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https://www.readbyqxmd.com/read/29140948/hypertonic-saline-resuscitation-following-emergent-laparotomy-and-temporary-abdominal-closure
#1
Tyler J Loftus, Philip A Efron, Trina M Bala, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Our objective was to establish the safety of 3% hypertonic saline (HTS) resuscitation for trauma and acute care surgery patients undergoing emergent laparotomy and temporary abdominal closure (TAC) with the hypothesis that HTS administration would be associated with hyperosmolar hypercholoremic acidosis, lower resuscitation volumes, and higher fascial closure rates, without adversely affecting renal function. METHODS: We performed a retrospective cohort analysis of 189 trauma and acute care surgery patients who underwent emergent laparotomy and TAC, comparing patients with normal baseline renal function who received 3% HTS at 30 mL/h (n=36) to patients with standard resuscitation (n=153) by baseline characteristics, resuscitation parameters, and outcomes including primary fascial closure and KDIGO stages of acute kidney injury...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29138794/noninvasive-cardiac-testing-vs-clinical-evaluation-alone-in-acute-chest-pain-a-secondary-analysis-of-the-romicat-ii-randomized-clinical-trial
#2
Samuel W Reinhardt, Chien-Jung Lin, Eric Novak, David L Brown
Importance: The incremental benefit of noninvasive testing in addition to clinical evaluation (history, physical examination, an electrocardiogram [ECG], and biomarker assessment) vs clinical evaluation alone for patients who present to the emergency department (ED) with acute chest pain is unknown. Objective: To examine differences in outcomes with clinical evaluation and noninvasive testing (coronary computed tomographic angiography [CCTA] or stress testing) vs clinical evaluation alone...
November 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29138760/cardiac-surgery-after-heart-transplantation-elective-operation-or-last-exit-strategy
#3
Johannes Goekler, Andreas Zuckermann, Emilio Osorio, Faris F Brkic, Keziban Uyanik-Uenal, Guenther Laufer, Arezu Aliabadi-Zuckermann
Background: Because of improved long-term survival after heart transplantation (HTx), late graft pathologies such as valvular disease or cardiac allograft vasculopathy (CAV) might need surgical intervention to enhance longer survival and ensure quality of life. To this date, there exist no guidelines for indication of cardiac surgery other than retransplantation after HTx. Methods: In this retrospective, single-center study, we evaluated patients who underwent cardiac surgery after HTx at our institution...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29138380/-three-patients-with-gastric-cancer-who-underwent-surgery-during-ramucirumab-treatment
#4
Hayato Omori, Sadayuki Kawai, Rie Makuuchi, Tomoyuki Irino, Masanori Tokunaga, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Hirofumi Yasui, Masanori Terashima
According to the REGARD and RAINBOW trials, ramucirumab(RAM)was introduced as second-line therapy for advanced or metastatic gastric cancer. RAM may impair wound healing due to the inhibition of angiogenesis; details on the postoperative course of patients who underwent surgery during RAM treatment remain unclear. Between 2011 and 2016, 93 patients with incurable gastric cancer were treated with RAM in our institute. Among them, 3 patients underwent surgery after RAM treatment. Case 1: A 74-year-old man with liver metastasis from gastric cancer was treated with a paclitaxel(PTX)plus RAM regimen...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29137023/a-case-report-of-schatzker-type-vi-tibial-plateau-fracture-treated-with-double-reverse-traction-closed-reduction-combined-with-minimally-invasive-percutaneous-plate-osteosynthesis-technique-a-case-report
#5
Dian-Qing Li, De-Ye Song, Jiang-Dong Ni, Mu-Liang Ding, Jun Huang
RATIONALE: The knee joint is an important weight-bearing joint, tibial plateau fractures affect knee function and stability. High-energy intra-articular fractures involving the tibial plateau can cause management-related problems such as wound dehiscence; severe comminution leading to malalignment; and delayed complications such as varus collapse, implant failure, and arthritis of the knee joint. The treatment of severe or complex tibial plateau fractures can be quite difficult. Traditional methods of open reduction and plating require extensive exposures, which may further compromise soft tissue and devascularize bone fragments, leading to infection...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136990/reply-seasonal-variation-in-emergency-general-surgery-why-is-february-underrepresented
#6
Bellal Joseph, Peter Rhee, Bardiya Zangbar
No abstract text is available yet for this article.
December 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29136989/seasonal-variation-in-emergency-general-surgery-why-is-february-underrepresented
#7
Robert Martin Eisele, Jochen Schuld
No abstract text is available yet for this article.
December 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29135566/management-of-hypertonia-in-cerebral-palsy
#8
Nickolas J Nahm, H Kerr Graham, Mark E Gormley, Andrew G Georgiadis
PURPOSE OF REVIEW: The review provides an update on the treatment of hypertonia in cerebral palsy, including physical management, pharmacotherapy, neurosurgical, and orthopedic procedures. RECENT FINDINGS: Serial casting potentiates the effect of Botulinum neurotoxin A injections for spasticity. Deep brain stimulation, intraventricular baclofen, and ventral and dorsal rhizotomy are emerging tools for the treatment of dystonia and/or mixed tone. The long-term results of selective dorsal rhizotomy and the timing of orthopedic surgery represent recent advances in the surgical management of hypertonia...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29135529/acute-coronary-artery-thrombus-after-tranexamic-acid-during-total-shoulder-arthroplasty-in-a-patient-with-coronary-stents-a-case-report
#9
Kathryn H Bridges, Sylvia H Wilson
Tranexamic Acid (TXA), an antifibrinolytic, is routinely used to decrease transfusion rates in total joint replacement surgery. While recent publications have indicated a low risk of TXA-associated thromboembolic events in this orthopedic population, few studies specifically address the safety of TXA administration in high-risk patients. We present a case of acute coronary thrombus requiring emergent intervention in a patient with indwelling coronary stents who underwent shoulder arthroplasty with TXA administration...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29134536/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-3-coronary-artery-bypass-surgery
#10
Aya Saito, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
OBJECTIVE AND METHODS: Data on isolated coronary artery bypass grafting (CABG) performed in 2013 and 2014, and registered in the Japan Cardiovascular Surgery Database were reviewed for preoperative characteristics, postoperative outcomes, and choice of graft material for the left anterior descending artery (LAD). RESULTS: Isolated CABG was performed off-pump in 54.7% of cases, and graft material for the LAD was left internal thoracic artery in 74.3% and right internal thoracic artery in 15...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29133112/persistent-abdominal-pain-after-laparoscopic-cholecystectomy-is-associated-with-increased-healthcare-consumption-and-sick-leave
#11
Sarah Z Wennmacker, Marcel G W Dijkgraaf, Gert P Westert, Joost P H Drenth, Cornelis J H M van Laarhoven, Philip R de Reuver
BACKGROUND: Although, 33% to 40% of symptomatic gallstone patients reported persistent abdominal pain after laparoscopic cholecystectomy, there is no data on the burden of this pain to the healthcare system and society at large. This study determined healthcare consumption, sick leave, and costs in patients with persistent abdominal pain after laparoscopic cholecystectomy. Secondly, predictive factors for healthcare consumption were assessed. METHODS: This cross-sectional study included all 146 patients with persistent abdominal pain (patient-reported on Gastro-Intestinal Quality of Life Index (score 0-3) 24 weeks after laparoscopic cholecystectomy, derived from a previous prospective cohort...
November 10, 2017: Surgery
https://www.readbyqxmd.com/read/29133083/jejunal-diverticulitis-review-and-treatment-algorithm
#12
Houssem Harbi, Nizar Kardoun, Sami Fendri, Nouha Dammak, Nozha Toumi, Ahmed Guirat, Rafik Mzali
Diverticulitis is much less common in the jejunum than in colonic diverticula probably because of diverticulum larger size, better intra-luminal flow and relatively sterile jejunal content. Complications of jejunal diverticulitis are acute intestinal obstruction, diverticular bleeding and mainly perforation with mesenteric abscess, localized or generalized peritonitis. The Multi-detector row computed tomography is now the best diagnostic imaging for small bowel diverticulitis as well as its complications. Magnetic resonance enterography is also quite useful but it is still impractical to resort to such an imaging in an abdominal emergency...
November 10, 2017: La Presse M├ędicale
https://www.readbyqxmd.com/read/29133070/percutaneous-treatment-for-native-mitral-regurgitation
#13
REVIEW
Paul Sorajja, Francesco Maisano
Severe mitral regurgitation (MR) confers an adverse prognosis, frequently with debilitating symptoms of heart failure. While open surgical correction has been the standard of care for decades, novel catheter-based technologies have emerged that are highly effective in the treatment of MR. These percutaneous technologies, which include methods for both repair as well as valve replacement, have the potential to address unmet clinical needs in patients with MR, and serve as a viable alternative to surgery.
November 10, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29132702/neutrophil-lymphocyte-ratio-prognostic-impact-in-heart-surgery-early-outcomes-and-late-survival
#14
Shuli Silberman, Ulfat Abu-Yunis, Rachel Tauber, Linda Shavit, Tal Grenader, Daniel Fink, Daniel Bitran, Ofer Merin
BACKGROUND: The neutrophil-lymphocyte ratio (NLR) is a recognized marker of inflammation associated with poor outcomes in various clinical situations. We analyzed the prognostic significance of preoperative elevated NLR in patients undergoing cardiac surgery. METHODS: We performed a retrospective review of 3,027 consecutive patients undergoing cardiac surgery. Receiver-operating-characteristic was used to determine the cutoff value for elevated NLR. Multivariate regression was used to determine the predictive value of preoperative NLR on clinical outcomes...
November 10, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132646/should-they-stay-or-should-they-go-now-exploring-the-impact-of-team-familiarity-on-interprofessional-team-training-outcomes
#15
Kavita Joshi, Jessica Hernandez, Joseph Martinez, Kareem AbdelFattah, Aimee K Gardner
INTRODUCTION: Although simulation is an effective method for enhancing team competencies, it is unclear how team familiarity impacts this process. We examined how team familiarity impacted team competencies. METHODS: Trainees were assigned to stable or dynamic teams to participate in three simulated cases. Situation awareness (SA) data was collected through in-scenario freezes. The recorded performances were assessed for clinical effectiveness (ClinEff) and teamwork...
November 4, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29132477/elective-division-of-ilioinguinal-nerve-in-inguinal-hernioplasty-remedy-for-the-morbid-postoperative-inguinal-pain
#16
Muhammad Danish Muneeb, Mirza Aga Naushad Baig
OBJECTIVE: To compare the postoperative pain in inguinal hernioplasty, by preserving versus wide elective division of ilioinguinal nerve. STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: Surgical Department, Civil Hospital, Karachi, from January till August 2015. METHODOLOGY: All patients of either gender above 15 years of age, undergoing mesh repair for unilateral, reducible inguinal hernia, were included...
November 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29131778/adventures-and-misadventures-in-plastic-surgery-and-soft-tissue-implants
#17
Dana J Lin, Tony T Wong, Gina A Ciavarra, Jonathan K Kazam
Soft-tissue augmentation and implants are increasingly seen by the radiologist as more techniques emerge for a variety of indications and locations. Some surgical and implant procedures are performed for purely cosmetic reasons in otherwise healthy patients seeking to improve their body image, and some are performed for reconstruction after cancer or other chronic illnesses. Abdominoplasty, liposuction, and autologous fat grafting can be performed for abdominal and gluteal contouring. Injection of liquid injectable silicone has historically been fraught with legal issues, although it continues to be used for augmentation in a variety of anatomic locations...
November 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29131754/perioperative-local-and-systemic-warming-in-surgical-site-infection-a-systematic-review-and-meta-analysis
#18
K Ousey, K-L Edward, S Lui, J Stephenson, K Walker, J Duff, D Leaper
OBJECTIVE: Surgical site infection (SSI) is a common cause of postoperative morbidity. Perioperative hypothermia may contribute to surgical complications including increased risk of SSI. In this systematic review and meta-analysis, the effectiveness of active and passive perioperative warming interventions to prevent SSI was compared with standard (non-warming) care. METHOD: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register, and The Cochrane Central Register of Controlled Trials were searched, with no restrictions on language, publication date or study setting for randomised controlled trials (RCTs) and cluster RCTs...
November 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29130616/emergency-extracorporeal-membrane-oxygenation-in-transcatheter-aortic-valve-implantation-a-two-center-experience-of-incidence-outcome-and-temporal-trends-from-2010-to-2015
#19
Teresa Trenkwalder, Costanza Pellegrini, Andreas Holzamer, Alois Philipp, Tobias Rheude, Jonathan Michel, Wibke Reinhard, Michael Joner, Albert M Kasel, Adnan Kastrati, Heribert Schunkert, Dierk Endemann, Kurt Debl, N Patrick Mayr, Michael Hilker, Christian Hengstenberg, Oliver Husser
BACKGROUND: Although the incidence of periprocedural complications has decreased in transcatheter aortic valve implantation (TAVI), life-threatening complications occur and emergency veno-arterial extracorporeal membrane oxygenation (vaECMO) can provide immediate circulatory stabilization. We report our two-center experience of vaECMO during life-threatening complications in TAVI. METHODS: From January 2010 to December 2015, 1,810 consecutive patients underwent TAVI at two centers...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130506/animal-models-of-acquired-epilepsy-insights-into-mechanisms-of-human-epileptogenesis
#20
Albert J Becker
In many patients who suffer from epilepsies, recurrent epileptic seizures do not start at birth but develop later in life. This holds particularly true for epilepsies with a focal seizure origin including focal cortical dysplasias (FCDs) and temporal lobe epilepsy (TLE). TLE most frequently has its seizure onset in the hippocampal formation. Hippocampal biopsies of pharmacoresistant TLE patients undergoing epilepsy surgery for seizure control most frequently reveal the damage pattern of hippocampal sclerosis, i...
November 12, 2017: Neuropathology and Applied Neurobiology
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