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https://www.readbyqxmd.com/read/28736997/distinct-histopathologic-features-of-radiation-induced-chronic-sinusitis
#1
Hannah N Kuhar, Bobby A Tajudeen, Ashley Heilingoetter, Mahboobeh Mahdavinia, Paolo Gattuso, Ritu Ghai, Ferry Gunawan, Aidnag Z Diaz, George Tolekidis, Pete S Batra
BACKGROUND: Chronic rhinosinusitis (CRS) is a commonly observed sequela after radiation therapy to the paranasal sinuses. The histopathologic features of radiation-induced CRS have yet to be determined and may have major implications in disease management. METHODS: A structured histopathology report was utilized to analyze sinus tissue removed during functional endoscopic sinus surgery (FESS). Histopathology variables, Lund-Mackay score (LMS), and 22-item Sino-Nasal Outcome Test (SNOT-22) scores were compared among patients with radiation-induced CRS (CRSr), CRS without nasal polyps (CRSsNP), and CRS with nasal polyps (CRSwNP)...
July 24, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28736288/rapid-decay-of-transthoracic-echocardiography-skills-at-1-month-a-prospective-observational-study
#2
Ryo Yamamoto, David Clanton, Ross E Willis, Rachelle Babbitt Jonas, Ramon F Cestero
OBJECTIVE: Focused transthoracic echocardiography (FTTE) is an emerging tool in the management of critically ill patients, but the lack of adequate training models has limited the expansion of this technology. Although basic FTTE training courses have been shown to be sufficient in developing echocardiography skills, limited data exist regarding skill retention. In an effort to develop an adequate FTTE training model, we sought to determine the degree of skill retention after FTTE training...
July 20, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28735976/predictive-value-of-procalcitonin-for-intestinal-ischemia-and-or-necrosis-in-pediatric-patients-with-adhesive-small-bowel-obstruction-asbo
#3
Eduardo Bracho-Blanchet, Alfredo Dominguez-Muñoz, Emilio Fernandez-Portilla, Cristian Zalles-Vidal, Roberto Davila-Perez
PURPOSE: Evaluate serum procalcitonin (PCT) level as a predictor of intestinal ischemia or necrosis (IN) in patients with postoperative adhesive small bowel obstruction (ASBO). METHODS: Prospective cohort of consecutive patients with ASBO. Patients previously treated with antibiotics or septic were excluded. PCT was measured at the diagnosis of ASBO and every 24 h afterwards. MAIN OUTCOME: intestinal ischemia or necrosis (IN). RESULTS: Fifty-nine patients were included, 12 of whom were excluded; 47 patients remained in the study; male-to-female ratio = 1...
July 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28734971/robotic-assistance-confers-ambidexterity-to-laparoscopic-surgeons
#4
Souzana Choussein, Serene S Srouji, Leslie V Farland, Ashley Wietsma, Stacey A Missmer, Michael Hollis, Richard N Yu, Charles N Pozner, Antonio R Gargiulo
STUDY OBJECTIVE: To examine whether a robotic surgical platform can complement the fine motor skills of the non-dominant hand, compensating for the innate difference in dexterity between the surgeon's hands, thereby conferring virtual ambidexterity. DESIGN: Crossover intervention study. DESIGN CLASSIFICATION: Level II-1 evidence. SETTING: Centers for medical simulation of two tertiary care hospitals of Harvard Medical School...
July 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28734829/feasibility-of-prophylactic-salpingectomy-during-vaginal-hysterectomy
#5
Danielle D Antosh, Rachel High, Heidi W Brown, Sallie S Oliphant, Husam Abed, Nisha Philip, Cara L Grimes
BACKGROUND: The American Congress of Obstetricians and Gynecologists recommends that "the surgeon and patient discuss the potential benefits of the removal of the fallopian tubes during a hysterectomy in women at population risk of ovarian cancer who are not having an oophorectomy," resulting in an increasing rate of salpingectomy at the time of hysterectomy. Rates of salpingectomy are highest for laparoscopic and lowest for vaginal hysterectomy. OBJECTIVES: The primary objective of this study was to determine the feasibility of bilateral salpingectomy at the time of vaginal hysterectomy...
July 19, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28734497/functional-not-chronologic-age-frailty-index-predicts-outcomes-in-advanced-ovarian-cancer
#6
Amanika Kumar, Carrie L Langstraat, Stephanie R DeJong, Michaela E McGree, Jamie N Bakkum-Gamez, Amy L Weaver, Nathan K LeBrasseur, William A Cliby
OBJECTIVES: To assess the impact of frailty as measured by a frailty deficit index (FI) on outcomes in advanced epithelial ovarian cancer (EOC) after primary debulking surgery (PDS). METHODS: Women with Stage IIIC/IV EOC who underwent PDS between 1/1/2003-12/31/2011 were included. Medical records were reviewed for patient characteristics and outcomes. The FI includes 30 items scored at 0, 0.5 or 1 and is calculated by summing across all the item scores and dividing by the total...
July 19, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28731535/ultrasound-guided-drainage-for-pediatric-soft-tissue-abscesses-decreases-clinical-failure-rates-compared-to-drainage-without-ultrasound-a-retrospective-study
#7
Romolo Joseph Gaspari, Alexandra Sanseverino
OBJECTIVES: Soft tissue abscesses are common in the pediatric emergency department (ED). Ultrasound (US) can be used to both diagnose soft tissue abscesses as well as guide drainage. We hypothesized that clinical failure rates would be less in pediatric patients with suspected skin abscesses when evaluated with US. METHODS: We performed a retrospective review of suspected pediatric skin abscesses at 4 EDs over a 22-month period. Cases were identified through electronic medical record descriptions, discharge diagnoses, and US database records...
July 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28731391/malpractice-litigation-following-spine-surgery
#8
Alan H Daniels, Roy Ruttiman, Adam E M Eltorai, J Mason DePasse, Bielinsky A Brea, Mark A Palumbo
OBJECTIVE Adverse events related to spine surgery sometimes lead to litigation. Few studies have evaluated the association between spine surgical complications and medical malpractice proceedings, outcomes, and awards. The aim of this study was to identify the most frequent causes of alleged malpractice in spine surgery and to gain insight into patient demographic and clinical characteristics associated with medical negligence litigation. METHODS A search for "spine surgery" spanning February 1988 to May 2015 was conducted utilizing the medicolegal research service VerdictSearch (ALM Media Properties, LLC)...
July 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28730300/health-related-quality-of-life-in-paediatric-patients-with-congenital-heart-defects-association-with-the-type-of-heart-defect-and-the-surgical-technique
#9
A Heusch, H J Kahl, K O Hensel, G Calaminus
The aim of the study was to investigate the impact of a number of surgical interventions for a various congenital cardiac defects (CHDs) on self-reported HRQoL. METHODS: Patients who had received corrective surgery of several congenital heart defects (surgical VSD closure, Fallot, TGA after atrial or arterial switch or Fontan-type circulation for univentricular AV-connection) were interviewed in the office of their home peadiatric cardiologist. HRQoL in children along 7 dimensions was assessed using a standardised questionnaire (PEDQoL); information on the medical case history of each respondent was also collected...
July 20, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28728828/obstruction-of-peritoneal-dialysis-catheter-is-associated-with-catheter-type-and-independent-of-omentectomy-a-comparative-data-analysis-from-a-transplant-surgical-and-a-pediatric-surgical-department
#10
Josephine Radtke, Raphael Schild, Marc Reismann, Robert-Richard Ridwelski, Caroline Kempf, Bjoern Nashan, Karin Rothe, Martina Koch
BACKGROUND: Peritoneal dialysis (PD) catheter occlusion is a common complication with up to 36% of catheter obstructions described in the literature. We present a comparison of complications and outcome after implantation of PD catheters in a transplant surgical and a pediatric surgical department. METHODS: We retrospectively analyzed 154 PD catheters, which were implanted during 2009-2015 by transplant surgeons (TS, University Medical Center Hamburg-Eppendorf, Germany, n=85 catheters) and pediatric surgeons (PS, Charité University Medicine Berlin, Germany, n=69 catheters) in 122 children (median (range) age 3...
July 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28721482/the-impact-of-urodynamics-on-treatment-and-outcomes-in-women-with-an-overactive-bladder-a-longitudinal-prospective-follow-up-study
#11
Tina Sara Verghese, Lee J Middleton, Jane P Daniels, Jonathan J Deeks, Pallavi Manish Latthe
INTRODUCTION AND HYPOTHESIS: The aim of this study was to establish if the management of women with overactive bladder (OAB) and patient-reported outcomes differed based on the findings of urodynamics (UDS). METHODS: A prospective, longitudinal observational study conducted in urogynaecology clinics in 22 UK hospitals participating in the Diagnostic Accuracy of Bladder Ultrasound Study (BUS). A total of 687 women with OAB symptoms or urgency-predominant mixed urinary incontinence were recruited into a diagnostic study that used UDS as the reference standard...
July 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28720425/toward-best-practices-for-surgical-morbidity-and-mortality-conferences-a-mixed-methods-study
#12
Marit S de Vos, Perla J Marang-van de Mheen, Ann D Smith, Danny Mou, Edward E Whang, Jaap F Hamming
OBJECTIVE: To assess formats for surgical morbidity and mortality conferences (M&M) for strengths and challenges. DESIGN: A mixed methods approach with local observations to assess key domains of M&M practice (i.e., goals, structure, and process/content) and surveys to assess participants' expectations and experiences. SETTING: Surgical departments of two teaching hospitals (Boston, USA and Leiden, Netherlands). PARTICIPANTS: Participants of surgical M&M, including attending surgeons, residents, physician assistants, and medical students (total n = 135)...
July 15, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28720410/increased-use-of-antihypertensive-medications-after-partial-nephrectomy-vs-radical-nephrectomy
#13
Ryan Hutchinson, Nirmish Singla, Laura-Maria Krabbe, Solomon Woldu, Gong Chen, Charles Rew, Isamu Tachibana, Yair Lotan, Jeffrey A Cadeddu, Vitaly Margulis
PURPOSE: A prospective study of partial vs. radical nephrectomy demonstrated worse overall survival in patients undergoing partial nephrectomy which appeared to be driven by cardiovascular outcomes. We sought to determine if the blood pressures or use of antihypertensive medications differed between patients who underwent partial or radical nephrectomy. MATERIALS AND METHODS: A tertiary-referral institutional renal mass database was queried for patients between 2006 and 2012 undergoing partial or radical nephrectomy...
July 15, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28718906/a-retrospective-analysis-of-the-effectiveness-of-anterior-pelvic-organ-prolapse-repair-with-prolift-versus-elevate-vaginal-mesh
#14
Isabel Barros-Pereira, Alexandre Valentim-Lourenço, Andreia Fonseca, Bruna Melo, Alexandra Henriques, Ana Ribeirinho
OBJECTIVE: To compare the effectiveness of anterior pelvic organ prolapse (POP) repair using Prolift (Ethicon, Somerville, NJ, USA) or Elevate (American Medical Systems, Minnetonka, MN, USA) vaginal mesh at 12 months of follow-up. METHODS: A retrospective study was undertaken using the records for the first 50 Prolift procedures in 2007-2009 and the first 50 Elevate procedures in 2013-2015 performed at a tertiary urogynecology unit in Lisbon, Portugal. Postoperative follow-up occurred at 3, 6, and 12 months...
July 18, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28715950/efficacy-of-the-novel-medical-adhesive-mar-vivo-107-in-an-acute-porcine-liver-resection-model
#15
Hirokazu Tanaka, Kenji Fukushima, Pramod Kadaba Srinivasan, Kerstin Pawlowsky, Babette Koegel, Koichiro Hata, Yonson Ku, Shinji Uemoto, René H Tolba
BACKGROUND: Despite modern surgical techniques, insufficient hemostasis after liver trauma is still a major cause of morbidity and mortality after injury. Therefore, efficient hemostatic agents are indicated. In this study, we evaluated the hemostatic efficacy of a novel synthetic wound adhesive (MAR-VIVO-107) based on polyurethane/polyurea, compared with a widely used fibrin adhesive (Tisseel). MATERIALS AND METHODS: Twelve German Landrace pigs were randomly assigned to 2 groups...
July 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28712581/cost-and-contribution-margin-of-transcatheter-versus-surgical-aortic-valve-replacement
#16
Fenton H McCarthy, Danielle C Savino, Chase R Brown, Joseph E Bavaria, Vinay Kini, Danielle D Spragan, Taylor R Dibble, Howard C Herrmann, Saif Anwaruddin, Jay Giri, Wilson Y Szeto, Peter W Groeneveld, Nimesh D Desai
OBJECTIVE: To compare the cost of and payments for transcatheter aortic valve replacement (TAVR), a novel and expensive technology, and surgical aortic valve replacement (SAVR). METHODS: Medicare claims provided hospital charges, payments, and outcomes between January and December 2012. Hospital costs and charges were estimated using hospital-specific cost-to-charge ratios. Costs and payments were examined in propensity score- matched TAVR and SAVR patients. RESULTS: Medicare spent $215,770,200 nationally on 4083 patients who underwent TAVR in 2012...
June 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28712580/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#17
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
BACKGROUND: The del Nido cardioplegia (DC) procedure offers prolonged cardiac protection with single-dose administration and has proven safe in adult coronary artery bypass grafting (CABG) surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of DC versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. METHODS: Between August 2011 and May 2016, 178 patients underwent minimally invasive aortic valve replacement (AVR) with BC (n = 101) or DC (n = 77)...
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28707992/transitional-care-services-a-quality-and-safety-process-improvement-program-in-neurosurgery
#18
Faith C Robertson, Jessica L Logsdon, Hormuzdiyar H Dasenbrock, Sandra C Yan, Siobhan M Raftery, Timothy R Smith, William B Gormley
OBJECTIVE Readmissions increasingly serve as a metric of hospital performance, inviting quality improvement initiatives in both medicine and surgery. However, few readmission reduction programs have targeted surgical patient populations. The objective of this study was to establish a transitional care program (TCP) with the goal of decreasing length of stay (LOS), improving discharge efficiency, and reducing readmissions of neurosurgical patients by optimizing patient education and postdischarge surveillance...
July 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28707718/bracketed-radioactive-seed-localization-vs-bracketed-wire-localization-in-breast-surgery
#19
Monica Da Silva, Jessica Porembka, Ali A Mokdad, Stephen Seiler, James Huth, Aeisha Rivers, Rachel Wooldridge, Amanda Chu, Emily Brown, Jean Bao, Deborah Farr, Meghan Hansen, Alison Unzeitig-Barron, Marilyn Leitch, Roshni Rao
Multiple localizers placed in a bracketed fashion facilitates excision of radiographically extensive breast lesions. In this study, bracketed radioactive seed localization (bRSL) was compared to bracketed wire localization (bWL). We hypothesized that bRSL would achieve adequate margins and decrease re-operation rates with similar or less specimen volumes (SV) than bWL. Retrospective review identified patients who underwent bracketed breast procedures at an academic medical center. Data collected included patient demographics, tumor features, treatment variables, and surgical outcomes...
July 14, 2017: Breast Journal
https://www.readbyqxmd.com/read/28703900/rapid-genetic-counseling-and-testing-in-newly-diagnosed-breast-cancer-patients-and-health-professionals-attitudes-experiences-and-evaluation-of-effects-on-treatment-decision-making
#20
Marijke R Wevers, Neil K Aaronson, Eveline M A Bleiker, Daniela E E Hahn, Titia Brouwer, Thijs van Dalen, Evert B Theunissen, Bart van Ooijen, Marnix A de Roos, Paul J Borgstein, Bart C Vrouenraets, Eline Vriens, Wim H Bouma, Herman Rijna, Johannes P Vente, Marianne A Kuenen, Jacoline van der Sanden-Melis, Arjen J Witkamp, Emiel J Th Rutgers, Senno Verhoef, Margreet G E M Ausems
BACKGROUND: Rapid genetic counseling and testing (RGCT) in newly diagnosed high-risk breast cancer (BC) patients may influence surgical treatment decisions. To successfully integrate RGCT in practice, knowledge of professionals', and patients' attitudes toward RGCT is essential. METHODS: Between 2008 and 2010, we performed a randomized clinical trial evaluating the impact of RGCT. Attitudes toward and experience with RGCT were assessed in 265 patients (at diagnosis, 6- and 12-month follow-up) and 29 medical professionals (before and after the recruitment period)...
July 13, 2017: Journal of Surgical Oncology
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