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https://www.readbyqxmd.com/read/29778336/implementation-of-the-aortic-no-touch-technique-to-reduce-stroke-after-off-pump-coronary-surgery
#1
Alexander Albert, Jürgen Ennker, Yasser Hegazy, Sebastian Ullrich, Georgi Petrov, Payam Akhyari, Stefan Bauer, Eda Ürer, Ina Carolin Ennker, Artur Lichtenberg, Horst Priss, Alexander Assmann
OBJECTIVES: Despite substantial scientific effort, the relationship between stroke after coronary artery bypass grafting and the use of the aortic no-touch off-pump technique (anOPCAB) remains incompletely understood. The present study aimed to define the effect of anOPCAB on the occurrence and time point of stroke. METHODS: A total cohort of 15,042 consecutive patients underwent surgical myocardial revascularization at a single institution. After establishing anOPCAB as routine procedure, 4695 patients received surgery by 18 different surgeons using the anaortic approach...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29777851/point-of-care-ultrasound-performed-by-a-medical-student-compared-to-physical-examination-by-vascular-surgeons-in-the-detection-of-abdominal-aortic-aneurysms
#2
Trinh Mai, Michael Y Woo, Kim Boles, Prasad Jetty
OBJECTIVE: To determine the test characteristics of point-of-care ultrasonography performed by a medical student versus physical examination by vascular surgeons compared to a gold standard reference scan for the detection of abdominal aortic aneurysms. METHODS: We conducted a prospective, observer-blinded study recruiting patients from an outpatient vascular surgery clinic. Participants were screened for abdominal aortic aneurysms by standardized physical examination by a blinded vascular surgeon, followed by a point-of-care ultrasound examination by a blinded medical student...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777350/the-american-association-for-the-surgery-of-trauma-emergency-general-surgery-anatomic-severity-scoring-system-as-a-predictor-of-cost-in-appendicitis
#3
Eric J Finnesgard, Matthew C Hernandez, Johnathon M Aho, Martin D Zielinski
BACKGROUND: The World Society for Emergency Surgery determined that for appendicitis managed with appendectomy, there is a paucity of evidence evaluating costs with respect to disease severity. The American Association for the Surgery of Trauma (AAST) disease severity grading system is valid and generalizable for appendicitis. We aimed to evaluate hospitalization costs incurred by patients with increasing disease severity as defined by the AAST. We hypothesized that increasing disease severity would be associated with greater cost...
May 17, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29777269/pediatric-appendicitis-severity-in-kwazulu-natal-south-africa-a-retrospective-cohort-analysis
#4
Matthew C Hernandez, Victor Y Kong, John L Bruce, Johnathon M Aho, Grant L Laing, Martin D Zielinski, Damian L Clarke
BACKGROUND: Acute appendicitis is a common pediatric surgical emergency; however, there are few grading systems to assign disease severity. The American Association for the Surgery of Trauma (AAST) recently developed a grading system for a variety of emergency surgical conditions, including appendicitis. The severity of acute appendicitis in younger patients in KwaZulu-Natal (South Africa) is unknown. We aimed to describe the disease severity in this patient population using the AAST grading system hypothesizing that the AAST grade would correlate with morbidity, management type, and duration of stay...
May 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29777042/rates-of-infection-after-colonoscopy-and-osophagogastroduodenoscopy-in-ambulatory-surgery-centres-in-the-usa
#5
Peiqi Wang, Tim Xu, Saowanee Ngamruengphong, Martin A Makary, Anthony Kalloo, Susan Hutfless
OBJECTIVE: Over 15 million colonoscopies and 7 million osophagogastroduodenoscopies (OGDs) are performed annually in the USA. We aimed to estimate the rates of infections after colonoscopy and OGD performed in ambulatory surgery centres (ASCs). DESIGN: We identified colonoscopy and OGD procedures performed at ASCs in 2014 all-payer claims data from six states in the USA. Screening mammography, prostate cancer screening, bronchoscopy and cystoscopy procedures were comparators...
May 18, 2018: Gut
https://www.readbyqxmd.com/read/29776871/patients-experiences-of-pain-have-an-impact-on-their-pain-management-attitudes-and-strategies
#6
Eva Angelini, Helle Wijk, Helena Brisby, Adad Baranto
Postoperative pain remains undermanaged in orthopedic surgery. To identify areas of improvement for future structural changes in pain management, patients' experiences of pain and pain management when undergoing elective lumbar spine surgery were explored, using a qualitative method with focus group interviews. The study setting was an orthopedic spine surgery department at a University Hospital in Sweden. This study consisted of two focus group interviews with patients (n = 6/group, a total of 12 patients) who had undergone lumbar spine surgery 4 days to 5 weeks prior to the focus group interviews...
May 15, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29776670/-predictors-of-in-hospital-mortality-in-patients-undergoing-elective-surgery-in-a-university-hospital-a-prospective-cohort
#7
Adriene Stahlschmidt, Betânia Novelo, Luiza Alexi Freitas, Sávio Cavalcante Passos, Jairo Alberto Dussián-Sarria, Elaine Aparecida Félix, Patrícia Wajnberg Gamermann, Wolnei Caumo, Luciana Paula Cadore Stefani
INTRODUCTION: Morbidity and mortality associated with urgent or emergency surgeries are high compared to elective procedures. Perioperative risk scores identify the non-elective character as an independent factor of complications and death. The present study aims to characterize the population undergoing non-elective surgeries at the Hospital de Clínicas de Porto Alegre and identify the clinical and surgical factors associated with death within 30 days postoperatively. METHODOLOGY: A prospective cohort study of 187 patients undergoing elective surgeries between April and May 2014 at the Hospital de Clínicas, Porto Alegre...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29776668/-fatal-cardiac-tamponade-that-developed-in-the-post-anesthesia-care-unit-a-rare-complication-after-lung-lobectomy
#8
Hyung Mook Lee, Young Jae Jeon, Hye Won Chung, Hyo Min Yun, Mi Hyun Kim
BACKGROUND AND OBJECTIVES: Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy. CASE REPORT: A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29776472/spherical-versus-elliptical-prosthetic-humeral-heads-a-comparison-of-anatomic-fit
#9
C Scott Humphrey, Andrea L Gale
BACKGROUND: The aim of this study was to quantify the influence of prosthetic humeral head shape, as well as the number of available prosthetic head sizes, on replicating the normal humeral head anatomy during shoulder reconstructive surgery. METHODS: Computer modeling software was used to create virtual sets of both spherical and elliptical prosthetic heads, which were virtually implanted into 3-dimensional computed tomography scan-based models of 79 proximal humeri...
June 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#10
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29775157/blood-based-biomarkers-in-breast-cancer-from-proteins-to-circulating-tumor-cells-to-circulating-tumor-dna
#11
Michael J Duffy, Enda W McDermott, John Crown
Biomarkers are the key to personalized treatment in patients with breast cancer. While tissue biomarkers are most useful in determining prognosis and upfront predicting response to therapy, circulating protein biomarkers such as CA 15-3 and carcinoembryonic antigen are mainly used in monitoring response to endocrine or chemotherapy in patients with advanced disease. Although several centers measure biomarkers in asymptomatic patients following curative surgery for primary breast cancer, the clinical utility of this practice is unclear...
May 2018: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
https://www.readbyqxmd.com/read/29774194/improper-use-of-thrombolytic-agents-in-acute-hemiparesis-following-misdiagnosis-of-acute-ischemic-stroke
#12
Min Chan Kim, Seok Won Kim
Objective: Acute hemiparesis is often an early presentation of acute ischemic stroke, though it can occur in various disorders. This study aimed to investigate the improper use of thrombolytic agents for patients with acute hemiparesis, following the misdiagnosis of acute ischemic stroke. Methods: We analyzed the clinical and radiological data of nine patients initially misdiagnosed with cerebral stroke in the emergency room from May 2013 to January 2017. All the patients were treated with tissue plasminogen activator (TPA) owing to the presence of acute hemiparesis...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29774192/efficacy-of-the-all-in-one-therapeutic-strategy-for-severe-traumatic-brain-injury-preliminary-outcome-and-limitation
#13
Young-Soo Park, Yohei Kogeichi, Yoichi Shida, Hiroyuki Nakase
Objective: Despite recent advances in medicine, no significant improvement has been achieved in therapeutic outcomes for severe traumatic brain injury (TBI). In the treatment of severe multiple traumas, accurate judgment and prompt action corresponding to rapid pathophysiological changes are required. Therefore, we developed the "All-in-One" therapeutic strategy for severe TBI. In this report, we present the therapeutic concept and discuss its efficacy and limitations. Methods: From April 2007 to December 2015, 439 patients diagnosed as having traumatic intracranial injuries were treated at our institution...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29773328/molecular-and-immune-biomarker-testing-in-squamous-cell-lung-cancer-effect-of-current-and-future-therapies-and-technologies
#14
REVIEW
Fred R Hirsch, Keith M Kerr, Paul A Bunn, Edward S Kim, Coleman Obasaju, Maurice Pérol, Philip Bonomi, Jeffrey D Bradley, David Gandara, James R Jett, Corey J Langer, Ronald B Natale, Silvia Novello, Luis Paz-Ares, Suresh S Ramalingam, Martin Reck, Craig H Reynolds, Egbert F Smit, Mark A Socinski, David R Spigel, Thomas E Stinchcombe, Johan F Vansteenkiste, Heather Wakelee, Nick Thatcher
Patients with non-small-cell lung cancer, including squamous-cell lung cancer (SqCLC), typically present at an advanced stage. The current treatment landscape, which includes chemotherapy, radiotherapy, surgery, immunotherapy, and targeted agents, is rapidly evolving, including for patients with SqCLC. Prompt molecular and immune biomarker testing can serve to guide optimal treatment choices, and immune biomarker testing is becoming more important for this patient population. In this review we provide an overview of current and emerging practices and technologies for molecular and immune biomarker testing in advanced non-small-cell lung cancer, with a focus on SqCLC...
March 21, 2018: Clinical Lung Cancer
https://www.readbyqxmd.com/read/29772314/urgent-use-of-gore-excluder-iliac-branch-endoprosthesis-ibe-with-left-transaxillary-approach-for-preservation-of-the-residual-hypogastric-artery-a-case-series
#15
D'Oria Mario, Chiarandini Stefano, Pipitone Marco, Calvagna Cristiano, Riccitelli Francesco, Rotelli Alice, Zamolo Francesca, Griselli Filippo
Preservation of the residual hypogastric artery (HGA) in patients with previous endovascular aortic aneurysm repair (EVAR) may require complex operative strategies. We report an alternative technique to preserve the residual HGA with the Gore Excluder Iliac Branch endoprosthesis (IBE) in urgent situations. MethodsWe report the case of two high-risk patients (unfit for open surgery), with previous EVAR and exclusion of one HGA, treated in emergency setting. Both patients met the anatomical requirements for Gore IBE use...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772050/combined-femtosecond-laser-assisted-cataract-surgery-and-small-gauge-pars-plana-vitrectomy-using-different-devices-a-new-trend-for-vitreoretinal-surgery
#16
Bruno de Queiroz Alves, Oswaldo Ferreira Moura Brasil, Cristiano Toesca Espinhosa, Ricardo Miguel Japiassu, Mariana Batista Gonçalves, Otaviano Magalhães Júnior, André Maia, Emmerson Badaró, Paula Serraino, Arturo Alezzandrinni, Mauricio Maia
BACKGROUND AND OBJECTIVE: To report the efficacy, safety, and benefits of femtosecond laser-assisted cataract surgery (FLACS) combined with sutureless 23-gauge pars plana vitrectomy (PPV). PATIENTS AND METHODS: This multicenter, retrospective study evaluated patient records and videos of 43 cases with retinal pathologies and cataract who underwent the combined procedure. RESULTS: In 44.2% and 55.8% of cases, respectively, the LenSx Laser (femtosecond machine; Alcon, Fort Worth, TX) and the Constellation (vitreous cutter; Alcon, Fort Worth, TX), and the Victus (femtosecond machine; Bausch + Lomb, Rochester, NY) and Stellaris PC (vitreous cutter; Bausch + Lomb, Rochester, NY) were used...
May 1, 2018: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/29771848/review-of-emergency-surgery-for-medicare-beneficiaries-admitted-to-critical-access-hospitals-by-ibrahim-am-regenbogen-se-thumma-jr-dimick-jb-in-ann-surg-267-473-477-2018
#17
LeslieAnn S Kao, Larry H Hollier
No abstract text is available yet for this article.
May 15, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#18
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29771396/lyme-arthritis-of-the-pediatric-elbow-a-case-series
#19
David Gendelberg, William L Hennrikus
Most patients with untreated Lyme disease will experience joint symptoms. Owing to their resemblance in clinical presentation, Lyme arthritis and septic arthritis are often difficult to differentiate. However, their treatment is different. The elbow is rarely the first joint to present with symptoms. Therefore, Lyme disease is not commonly included in the differential diagnosis for children presenting with isolated elbow pain. The authors report 4 cases of monoarticular Lyme arthritis presenting in the elbow...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29771279/peri-operative-therapy-for-operable-gastroesophageal-adenocarcinoma-past-present-and-future
#20
V Aggelis, D Cunningham, F Lordick, E C Smyth
Surgery represents the only chance of cure for patients with gastroesophageal adenocarcinoma; however surgery alone does not cure most patients. Over the past decade, several multimodality adjunctive treatments have improved survival for patients with operable gastroesophageal adenocarcinoma who are undergoing surgical resection; these include peri-operative chemotherapy, neoadjuvant chemoradiotherapy, adjuvant chemotherapy and adjuvant chemoradiotherapy. More recently, the results of several large randomised trials are leading to a shift in the peri-operative treatment of gastroesophageal cancer, away from anthracycline-based and towards taxane-based chemotherapy regimens...
May 16, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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