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https://www.readbyqxmd.com/read/28351116/management-of-people-with-early-or-very-early-stage-hepatocellular-carcinoma-an-attempted-network-meta-analysis
#1
REVIEW
Avik Majumdar, Davide Roccarina, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Hepatocellular carcinoma (primary liver cancer) is classified in many ways. The Barcelona Clinic Liver Cancer (BCLC) group staging classifies the cancer based on patient's life expectancy. People with very early- or early-stage hepatocellular carcinoma have single tumour or three tumours of maximum diameter of 3 cm or less, Child-Pugh status A to B, and performance status 0 (fully functional). Management of hepatocellular carcinoma is uncertain. OBJECTIVES: To assess the comparative benefits and harms of different interventions used in the treatment of early or very early hepatocellular carcinoma through a network meta-analysis and to generate rankings of the available interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28351086/independent-risk-factors-predicting-central-lymph-node-metastasis-in-papillary-thyroid-microcarcinoma
#2
Xiaolong Yu, Xuejia Song, Wenhai Sun, Shihua Zhao, Jiajun Zhao, Yan-Gang Wang
The incidence of papillary thyroid microcarcinoma (PTMC) has risen rapidly in recent years, and PTMC patients with central lymph node metastasis (CLNM) usually have poor prognosis. Independent risk factors predicting CLNM in PTMC have not been well understood. The aim of our study was to identify useful clinicopathological risk factors predicting CLNM in PTMC patients. This was a retrospective study of 917 patients with PTMC treated with surgery from January 2014 to December 2015 in our hospital. The relationship between clinicopathological factors and CLNM was analyzed to identify those factors predicting CLNM in PTMC...
March 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28351071/neurologic-deficits-have-a-negative-impact-on-patient-related-outcomes-in-primary-presentation-adult-symptomatic-lumbar-scoliosis-surgical-treatment-at-one-year-follow-up
#3
Daniel G Kang, Christine Baldus, Steven D Glassman, Christopher I Shaffrey, Jon D Lurie, Keith H Bridwell
STUDY DESIGN: A retrospective analysis of prospective, multicenter National Institute of Health clinical trial. OBJECTIVE: The aim of this study was to assess the rate of neurologic complications and impact of new neurologic deficits on 1-year postoperative patient-reported outcomes (PROs). SUMMARY OF BACKGROUND DATA: There are limited studies evaluating the impact of new neurologic deficits on PROs following surgery for primary presentation adult lumbar scoliosis...
April 1, 2017: Spine
https://www.readbyqxmd.com/read/28351070/does-resection-of-the-posterior-longitudinal-ligament-impact-the-incidence-of-c5-palsy-after-cervical-corpectomy-procedures-a-review-of-459-consecutive-cases
#4
Ahmad Nassr, Ilyas S Aleem, Jason C Eck, Barrett Woods, Ravi K Ponnappan, William F Donaldson, James D Kang
STUDY DESIGN: Retrospective review. OBJECTIVE: To evaluate key risk factors for the development of C5 palsy after cervical corpectomy, including resection of the posterior longitudinal ligament (PLL). SUMMARY OF BACKGROUND DATA: Postoperative C5 palsy is a well-known complication after cervical spine surgery. It is unknown whether resection of the PLL affects the incidence of C5 palsy. METHODS: We performed a retrospective review of 459 consecutive patients undergoing anterior cervical corpectomies over a 15-year period...
April 1, 2017: Spine
https://www.readbyqxmd.com/read/28351053/macular-edema-rationale-for-therapy
#5
Thomas J Wolfensberger
Macular edema represents the end-stage of multiple pathophysiological pathways in a multitude of ocular vascular, inflammatory, and other diseases. The rationale for clinical treatment of macular edema is based on the understanding and the inhibition of these pathophysiological mechanisms. When macular edema is caused by a generalized health problem such as diabetes, high blood pressure, or generalized inflammatory conditions, treatment of these generalized diseases can in many cases cure macular edema directly...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28351050/miscellaneous
#6
Catherine Creuzot-Garcher
This chapter provides the reader with practical information to be applied to the various remaining causes of macular edema. Some clinical cases of macular edema linked to ocular diseases like postradiotherapy for ocular melanomas remained of poor functional prognosis due to the primary disease. On the contrary, macular edema occurring after retinal detachment or after diverse systemic or local treatment use is often temporary. Macular edema associated with epiretinal membranes or vitreomacular traction is the main cause of poor functional recovery...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28351047/postsurgical-cystoid-macular-edema
#7
Dinah Zur, Anat Loewenstein
Cystoid macular edema (CME) is a primary cause of reduced vision following both cataract and successful vitreoretinal surgery. The incidence of clinical CME following modern cataract surgery is 0.1-2.35%. Preexisting conditions such as diabetes mellitus and uveitis as well as intraoperative complications can raise the risk of postsurgical CME. The etiology of CME is not completely understood. Prolapsed or incarcerated vitreous and postoperative inflammatory processes have been proposed as causative agents. Pseudophakic CME is characterized by poor postoperative visual acuity...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28350975/long-lasting-postoperative-ileus-after-surgery-for-intestinal-obstruction-due-to-left-paraduodenal-hernia-lpdh-case-report
#8
A Volpi, P Ialongo, A Panebianco, R Lozito, A Prestera, R Laforgia, C Punzo, N Palasciano
Left paraduodenal hernia is a rare congenital anomaly which arises from an error of rotation of the midgut; sometimes can be responsible for intestinal occlusion, that require surgery. In many cases of literature a prompt diagnosis and therapy reduced morbidity and mortality and almost all patients were discharged on 4th or 5th postoperative day (POD). We report a case of a 59 years old patient who underwent surgery for intestinal obstruction due to a massive left paraduodeneal hernia, that had a very long period (20 days) of postoperative ileus...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28350974/topical-hemostasis-in-laparoscopic-surgery
#9
REVIEW
R Vecchio, R Catalano, F Basile, C Spataro, M Caputo, E Intagliata
A major goal during any surgical intervention is minimization of blood loss, which reduces the need for blood transfusion. In open surgery, the possibility for the surgeon to use the hands directly in contact with the bleeding tissues for hemostasis, makes mechanical methods, such as compression, ligatures or sutures, important to achieve proper hemostasis. In laparoscopic surgery, where the intervention is performed by means of small incisions through which the surgeon's hand cannot directly achieve the tissues, the problem of hemostasis is critical and needs more attention...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28350973/is-it-really-useful-the-harmonic-scalpel-in-axillary-dissection-for-locally-advanced-breast-cancer-a-case-series
#10
G Militello, P De Marco, N Falco, K Kabhuli, A Mascolino, L Licari, R Tutino, G Cocorullo, G Gulotta
BACKGROUND: The seroma is one of the most common complications in the axillary lymph nodal dissection (different surgical approaches have been tried to reduce the seroma incidence). In our study we evaluate the outcome of patients using or not the ultrasonic scalpel (Harmonic scalpel) according to a standardized surgical technique. PATIENTS AND METHODS: From January 2011 to December 2015 120 patients underwent axillary dissection for breast cancer. Patients were divided in two groups: patients belonging to the first group underwent Harmonic scalpel dissection and patients belonging to the second group underwent classical dissection...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28350972/open-sphincter-preserving-surgery-of-extraperitoneal-rectal-cancer-without-primary-stoma-and-fast-track-protocol
#11
G Pappalardo, S Coiro, F De Lucia, A Giannella, F Ruffolo, F M Frattaroli
AIM: Fast track protocol (FTP) showed to improve perioperative care. The study aims to evaluate the impact of the FTP in the open extraperitoneal rectal cancer (ERC) surgical treatment without a primary derivative stoma (DS) and the QoL in patients with or without a secondary DS. PATIENTS AND METHODS: 50 patients affected by ERC were enrolled and operated on with open low anterior resection without a primary DS. They were randomized in two groups: one was treated perioperativelly in the traditional way (group T), the other using a modif ed FTP (group FT)...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28350971/early-discharge-after-total-thyroidectomy-a-retrospective-feasibility-study
#12
F Tartaglia, A Giuliani, S Sorrenti, L Tromba, S Carbotta, A Maturo, G Carbotta, L De Anna, R Merola, G Livadoti, F Pelle, S Ulisse
AIM: The continued hospitalization after total thyroidectomy is often due to the onset of hypocalcemic complications more than 24 hours after surgery. So it would be important to predict which patients will not develop the hypocalcemic complication to discharge them early. This was the aim of our study. PATIENTS AND METHODS: Our retrospective study was conducted on 327 consecutive thyroidectomized patients, operated on for benign and malignant diseases. We evaluated the values of preoperative serum calcium levels (Cal0) and of the first postoperative day (Cal1) and two new variables were calculated (dCal and dCaln)...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28350952/future-advances-in-spine-surgery-the-aospine-north-america-perspective
#13
Michael G Fehlings, Christopher S Ahuja, Thomas Mroz, Wellington Hsu, James Harrop
This focus issue highlights state-of-the-art techniques, equipment, and practices in the modern era of spine surgery while providing a glimpse into the next generation of patient care. A broad range of topics are presented to cover the full spectrum of the field. Degenerative diseases are discussed in a series of 3 articles on (1) pathophysiology, management, and surgical approaches to degenerative cervical myelopathy; (2) novel approaches to degenerative thoracolumbar disease (eg, interspinous process spacers, minimally invasive/endoscopic approaches); and (3) animal models and emerging therapeutics in degenerative disk disease...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350951/novel-osteobiologics-and-biomaterials-in-the-treatment-of-spinal-disorders
#14
Wellington K Hsu, Christina L Goldstein, Mohammed F Shamji, Sam K Cho, Paul M Arnold, Michael G Fehlings, Tom E Mroz
Spinal osteobiologics have evolved substantially in this century after the development of many product categories such as growth factors, allograft, and stem cells. The indications for the use of novel biologics within spine surgery are rapidly expanding as the mechanism of each is elucidated. While the knowledge base of bone morphogenetic protein increases with each subsequent year, the application of new nanotechnology and cell-based strategies are being reported. This review will discuss the most recent data in novel osteobiologics, and where we could use future study...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350950/spine-oncology-metastatic-spine-tumors
#15
David Choi, Mark Bilsky, Michael Fehlings, Charles Fisher, Ziya Gokaslan
Surgery for spinal metastases remains the mainstay treatment for pain, instability, and neurological deterioration due to tumor infiltration of the spine. However, several new therapies are emerging which may improve outcomes further, and in some cases even replace the need for surgery. We now have a better understanding of which factors influence survival and quality of life after surgery, and this underpins the development and application of new treatments, and assessment of outcome.Depending on genetic subtyping of tumors, novel immunotherapies and chemotherapies may be very effective in prolonging quality of life...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350948/bending-the-cost-curve-establishing-value-in-spine-surgery
#16
Scott L Parker, Silky Chotai, Clinton J Devin, Lindsay Tetreault, Thomas E Mroz, Darrel S Brodke, Michael G Fehlings, Matthew J McGirt
BACKGROUND: As publically promoted by all stakeholders in health care reform, prospective outcomes registry platforms lie at the center of all current evidence-driven value-based models. OBJECTIVE: To demonstrate the variability in outcomes and cost at population level and individual patient level for patients undergoing spine surgery for degenerative diseases. METHODS: Retrospective analysis of prospective longitudinal spine registry data was conducted...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350946/emerging-techniques-in-degenerative-thoracolumbar-surgery
#17
Theodore J Choma, Thomas E Mroz, Christina L Goldstein, Paul Arnold, Mohammed F Shamji
There continue to be incremental advances in thoracolumbar spine surgery techniques in attempts to achieve more predictable outcomes, minimize risk of complications, speed recovery, and minimize the costs of these interventions. This paper reviews recent literature with regard to emerging techniques of interest in the surgical treatment of lumbar spinal stenosis, fusion fixation and graft material, degenerative lumbar spondylolisthesis, and thoracolumbar deformity and sacroiliac joint degeneration. There continue to be advances in minimal access options in these areas, although robust outcome data are heterogeneous in its support...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350944/navigation-and-robotics-in-spinal-surgery-where-are-we-now
#18
Samuel C Overley, Samuel K Cho, Ankit I Mehta, Paul M Arnold
Spine surgery has experienced much technological innovation over the past several decades. The field has seen advancements in operative techniques, implants and biologics, and equipment such as computer-assisted navigation and surgical robotics. With the arrival of real-time image guidance and navigation capabilities along with the computing ability to process and reconstruct these data into an interactive three-dimensional spinal "map", so too have the applications of surgical robotic technology. While spinal robotics and navigation represent promising potential for improving modern spinal surgery, it remains paramount to demonstrate its superiority as compared to traditional techniques prior to assimilation of its use amongst surgeons...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350943/controversies-in-spinal-trauma-and-evolution-of-care
#19
James S Harrop, George N Rymarczuk, Alexander R Vaccaro, Michael P Steinmetz, Lindsay A Tetreault, Michael G Fehlings
Management of spinal trauma is a complex and rapidly evolving field. To optimize patient treatment algorithms, an understanding of and appreciation for current controversies and advancing technologies in the field of spinal trauma is necessary. Therefore, members of the AOSpine Knowledge Forum Trauma initiative used a modified Delphi method to compile a list of controversial issues and emerging technologies in the field of spinal trauma, and a list of the 14 most relevant topics was generated. A total of 45 440 manuscripts covering the breadth of spine and spinal trauma were initially identified...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350942/prevention-of-surgical-site-infection-in-spine-surgery
#20
Paul A Anderson, Jason W Savage, Alexander R Vaccaro, Kristen Radcliff, Paul M Arnold, Brandon D Lawrence, Mohammed F Shamji
BACKGROUND: Spine surgery is complicated by an incidence of 1% to 9% of surgical site infection (SSI). The most common organisms are gram-positive bacteria and are endogenous, that is are brought to the hospital by the patient. Efforts to improve safety have been focused on reducing SSI using a bundle approach. The bundle approach applies many quality improvement efforts and has been shown to reduce SSI in other surgical procedures. OBJECTIVE: To provide a narrative review of practical solutions to reduce SSI in spine surgery...
March 1, 2017: Neurosurgery
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