprameatal-urethrolysis-with-martius-flap-for-refractory-bladder-outflow-obstruction-following-stress-incontinence-surgery-in-females
#1
Janine L Oliver, Shlomo Raz
AIMS: To present our technique of suprameatal urethrolysis with Martius flap (SMUM) and outcomes of this procedure for refractory female bladder outflow obstruction (BOO). METHODS: A retrospective chart review was performed to identify female patients who underwent SMUM between January 2010 and August 2016 after failed transvaginal urethrolysis (TVU) for BOO due to prior stress urinary incontinence (SUI) surgery. The primary outcome measure was surgical success defined as patient ability to void volitionally without need for catheterization or additional surgery for BOO...
June 20, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28625300/preeclampsia-in-2017-obstetric-and-anaesthesia-management
#2
REVIEW
Ross Hofmeyr, Mushi Matjila, Robert Dyer
In many centres, anaesthesia now incorporates perioperative medicine. Preeclampsia is a perioperative medical challenge requiring a multi-disciplinary team. New definitions stress the rapid progression of the disease and highlight the importance of early detection. Anaesthesiologists should understand the pathophysiology of the disease and develop the ultrasound skills required to assist in the assessment of disease severity. This facilitates the choice of anaesthesia method and perioperative management in complicated cases...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28609324/results-of-the-2015-scoliosis-research-society-survey-on-single-versus-dual-attending-surgeon-approach-for-adult-spinal-deformity-surgery
#3
Justin K Scheer, Rajiv K Sethi, Lloyd A Hey, Michael O LaGrone, Malla Keefe, Henry E Aryan, Thomas J Errico, Vedat Deviren, Robert A Hart, Virginie Lafage, Frank Schwab, Michael D Daubs, Christopher P Ames
STUDY DESIGN: An electronic survey administered to Scoliosis Research Society (SRS) membership. OBJECTIVE: To characterize surgeon practices and views regarding the use of two attending surgeons for adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: The use of two experienced attending surgeons can decrease the operative time, estimated blood loss, and perioperative complication rates. However, the current practice patterns for the use of two attending surgeons remains unknown...
June 15, 2017: Spine
https://www.readbyqxmd.com/read/28607342/continuous-regional-anesthesia-a-review-of-perioperative-outcome-benefits
#4
Dario Bugada, Daniela Ghisi, Edward R Mariano
Routine use of regional anesthesia for patients having surgery is supported by general safety and proven effectiveness as a targeted modality in the prevention and treatment of acute pain. Recently, perioperative physicians have become much more interested in improving long-term outcomes after surgery rather than focusing on the well-established short-term benefits of regional anesthesia. This interest has raised important questions regarding the potential influence of regional anesthesia on morbidity and mortality, persistent pain and cancer prognosis...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28592749/dynamics-of-oxidative-stress-evoked-by-myocardial-ischemia-reperfusion-after-off-pump-coronary-artery-bypass-grafting-elucidated-by-bilirubin-oxidation
#5
Masaki Yamamoto, Hideaki Nishimori, Takashi Fukutomi, Tokio Yamaguchi, Kazumasa Orihashi
BACKGROUND: Revascularization therapy relieves myocardial ischemia, but can also result in ischemia-reperfusion injury caused by oxidative stress. However, the biokinetics of oxidative stress after myocardial ischemia-reperfusion are uncertain. This study aimed to evaluate the dynamics of oxidative stress after off-pump coronary artery bypass grafting (OPCAB) by measuring urinary biopyrrin levels. Biopyrrin is an oxidative metabolite of bilirubin thought to reflect oxidative stress, along with reactive nitrogen species (RNS)...
June 8, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28580496/concurrent-midurethral-sling-excision-or-lysis-at-the-time-of-repeat-sling-for-treatment-of-recurrent-or-persistent-stress-urinary-incontinence
#6
Sarah E Steele, Audra J Hill, Cecile A Unger
INTRODUCTION AND HYPOTHESIS: Limited evidence guides operative technique in primary midurethral sling (MUS) lysis or excision at the time of repeat sling placement for persistent or recurrent stress urinary incontinence (SUI). Our objective is to compare subjective improvement in patients undergoing repeat MUS placement with and without concurrent primary sling lysis or removal. METHODS: This was a retrospective cohort study with a prospective survey of patients who underwent two MUS placements for SUI at a single institution from January 1996 to December 2015...
June 3, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28578172/major-postoperative-complications-following-surgical-procedures-for-pelvic-organ-prolapse-a-secondary-database-analysis-of-the-acs-nsqip
#7
Elisabeth Erekson, Regan L Murchison, Kristen A Gerjevic, Vivienne T Meljen, Kris Strohbehn
BACKGROUND: Surgical approaches to the correction of pelvic organ prolapse include abdominal, vaginal and obliterative approaches. These approaches require vastly different anatomical dissections, surgical techniques and operative times and are often selected by the patient and surgeon to match preoperative multi-morbidity and ability of the patient to tolerate the stress of surgery. OBJECTIVE: To describe the occurrence of postoperative complications occurring after three different surgical approaches to treat pelvic organ prolapse: vaginal, abdominal and obliterative...
May 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28571235/effect-of-dexmedetomidine-versus-fentanyl-on-haemodynamic-response-to-patients-undergoing-elective-laparoscopic-surgery-a-double-blinded-randomized-controlled-study
#8
Lovina Neil, Ashok Patel
INTRODUCTION: Dexmedetomidine, an α2 agonist, can be used as an adjuvant in general anaesthesia as it attenuates the stress response to various noxious stimuli and helps in maintaining the perioperative haemodynamic stability along with sedation and not causing any significant respiratory depression in the postoperative period. AIM: To study the difference in haemodynamic responses of dexmedetomidine and fentanyl in patients undergoing laparoscopic surgery. MATERIALS AND METHODS: Sixty patients were divided into two groups of 30 each randomly...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28571061/psychology-of-the-facelift-patient
#9
David Sarcu, Peter Adamson
This paper presents an extensive literature review of the psychology of facelift patients as it has evolved over the past 50 years. Earlier studies revealed significant levels of pre and perioperative depression. Facelift patients generally exhibit emotional and social concerns about facial appearance that are higher than the general population. Many are undergoing midlife situational stresses and may lack the positive characteristics to deal with them. The most common diagnoses seen include depression, impulsivity, unstable personality, and passive dependence, albeit not necessarily serious...
June 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28553135/impact-of-different-analgesic-depths-and-abdominal-trauma-of-different-severities-on-stress-and-recovery-of-rats-undergoing-total-intravenous-anesthesia
#10
Hai-Ming Huang, Jun Cao, Lin-Mei Zhu, Yu-Qing Chen, Fu-Ding Lu, Hong-Wei Cai
A number of animal models have been developed to examine the pathophysiological consequences of surgical procedures, but anesthetic methods, monitoring, and management measures in these models are very different from those used in humans. This study was designed to create a rat model of abdominal surgery using anesthetic methods and perioperative treatment similar to those used in the clinic and to investigate the effects of different injury severities and depths of anesthesia and analgesia on surgical stress and postoperative recovery...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28550240/the-role-of-gst-polymorphism-in-reperfusion-induced-oxidative-stress-inflammatory-responses-and-clinical-complications-after-surgical-and-percutaneous-coronary-intervention
#11
Örs Pintér, Péter Hardi, Tibor Nagy, Balázs Gasz, Viktoria Kovács, Endre Arató, László Sínay, László Lénárd, Gábor Jancsó
BACKGROUND: Patients having coronary artery disease treated by coronary bypass or PCI procedure are exposed to tissue damage because of the phenomenon called reperfusion injury. Reperfusion injury can be characterized/monitored by oxidative stress parameters, inflammatory markers and by post-operative complication rate. OBJECTIVE: Beyond the obvious factors determining its severity (affected myocardial mass, ischaemic time, collateral circulation etc.) we examined the GST enzyme group's most cardio selective member, GSTP1 and its genetic polymorphism if there is any genetically determined preventive effect on the above-mentioned parameters...
May 24, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28538406/dexmedetomidine-based-intravenous-anesthesia-of-a-pediatric-patient-with-glucose-6-phosphate-dehydrogenase-g6pd-deficiency-a-case-report
#12
Nanae Takahashi, Takashi Ogawa, Zen'ichiro Wajima, Akibumi Omi
RATIONALE: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect, resulting in deficits in nicotinamide adenine dinucleotide phosphate production, an important intracellular antioxidant enzyme. G6PD-deficient subjects present with a susceptibility of erythrocytes to oxidative stress and hemolysis, and should avoid drugs or stressors that have oxidative actions. Dexmedetomidine is an anesthetic agent with antioxidant actions. PATIENT CONCERNS AND DIAGNOSES: A 5-year-old boy with G6PD deficiency...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28534323/-era-of-enhanced-recovery-after-surgery-and-robotic-gastric-cancer-surgery
#13
Yanbing Zhou
Enhanced recovery after surgery (ERAS) has been rapidly developing by combining several techniques with evidence-based adjustments, including preoperative education, preoperative carbohydrate loading, epidural or regional anesthesia, early initiation of enteral nutrition, ambulation and multi-modal pain management. The core part of ERAS is to reduce and reverse surgical stress and therefore greatly improve clinical outcome. Under the guidance of ERAS, perioperative management of robotic gastric cancer operation should follow the basic principles of ERAS and clinical pathway to maximize the advantages of the robotic surgery...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28528397/perioperative-hypothalamic-pituitary-adrenal-function-in-patients-with-silent-corticotroph-adenomas
#14
Abdelle F Cheres, Nadine ElAsmar, Aman Rajpal, Warren R Selman, Baha M Arafah
BACKGROUND: Silent corticotroph adenomas (SCAs) are characterized by strong ACTH immunostaining without clinical manifestations of hypercortisolism. Patients with SCAs often present with mechanical symptoms related to tumor growth. This study investigates the hypothalamic pituitary adrenal axis (HPA) characteristics after adenomectomy in patients with SCAs. METHODS: Biochemical parameters of HPA function were monitored frequently after surgical resection of non-functioning macroadenomas...
May 20, 2017: Pituitary
https://www.readbyqxmd.com/read/28527646/high-dose-amino-acid-administration-achieves-an-anabolic-response-in-type-2-diabetic-patients-that-is-independent-of-glycaemic-control-a-randomized-clinical-trial
#15
Chelsia Gillis, Patricia S Roque, Jürgen Bläss, Albert Urwyler, Harald Schepperle, Guido Kunz, Thomas Peters, Thomas Schricker, Linda Wykes, Andrea Kopp Lugli
BACKGROUND & AIMS: Surgical stress provokes protein catabolism and hyperglycaemia that is enhanced in patients with type 2 diabetes (T2DM), and increases perioperative morbidity. This study hypothesized that perioperative administration of high dose intravenous (IV) amino acids (AA) will augment protein balance in T2DM patients receiving tight plasma glucose control via continuous IV insulin compared to standard plasma glucose control via subcutaneous (SC) insulin sliding scale. METHODS: Eighteen patients with well-controlled T2DM (HbA1C% < 7...
May 3, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28525663/management-of-male-and-female-neurogenic-stress-urinary-incontinence-in-spinal-cord-injured-sci-patients-using-adjustable-continence-therapy
#16
Enrico Ammirati, Alberto Manassero, Alessandro Giammò, Roberto Carone
INTRODUCTION: Artificial urinary sphincter (AUS) is an option for the treatment of neurogenic stress urinary incontinence (nSUI), but complications and re-operation rates are high, and there is no clear indication from guidelines (1). The aim of our study is to evaluate the effectiveness of a less invasive continence device in neurogenic population: Adjustable Continence Therapy ProACT/ACT®. METHODS: We retrospectively includedpatients with spinal cord injuries in this study, complaining of nSUI and treated at our Institution with Pro-ACT/ACT® implantation...
May 16, 2017: Urologia
https://www.readbyqxmd.com/read/28502744/effect-of-high-dose-sodium-selenite-in-cardiac-surgery-patients-a%C3%A2-randomized-controlled-bi-center-trial
#17
Tanja Schmidt, Hans Pargger, Esther Seeberger, Friedemann Eckhart, Stefanie von Felten, Christoph Haberthür
BACKGROUND & AIMS: Cardiac surgery is accompanied by oxidative stress and systemic inflammatory response, which may be associated with organ dysfunction and increased mortality. Selenium and selenoenzymes are important constituents of anti-oxidative defense. We hypothesized that high-dose sodium selenite supplementation can attenuate the postoperative inflammation and might, therefore, improve clinical outcome. METHODS: Randomized, placebo-controlled, double-blinded, bi-center study on 411 adult patients undergoing elective cardiac surgery...
May 2, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28498237/enhanced-recovery-after-surgery-for-advanced-ovarian-cancer-a-systematic-review-of-interventions-trialed
#18
Kristina Lindemann, Peey-Sei Kok, Martin Stockler, Ken Jaaback, Alison Brand
OBJECTIVES: We sought to summarize the evidence for interventions aiming at enhanced recovery after surgery (ERAS) in ovarian cancer through a systematic review. METHODS: We searched MEDLINE, EMBASE, and The Cochrane Library for studies testing ERAS interventions in patients undergoing surgery for ovarian cancer. Study selection and data extraction were done independently by 2 reviewers with disagreements resolved by discussion with a senior, third reviewer. RESULTS: We identified 25 studies including 1648 participants with ovarian cancer...
May 12, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28486888/endothelial-glycocalyx-basic-science-and-clinical-implications
#19
N L Pillinger, Pca Kam
The classic Starling principle proposed that microvascular fluid exchange was determined by a balance of hydrostatic and oncotic pressures relative to the vascular wall and this movement of water was regulated by gaps in the intercellular spaces. However, current literature on the endothelial glycocalyx (a jelly-like protective layer covering the luminal surface of the endothelium) has revised Starling's traditional concepts. This article aims to summarise the literature on the glycocalyx related to its basic science, clinical settings inciting injury, protective strategies and clinical perspectives...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28485227/perioperative-experience-of-parents-whose-children-undergo-cardiac-surgery-are-we-delivering
#20
Karen Byrne
Background Having children who require heart surgery is a complex and stressful experience for families ( Harvey et al 2013 , Re et al 2013 , Kosta et al 2015 ). The experience is high on the agenda of the NHS and is included in the Congenital Heart Disease Review Standards and Specifications ( NHS England 2015 ).
May 9, 2017: Nursing Children and Young People
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