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https://www.readbyqxmd.com/read/28749265/emergency-anesthesia-and-exploratory-laparotomy-in-a-compromised-pacific-white-sided-dolphin-lagenorhynchus-obliquidens
#1
Justin F Rosenberg, Martin Haulena, James E Bailey, Dean A Hendrickson, Marina Ivančić, Stephen A Raverty
Anesthesia and surgery in cetaceans have inherent risks and have rarely been utilized as viable treatment options. This report represents the first known multidisciplinary team approach to emergency laparotomy in a compromised, 22-yr-old, female Pacific white-sided dolphin ( Lagenorhynchus obliquidens ). The inciting clinical signs and ancillary diagnostics were consistent with a mechanical ileus. Although no torsion or obstruction was apparent during surgery, severe enteritis and peritonitis were noted. Postoperatively, the animal was maintained on aggressive medical management with continuous supportive care until succumbing 3 days later with clinical pathology indicative of terminal sepsis and profound inflammation...
June 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28748917/oesophageal-cancer
#2
REVIEW
Elizabeth C Smyth, Jesper Lagergren, Rebecca C Fitzgerald, Florian Lordick, Manish A Shah, Pernilla Lagergren, David Cunningham
Oesophageal cancer is the sixth most common cause of cancer-related death worldwide and is therefore a major global health challenge. The two major subtypes of oesophageal cancer are oesophageal squamous cell carcinoma (OSCC) and oesophageal adenocarcinoma (OAC), which are epidemiologically and biologically distinct. OSCC accounts for 90% of all cases of oesophageal cancer globally and is highly prevalent in the East, East Africa and South America. OAC is more common in developed countries than in developing countries...
July 27, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28748737/emergency-hartmann-s-procedure-and-its-reversal-a-totally-laparoscopic-2-step-surgery-for-the-treatment-of-hinchey-iii-and-iv-diverticulitis
#3
Diletta Cassini, Michelangelo Miccini, Farshad Manoochehri, Matteo Gregori, Gianandrea Baldazzi
BACKGROUND: Hartmann's procedure (HP) followed by reversal restoration is the first choice for treatment of diffuse diverticular peritonitis. There is no unanimous consensus regarding the use of laparoscopy to treat the same condition. METHODS: Data from 60 patients with diverticular diffuse peritonitis who underwent urgent HP followed by laparoscopic reversal were retrospectively analyzed. Patients were divided into 2 groups according to the open or laparoscopic HP (OHP, 24 patients; LHP, 36 patients)...
July 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28748429/admission-control-policies-for-surgery-patients
#4
Li Luo, Yong Luo, Chunrong Qin
In China, day surgery has been promoted because its operation time and post-operative hospital stay are shorter than those of elective surgery. Day surgery can speed up the turnover of beds and operation rooms. Usually, the conditions of elective surgery patients are more complicated than those of day surgery patients. The development of the discipline, which means that the hospital has improved the skills of the doctors and the ability of doctors to cope with serious diseases and has increased the overall medical level of the hospital, requires surgeons to operate in some complicated elective surgeries...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28748010/-acute-acalculous-gangrenous-cholecystitis-in-postoperative-period-after-orthopedic-surgery-about-a-case
#5
Hichem Cheikhrouhou, Karim Jmal, Amine Kharrat, Meriem Keskes, Abdelhamid Karoui
Postoperative acalculous gangrenous cholecystitis is a serious and severe complication, especially in patients hospitalized in the Department of Reanimation. It occurs most often during vascular surgery or major digestive surgery, a polytrauma, in a context septic or in a context of shock. We report the case of a 74 year man who underwent surgery for femoral neck fracture. On the sixth postoperative day, he developed acute cholecystitis. Radiological examinations confirmed acalculous cholecystitis. After emergency cholecystectomy, anatomo-pathologic study confirmed the diagnosis of acalculous gangrenous cholecystitis...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28747700/association-of-pre-operative-estimated-gfr-on-post-operative-pulmonary-complications-in-laparoscopic-surgeries
#6
Akihiro Shimomura, Yoshitsugu Obi, Reza Fazl Alizadeh, Shiri Li, Ninh T Nguyen, Michael J Stamos, Kamyar Kalantar-Zadeh, Hirohito Ichii
Despite a large body of evidence showing the pandemic of chronic kidney disease, the impact of pre-operative kidney function on the risk of post-operative pulmonary complications (PPCs) is not well known. We used multivariable logistic regression analyses with 3-level hierarchical adjustments to identify the association of pre-operative estimated glomerular filtration rate (eGFR) with PPCs in laparoscopic surgeries. Among 452,213 patients between 2005 and 2013 in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Database, a total of 3,727 patients (0...
July 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28747198/population-based-prevalence-survey-of-follicular-trachoma-and-trachomatous-trichiasis-in-the-casamance-region-of-senegal
#7
Emma M Harding-Esch, Julbert Kadimpeul, Boubacar Sarr, Awa Sane, Souleymane Badji, Mass Laye, Ansumana Sillah, Sarah E Burr, David MacLeod, Anna R Last, Martin J Holland, David C Mabey, Robin L Bailey
BACKGROUND: Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. We conducted the first population-based trachoma prevalence survey in the Casamance region of Senegal to enable the Senegalese National Eye Care Programme (NECP) to plan its trachoma control activities. The World Health Organization (WHO) guidelines state that any individual with trachomatous trichiasis (TT) should be offered surgery, but that surgery should be prioritised where the prevalence is >0...
July 26, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28747097/tissue-engineering-strategies-to-improve-osteogenesis-in-the-juvenile-swine-alveolar-cleft-model
#8
Montserrat Caballero, Donna C Jones, Zhengyuan Shan, Sajjad Soleimani, John A van Aalst
Alveolar <b>(gumline)</b> clefts are the most common congenital bone defect in humans, affecting 1 in 700 live births. Treatment <b>to repair these bony</b> defects relies on autologous, <b>cancellous</b> bone transfer from the iliac crest. This harvest requires a second surgical site <b>with increased </b>surgical time associated with potential complications, <b>while providing only limited cancellous bone</b>. Improvements in treatment protocols that avoid these limitations would be beneficial to patients with clefts and other craniofacial bone defects...
July 26, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28747077/sandwich-technique-for-endovascular-repair-of-acute-type-a-aortic-dissection
#9
Feng Gao, Qian Zeng, Fangming Lin, Xiaohu Ge
OVERVIEW: To describe a new endovascular procedure for acute type A aortic dissection (TAAD) repair. METHODS: Between 2013 and 2016, 12 patients (average age 54±9.6 years; 10 men) with acute TAAD (mean EURO score 11.4%±3.2%, range 5-17) and unfit for surgery underwent thoracic endovascular aortic repair (TEVAR) with 2 periscope grafts to preserve blood supply to supra-aortic branches plus bypass grafting as needed. If the ascending aorta was dilated to >40 mm, sternotomy was performed to wrap the ascending aorta and reduce its diameter to accommodate the aortic stent-grafts...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28746223/decreasing-incidence-and-mortality-among-hospitalized-patients-suffering-a-ventilator-associated-pneumonia-analysis-of-the-spanish-national-hospital-discharge-database-from-2010-to-2014
#10
Javier de Miguel-Díez, Ana López-de-Andrés, Valentín Hernández-Barrera, Isabel Jiménez-Trujillo, Manuel Méndez-Bailón, José M de Miguel-Yanes, Benito Del Rio-Lopez, Rodrigo Jiménez-García
The aim of this study was to describe trends in the incidence and outcomes of ventilator-associated pneumonia (VAP) among hospitalized patients in Spain (2010-2014).This is a retrospective study using the Spanish national hospital discharge database from year 2010 to 2014. We selected all hospital admissions that had an ICD-9-CM code: 997.31 for VAP in any diagnosis position. We analyzed incidence, sociodemographic and clinical characteristics, procedures, pathogen isolations, and hospital outcomes.We identified 9336 admissions with patients suffering a VAP...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28746074/understanding-the-multidimensional-effects-of-resident-duty-hours-restrictions-a-thematic-analysis-of-published-viewpoints-in-surgery
#11
Katharine S Devitt, Michael J Kim, Lesley Gotlib Conn, Frances C Wright, Carol-Anne Moulton, Itay Keshet, Najma Ahmed
PURPOSE: Individuals representing various surgical disciplines have expressed concerns with the impact of resident duty hours (RDH) restrictions on resident education and patient outcomes. This thematic review of published viewpoints aimed to describe the effects of these restrictions in surgery. METHOD: The authors conducted a qualitative systematic review of non-research-based literature published between 2003 and 2015. Articles were included if they focused on the RDH restrictions in surgery and resident wellness, health promotion, resident safety, resident education and/or training, patient safety, medical errors, and/or heterogeneity regarding training or disciplines...
July 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28746028/the-kaiser-permanente-northern-california-enhanced-recovery-after-surgery-program-design-development-and-implementation
#12
Vincent X Liu, Efren Rosas, Judith C Hwang, Eric Cain, Anne Foss-Durant, Molly Clopp, Mengfei Huang, Alexander Mustille, Vivian M Reyes, Shirley S Paulson, Michelle Caughey, Stephen Parodi
Complications are common after surgery, highlighting the need for innovations that reduce postsurgical morbidity and mortality. In this report, we describe the design, development, and implementation of an Enhanced Recovery After Surgery program in the Kaiser Permanente Northern California integrated health care delivery system. This program was implemented and disseminated in 2014, targeting patients who underwent elective colorectal resection and those who underwent emergent hip fracture repair across 20 Medical Centers...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28745793/hypoxia-associated-biomarkers-in-lung-cancer-an-update
#13
W Cui, F Wu, L Ma
The high incidence rates of lung cancer have resulted in multiple progressions in cancer research leading to the development of novel therapeutic strategies. The three main branches of cancer research where improvements are being made are surgery, chemotherapy, and radiotherapy. These research developments have significantly improved the survival rates of cancer patients as most of these therapeutic options target specific molecules involved in cancer progression and metastasis. Experimental research has successfully identified potentially important molecules responsible for cancer progression...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28745442/modification-of-pedicle-lengthening-through-perforator-transposition-in-free-anterolateral-thigh-flaps-with-pedicle-size-discrepancy-a-case-report
#14
Hyun Ho Han, Daiwon Jun, Goo Hyun Mun, Suk-Ho Moon
In spite of thorough presurgical planning, emergency situations requiring longer pedicle length may arise during anterolateral thigh (ALT) free flap surgeries. While performing vessel graft for pedicle lengthening, discrepancy may occur because of a certain genetic predisposition or vascular variation at the anastomosis site of the graft vessel and the flap pedicle. A 76-year-old male patient with neurofibromatosis type I had a 15 x 10 cm defect, which was caused by radical excision of a malignant peripheral nerve sheath tumor on his back...
July 26, 2017: Microsurgery
https://www.readbyqxmd.com/read/28744976/patient-experiences-of-adjusting-to-life-in-the-first-2%C3%A2-years-after-bariatric-surgery-a-qualitative-study
#15
Y Graham, C Hayes, P K Small, K Mahawar, J Ling
There is currently little research into the experiences of those who have undergone bariatric surgery, or how surgery affects their lives and social interactions. Adopting a constructivist grounded theory methodological approach with a constant comparative analytical framework, semi-structured interviews were carried out with 18 participants (11 female, 7 male) who had undergone permanent bariatric surgical procedures 5-24 months prior to interview. Findings revealed that participants regarded social encounters after bariatric surgery as underpinned by risk...
July 26, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28743482/adult-congenital-heart-disease-in-greece-preliminary-data-from-the-challenge-registry
#16
G Giannakoulas, K Vasiliadis, A Frogoudaki, C Ntellos, A Tzifa, S Brili, A Manginas, M Papaphylactou, D Parcharidou, N Kampourides, A Pitsis, A Chamaidi, M Kolios, G Papadopoulos, A Douras, P Davlouros, D Ntiloudi, H Karvounis, A Kalangos, C Tsioufis, S Rammos
BACKGROUND: The majority of patients with congenital heart disease (CHD), nowadays, survives into adulthood and is faced with long-term complications. We aimed to study the basic demographic and clinical characteristics of adult patients with congenital heart disease (ACHD) in Greece. METHODS: A registry named CHALLENGE (Adult Congenital Heart Disease Registry. A registry from Hellenic Cardiology Society) was initiated in January 2012. Patients with structural CHD older than 16years old were enrolled by 16 specialized centers nationwide...
July 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28743315/tight-intra-operative-blood-pressure-control-versus-standard-care-for-patients-undergoing-hip-fracture-repair-hip-fracture-intervention-study-for-prevention-of-hypotension-hip-hop-trial-study-protocol-for-a-randomised-controlled-trial
#17
Iain Keith Moppett, Stuart White, Richard Griffiths, Donal Buggy
BACKGROUND: Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control...
July 25, 2017: Trials
https://www.readbyqxmd.com/read/28743149/-the-influence-of-anesthesia-on-perioperative-outcome-in-children-institutional-and-individual-factors
#18
Frank Fideler, Christian Grasshoff
The perioperative care of children is challenging for health care providers. Since anesthetists cannot affect the nature of the disease and have hardly an impact on the decision for surgery we summarized in this review individual and institutional factors for improving perioperative outcome by anesthetists. Individual factors include the level of education and the professional experience of the anesthetist as well as an anesthetic management that is focused on the maintenance of an adequate cerebral perfusion...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#19
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742704/racial-ethnic-disparities-in-longer-term-outcomes-among-emergency-general-surgery-patients-the-unique-experience-of-universally-insured-older-adults
#20
Cheryl K Zogg, Wei Jiang, Taylor D Ottesen, Shahid Shafi, Kevin Schuster, Robert Becher, Kimberly A Davis, Adil H Haider
OBJECTIVES: To determine whether racial/ethnic disparities in 30/90/180-day mortality, major morbidity, and unplanned readmissions exist among universally insured older adult (≥65 years) emergency general surgery patients; vary by diagnostic category; and can be explained by variations in geography, teaching status, age-cohort, and a hospital's percentage of minority patients. SUMMARY OF BACKGROUND DATA: As the US population ages and discussions surrounding the optimal method of insurance provision increasingly enter into national debate, longer-term outcomes are of paramount concern...
July 24, 2017: Annals of Surgery
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