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https://www.readbyqxmd.com/read/27906721/preoperative-evaluation-and-preparation-of-the-morbidly-obese-patient
#1
Andreas B Böhmer, Frank Wappler
PURPOSE OF REVIEW: This review aims to familiarize with the most current findings regarding preoperative evaluation and preparation of morbidly obese patients prior to elective, noncardiac surgery. In the light of the increasing number of surgical patients being morbidly obese, the knowledge of evidence-based preoperative evaluation strategies is profound for a rational approach. RECENT FINDINGS: Preoperative evaluation should be carried out with sufficient time before the day of surgery to allow modification of the perioperative management...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27903009/temperature-controlled-continuous-cold-flow-device-after-total-knee-arthroplasty-a-randomized-controlled-trial-study
#2
Alberto Ruffilli, Francesco Castagnini, Francesco Traina, Isabella Corneti, Domenico Fenga, Sandro Giannini, Cesare Faldini
Total knee arthroplasty (TKA) is a widely accepted and successful procedure for end-stage arthritis. Nevertheless, fast-track may be compromised by many factors, such as pain, edema, and blood loss. Cryotherapy has been advocated as a safe and effective strategy to improve the postoperative results, acting on pain, edema, and blood loss. This study is a prospective randomized controlled study, involving 50 patients after primary TKA. A power analysis was performed preoperatively. Twenty-four patients were addressed to a postoperative treatment with a continuous cold flow device (Hilotherm, Hilotherm GmbH, Germany)...
November 30, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27894727/factors-associated-with-gait-speed-recovery-after-total-knee-arthroplasty-a-longitudinal-study
#3
Yong-Hao Pua, Felicia Jie-Ting Seah, Ross Allan Clark, Cheryl Lian-Li Poon, John Wei-Ming Tan, Hwei-Chi Chong
OBJECTIVES: Gait speed limitations can remain significant issues after a total knee arthroplasty (TKA) but their associated factors are not well understood. This study aimed to identify the factors associated with acute gait speed recovery post-TKA. METHODS: We performed a prospective longitudinal study of 1765 patients who underwent primary TKA between July 2013 and July 2015. At 4, 8, 12, and 16 weeks postsurgery, fast gait speed was measured. The factors associated with gait speed over time since TKA were identified using multivariable generalized least squares modeling...
November 1, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/27891421/imaging-modality-of-choice-for-pre-operative-cochlear-imaging-hrct-vs-mri-temporal-bone
#4
Poornima Digge, Rajendra N Solanki, Dipali C Shah, Rajesh Vishwakarma, Sandeep Kumar
INTRODUCTION: Congenital inner ear malformations occur as a result of the arrest or aberrance of inner ear development due to the heredity, gene mutation or other factors. Ever since the availability of cochlear implants, pre-operative evaluation by imaging of temporal bone has gained much attention. Precise selection of the candidate for cochlear implant dependent on preoperative radiological investigations. Only CT (Computed Tomography) and MRI (Magnetic Resonance Imaging) can provide a better picture of anatomy and pathology...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27887024/insulinoma-or-non-insulinoma-pancreatogenous-hypoglycemia-a-diagnostic-dilemma
#5
Blaire Anderson, Jordan Nostedt, Safwat Girgis, Tara Dixon, Veena Agrawal, Edward Wiebe, Peter A Senior, A M James Shapiro
Insulinoma is the most common cause of endogenous hyperinsulinemic hypoglycemia in adults. An alternate etiology, non-insulinoma pancreatogenous hypoglycemia (NIPH), is rare. Clinically, NIPH is characterized by postprandial hyperinsulinemic hypoglycemia, negative 72-h fasts, negative preoperative localization studies for insulinoma and positive selective arterial calcium infusion tests. Histologically, diffuse islet hyperplasia with increased number and size of islet cells is present and confirms the diagnosis...
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27884644/evaluating-augmentation-with-calcium-phosphate-cement-chronos-inject-for-bone-defects-after-internal-fixation-of-proximal-tibial-fractures-a-prospective-multi-center-observational-study
#6
Ki Chul Park, Chang-Wug Oh, Young-Hoon Jo
INTRODUCTION: Managing subchondral bone defects in proximal tibia fractures after plateau reduction is an important consideration.ChronOSInjectis a recently developed calcium phosphate bone substitute that shows relatively fast osteointegration. HYPOTHESIS: UsingchronOS Inject during internal fixation of proximal tibial fractures provides a satisfactory treatment option that is both clinically and radiologically safe. MATERIALS AND METHODS: Patients enrolled in this study were treated with ChronOS Injectbone void filler, during internal fixation of proximal tibial fractures...
November 21, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27870552/glycemic-predictors-of-insulin-independence-after-total-pancreatectomy-with-islet-auto-transplantation
#7
Michael Quartuccio, Erica Hall, Vikesh Singh, Martin A Makary, Kenzo Hirose, Niraj Desai, Christi Walsh, Daniel Warren, Zhaoli Sun, Ellen Stein, Rita R Kalyani
CONTEXT: Total pancreatectomy with islet auto transplantation (TPIAT) is a treatment for medically refractory chronic pancreatitis that can prevent postsurgical diabetes in a subset of patients. Predictors of insulin independence are needed for appropriate patient selection and counseling. OBJECTIVE: To explore glycemic predictors of insulin independence after TPIAT. DESIGN: A prospective cohort of patients undergoing TPIAT from 2011-2016...
November 21, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27868452/closed-reduction-of-zygomatic-tripod-fractures-using-a-towel-clip
#8
Anı Cinpolat, Ozlenen Ozkan, Gamze Bektas, Omer Ozkan
BACKGROUND: The zygomatic bone constitutes the prominence of the cheek. Fractures of the zygomatic bone are the second most treatment of zygomatic bone fractures and can be examined under two headings, open and closed reductions. This paper describes a new technique in the closed reduction of tripod fractures using a towel clip. METHODS: Seventeen consecutive patients (three females, 14 males) with a mean age of 35.5 years (range = 18-66 years) with zygomatic tripod fracture were treated using the towel clip technique between December 2011 and February 2014...
November 21, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27867860/laparoscopic-sleeve-gastrectomy-for-the-treatment-of-diabetes-mellitus-type-2-patients-single-center-early-experience
#9
Piotr Major, Michal Wysocki, Michał Pędziwiatr, Piotr Małczak, Magdalena Pisarska, Andrzej Budzyński
BACKGROUND: In recent years, laparoscopic sleeve gastrectomy (LSG) has become one of the most commonly used primary bariatric procedures for morbid obesity. While laparoscopic Roux-en-Y gastric bypass (LRYGB) has well documented positive clinical influence on type 2 diabetes, the role of LSG in diabetes treatment is debatable. The main aim of this study is to present our early experience in LSG as a method of bariatric treatment in patients with type 2 diabetes or abnormalities in glucose homeostasis...
October 2016: Gland Surgery
https://www.readbyqxmd.com/read/27861327/spinal-laser-interstitial-thermal-therapy-a-novel-alternative-to-surgery-for-metastatic-epidural-spinal-cord-compression
#10
Claudio E Tatsui, Sun-Ho Lee, Behrang Amini, Ganesh Rao, Dima Suki, Marilou Oro, Paul D Brown, Amol J Ghia, Shreyas Bhavsar, Keyuri Popat, Laurence D Rhines, R Jason Stafford, Jing Li
BACKGROUND: Although surgery followed by radiation effectively treats metastatic epidural compression, the ideal surgical approach should enable fast recovery and rapid institution of radiation and systemic therapy directed at the primary tumor. OBJECTIVE: To assess spinal laser interstitial thermotherapy (SLITT) as an alternative to surgery monitored in real time by thermal magnetic resonance (MR) images. METHODS: Patients referred for spinal metastasis without motor deficits underwent MR-guided SLITT, followed by stereotactic radiosurgery...
December 2016: Neurosurgery
https://www.readbyqxmd.com/read/27846126/implementation-of-the-american-society-of-anesthesiology-s-guidelines-to-reduce-prolonged-fasting-times-in-pediatric-preoperative-patients-a-best-practice-implementation-project
#11
Carol M Costello
BACKGROUND: The American Society of Anesthesiology (ASA) guidelines for pediatric preoperative fasting have been a standard for well over a decade. However, use of protocols involving an excessive fasting duration exposes patients to the physiological impacts of fluid volume loss. OBJECTIVES: The current project aimed to improve fluid supplementation during presurgical fasting in pediatric patients at an academic medical center. Specific objectives were to increase clinical staff knowledge regarding ASA fasting standards and implement them in specific pediatric patient populations...
October 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27844209/the-impact-of-parathyroidectomy-on-serum-adamts1-adamts4-levels-insulin-resistance-and-subclinical-cardiovascular-disease-in-primary-hyperparathyroidism
#12
Melia Karakose, Mustafa Caliskan, Muyesser Sayki Arslan, Taner Demirci, Suleyman Karakose, Erman Cakal
PURPOSE: Primary hyperparathyroidism has been associated with increased incidence of morbidity and mortality of the cardiovascular system. The etiopathogenetic mechanisms underlying this association are still not completely clear. Accumulating evidence suggested that a disintegrin and metalloproteinase with thrombospondin-like motifs (ADAMTS) has a role in the development of inflammation and atherosclerosis. In this study, we aimed to determine whether there is a change in serum levels of ADAMTS1, ADAMTS4, carotid intima-media thickness, and cardiovascular risk score after the surgery and also whether there is a relationship between ADAMTS levels and cardiovascular risk score in hypercalcemic primary hyperparathyroidism patients...
November 14, 2016: Endocrine
https://www.readbyqxmd.com/read/27834025/indocyanine-green-fluorescence-navigated-robotic-segmentectomy
#13
Chen-Ping Hsieh, Yun-Hen Liu, Yi-Cheng Wu, Ming-Ju Hsieh, Yin-Kai Chao
BACKGROUND: Pulmonary segmentectomy with radical lymphadenopathy has been considered effective to manage small primary lung cancers [1, 2]. This procedure provides the advantages of minimal invasive surgery and is reported sufficient for safe margin. However, segmentectomy is more difficult to be performed than lobectomy because intersegmental plane cannot be detected easily. Several methods have been reported for identifying the actual intersegmental plane [3-7], but the sensitivity of these methods is limited to the lung conditions like patients with emphysematous lung and needed skilled surgeon to perform...
November 11, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27821819/-effect-of-ultra-fast-track-extubation-in-cardiovascular-surgery
#14
Toshiro Kobayashi, Hiroshi Kurazumi, Hidenori Gohra, Seiichi Shibasaki, Yuko Kudo, Naoko Yamauchi, Takashi Tamura, Michio Shigedomi
Fast-track surgery has been widely implemented and allows such immediate extubation as in the operating room(OR). We retrospectively investigated the effect of routine ultra-fast-track(UFT) surgery extubating in the OR in patients undergoing cardiovascular operations. Among 333 consecutive patients, 224 (67.3%)were extubated in the OR. Five patients were re-intubated, but none were because of heart or respiratory failure. Independent predictors for failure of OR extubation were preoperative renal failure, pre-existent cerebrovascular disease, emergency surgery, and prolonged operation and/or cardiopulmonary bypass times...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27811457/effect-of-routine-preoperative-fasting-on-residual-gastric-volume-and-acid-in-patients-undergoing-myomectomy
#15
O V Ajuzieogu, A O Amucheazi, U I Nwagha, H A Ezike, S K Luka, D S Abam
BACKGROUND: Preoperative fasting of patients aims to reduce the residual gastric volume (RGV). The magnitude of this reduction is yet to be ascertained in the Nigerian population. AIM: To compare the RGV and pH of patients fasted for 6-12 h with those allowed oral intake of fluid up to 2 h preoperatively. SUBJECTS AND METHODS: This randomized study involved 90 American Society of Anesthesiologists physical status I-II patients booked for abdominal myomectomy under general anesthesia...
November 2016: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/27801780/preoperative-3d-fse-t1-weighted-mr-plaque-imaging-for-severely-stenotic-cervical-ica-accuracy-of-predicting-emboli-during-carotid-endarterectomy
#16
Yasushi Ogasawara, Yuiko Sato, Shinsuke Narumi, Makoto Sasaki, Shunrou Fujiwara, Masakazu Kobayashi, Kenji Yoshida, Yasuo Terayama, Kuniaki Ogasawara
The aim of the present study was to determine whether preoperative three-dimensional (3D) fast spin-echo (FSE) T1-weighted magnetic resonance (MR) plaque imaging for severely stenotic cervical carotid arteries could accurately predict the development of artery-to-artery emboli during exposure of the carotid arteries in carotid endarterectomy (CEA). Seventy-five patients underwent preoperative MR plaque imaging and CEA under transcranial Doppler ultrasonography of the ipsilateral middle cerebral artery. On reformatted axial MR image slices showing the maximum plaque occupation rate (POR) and maximum plaque intensity for each patient, the contrast ratio (CR) was calculated by dividing the internal carotid artery plaque signal intensity by the sternocleidomastoid muscle signal intensity...
October 27, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27791240/feasibility-of-day-case-total-hip-arthroplasty-a-single-centre-observational-study
#17
Jens Rolighed Larsen, Birgitte Skovgaard, Thomas Prynø, Laimonas Bendikas, Lone R Mikkelsen, Malene Laursen, Mette T Høybye, Søren Mikkelsen, Lene Bastrup Jørgensen
INTRODUCTION: Recent reports indicate that total hip arthroplasty (THA) can be further accelerated and might be managed as day-case. This could provide benefits to health care expenditure, lower patient risks and change patient satisfaction. We evaluated the feasibility, efficacy, safety and patient satisfaction of same-day (<12 hours) THA operation and discharge. METHODS: Consecutive patients were screened for eligibility (primary THA, ASA 1 or 2 physical status) and the presence of a support person to follow the patient for 48 hours postoperatively in an observational study...
October 24, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27777701/the-role-of-dna-amplification-and-cultural-growth-in-complicated-acute-appendicitis
#18
Francesca Tocchioni, Chiara Tani, Laura Bartolini, Maria Moriondo, Francesco Nieddu, Patrizia Pecile, Chiara Azzari, Antonio Messineo, Marco Ghionzoli
Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification versus traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012...
September 19, 2016: Pediatric Reports
https://www.readbyqxmd.com/read/27776372/early-removal-of-drainage-tube-after-fast-track-primary-total-knee-arthroplasty
#19
Shaoyun Zhang, Bin Xu, Qiang Huang, Huan Yao, Jinwei Xie, Fuxing Pei
There is no consensus as to whether drainage tube should be used and how long it should remain in use after primary total knee arthroplasty (TKA). As fast-track (FT) program has been implemented in TKA, whether drainage tube could be removed early, and the ideal timing for removal after FT primary TKA has been a new topic. The purpose of this prospective cohort study was to evaluate the safety and feasibility of early removal of drainage tube when FT program was implemented in primary TKA. A total of 101 patients undergoing FT primary TKA were prospectively allocated into three groups...
October 24, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27759831/caregivers-reactions-to-preoperative-procedures-in-outpatient-pediatric-surgery
#20
André Bohomol Velhote, Elena Bohomol, Manoel Carlos Prieto Velhote
Objective: To identify pediatric caregivers' reactions in outpatient surgery settings. Methods: A quantitative descriptive/exploratory survey-based study involving application of a semi-structured questionnaire to 62 caregivers in two hospitals. Results: Most caregivers (88.7%) were mothers who submitted to preoperative fasting with their children. Nervousness, anxiety and concern were the most common feelings reported by caregivers on the day of the surgery...
July 2016: Einstein
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