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https://www.readbyqxmd.com/read/28324874/strategies-and-outcomes-of-repeat-mitral-valve-interventions-after-failed-mitraclip-therapy
#1
Carmelo Grasso, Sergio Buccheri, Davide Capodanno, Antonio Popolo Rubbio, Maria Elena Di Salvo, Salvatore Scandura, Sarah Mangiafico, Tatiana Salerno, Stefano Cannata, Veronica Dezio, Giuseppe Castania, Marco Barbanti, Piera Capranzano, Corrado Tamburino
Percutaneous mitral valve repair (PMVR) with the MitraClip system (Abbott Vascular, Santa Clara, CA, USA) is a valid therapeutic option for patients with severe mitral regurgitation (MR) deemed to be at high or prohibitive surgical risk. Despite the reassuring data on efficacy and long-term durability of the procedure, the proportion of patients with residual or relapsing severe MR after MitraClip therapy is not negligible. In light of the detrimental prognostic impact of severe MR, repeat interventions are increasingly performed in clinical practice using different techniques...
March 22, 2017: Cardiology
https://www.readbyqxmd.com/read/28324802/pelvic-exenteration-case-series-a-single-surgeon-s-experience-at-one-institution-in-trinidad-and-tobago
#2
Ravi Maharaj, Vandana Devika Sookdeo, Maurice Fortuné, Meenakshi Akhilesh, Chalapathi Rao Adidam Venkata, Wayne Mohammed, Dave Harnanan, Wayne A Warner
INTRODUCTION: Pelvic exenteration (PE) is an ultra-radical surgical procedure characterized by the en bloc resection of the pelvic organs. METHODS: In this case series, we report retrospectively on four patients who underwent PE in Trinidad and Tobago from 2012 to 2016. One male patient had rectal cancer while one each of three women had cervical, colon, or rectal cancer. RESULTS: Early postoperative complications (≤30days) occurred in all patients, while late complications (>30days) occurred in one patient (Grade 1 - Clavien-Dindo classification)...
March 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28324681/morphometric-mri-features-are-associated-with-surgical-outcome-in-mesial-temporal-lobe-epilepsy-with-hippocampal-sclerosis
#3
Maria Teresa Fernandes Castilho Garcia, Larissa Botelho Gaça, Gabriel Barbosa Sandim, Idaiane Batista Assunção Leme, Henrique Carrete, Ricardo Silva Centeno, João Ricardo Sato, Elza Márcia Targas Yacubian
PURPOSE: Corticoamygdalohippocampectomy (CAH) improves seizure control, quality of life, and decreases mortality for refractory mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). One-third of patients continue having seizures, and it is pivotal to determine structural abnormalities that might influence the postoperative outcome. Studies indicate that nonhippocampal regions may play a role in the epileptogenic network in MTLE-HS and could generate seizures postoperatively...
March 1, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28324327/lumbar-disc-replacement-surgery-successes-and-obstacles-to-widespread-adoption
#4
REVIEW
Stephan N Salzmann, Nicolas Plais, Jennifer Shue, Federico P Girardi
PURPOSE OF REVIEW: Lumbar disc replacement has been a surgical alternative to fusion surgery for the treatment of lumbar degenerative disc disease (DDD) for many years. Despite enthusiasm after the approval of the first devices, implantation rates have remained low, especially in the USA. The goal of this review is to provide a general overview of lumbar disc replacement in order to comprehend the successes and obstacles to widespread adoption. RECENT FINDINGS: Although a large amount of evidence-based data including satisfactory long-term results is available, implantation rates in the USA have not increased in the last decade...
March 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28324284/nonoperative-management-or-watch-and-wait-for-rectal-cancer-with-complete-clinical-response-after-neoadjuvant-chemoradiotherapy-a-critical-appraisal
#5
Tarik Sammour, Brandee A Price, Kate J Krause, George J Chang
BACKGROUND: There is increasing interest in nonoperative management (NOM) for rectal cancer with complete clinical response (cCR) after neoadjuvant chemoradiation (nCRT). OBJECTIVE: The aim of this systematic review was to summarize the available data on NOM, with the intention of formulating standardized protocols on which to base future investigations. METHODS: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted...
March 21, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28324266/quality-of-life-in-patients-with-recurrent-breast-cancer-after-second-breast-conserving-therapy-in-comparison-with-mastectomy-the-german-experience
#6
Svenja Jendrian, Katharina Steffens, Barbara Schmalfeldt, Elena Laakmann, Corinna Bergelt, Isabell Witzel
BACKGROUND: Although some studies suggest that breast-conserving therapy (BCT) shows better psychosocial outcomes than mastectomy in patients with primary breast cancer, little is known about the outcomes of these surgical options in recurrent breast cancer. We investigated differences in overall survival and re-recurrence rates as well as psychosocial outcomes among patients who underwent BCT or mastectomy after the diagnosis of recurrent breast cancer in a single-center setting. METHODS: 124 of 186 eligible patients who underwent surgical treatment for breast cancer recurrence completed the questionnaires on quality of life (EORTC QLQ-C30 and -BR23), fear of progression (PA-F-KF), anxiety and depression (HADS), and body image (BIS)...
March 21, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28324232/reducing-surgical-site-infections-following-total-hip-and-knee-arthroplasty-an-israeli-experience
#7
R Finkelstein, O Eluk, T Mashiach, D Levin, B Peskin, G Nirenberg, S Karkabi, M Soudri
PURPOSE: To assess the changes observed in surgical site infection (SSI) rates following total joint arthroplasty (TJA) after the introduction of an infection control programme and evaluate the risk factors for the development of these infections. DESIGN: Prospective cohort study. SETTING: Large tertiary medical centre in Israel. METHODS: Data about SSIs and potential prophylaxis-, patient-, and procedure-related risk factors were collected for all patients who underwent elective total hip and total knee arthroplasty during the study period...
March 21, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28324187/frontal-burr-hole-approach-for-neuroendoscopic-resection-of-craniopharyngioma-with-the-nico-myriad-device-report-of-two-cases
#8
Reilin J Moore, Andrea Scherer, Daniel H Fulkerson
OBJECTIVE: Craniopharyngiomas are challenging tumors to resect due to their deep location and proximity to vital structures. The perceived benefit of gross total resection may be tempered by the possibility of permanent disability. Minimally invasive techniques may reduce surgical morbidity while still allowing effective resection. The authors describe their initial experience with a neuroendoscopic transcortical, transventricular approach to two craniopharyngiomas. The surgeries were performed through a right frontal burr hole using the NICO Myriad, a side-cutting, aspiration device that fits through the working channel of a standard neuroendoscope...
March 21, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28324183/multimodality-management-and-outcomes-of-brain-arterio-venous-malformations-avms-in-children-personal-experience-and-review-of-the-literature-with-specific-emphasis-on-age-at-first-avm-bleed
#9
REVIEW
Anan Shtaya, John Millar, Owen Sparrow
PURPOSE: The purpose of this paper is to study the presentation and analyse the results of multimodality treatment of brain arterio-venous malformations (AVMs) in children at our centre and review age at first AVM rupture in the literature. METHODS: Of 52 patients aged <18 years, 47 with brain AVMs (27 males and 20 females) aged 4-17 years (mean 12.2) were retrospectively reviewed. PubMed search revealed five additional studies including 267 patients where the prevalence of age-related AVMs rupture was analysed...
March 21, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28323804/transtibial-amputation-outcomes-study-taos-comparing-transtibial-amputation-with-and-without-a-tibiofibular-synostosis-ertl-procedure
#10
Michael J Bosse, Saam Morshed, Lisa Reider, William Ertl, James Toledano, Reeza Firoozabadi, Rachel B Seymour, Eben Carroll, Daniel O Scharfstein, Barbara Steverson, Ellen J MacKenzie
The optimal technique for a transtibial amputation in a young, active, and healthy patient is controversial. Proponents of the Ertl procedure (in which the cut ends of the tibia and fibula are joined with a bone bridge synostosis) argue that the residual limb is more stable which confers better prosthetic fit and improved function especially among high-performing individuals. At the same time, the Ertl procedure is associated with longer operative and healing time and may be associated with a higher complication rate compared with the standard Burgess procedure...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#11
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323788/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#12
Leah Carey Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura Bruce Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multicenter retrospective cohort study was performed across three Level I trauma centers encompassing traumatic colon injuries from January 2006 through June 2014...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28323717/treatment-of-lumbar-split-fracture-dislocation-with-short-segment-or-long-segment-posterior-fixation-and-anterior-fusion
#13
Fei Chen, Yijun Kang, Haisheng Li, Guohua Lv, Chang Lu, Jing Li, Bing Wang, Weihua Chen, Zhehao Dai
STUDY DESIGN: Retrospective analysis of 16 patients. SUMMARY OF BACKGROUND DATA: The lumbar split fracture-dislocation is a rare but severe injury, which is type C1.2.1 fracture in the Association for the Study of Internal Fixation spine fracture classification. The axial compressive and torsional force shattered the vertebral body into 2 halves and displaced them rotationally. This kind of fracture is so highly unstable that the treatment is very challenging. PURPOSE: The purpose of this study was to report and compare on clinical outcome and complications of patients with lumbar split fracture-dislocation which had been treated either short-segment or long-segment posterior fixation and anterior fusion...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323711/effect-of-bone-cement-volume-fraction-on-adjacent-vertebral-fractures-after-unilateral-percutaneous-kyphoplasty
#14
Dasheng Lin, Jianming Hao, Lin Li, Lei Wang, Huantang Zhang, Weitao Zou, Kejian Lian
STUDY DESIGN: A retrospective study. SUMMARY OF BACKGROUND DATA: Complications of the bone cement used in vertebroplasty and kyphoplasty procedures have received increasingly more attention, especially for bone cement volume. OBJECTIVE: The aim of the study was to retrospectively assess the relationship between bone cement volume fraction and adjacent vertebral fracture (AVF) after unilateral percutaneous kyphoplasty (PKP). MATERIALS AND METHODS: Between 2006 and 2011, 495 patients with single-level osteoporotic vertebral compression fracture (OVCF) were surgically treated by unilateral PKP and had completed 12-month follow-up in our hospital...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323709/single-stage-transpedicular-vertebrectomy-and-expandable-cage-placement-for-treatment-of-unstable-mid-and-lower-lumbar-burst-fractures
#15
Jong-Il Choi, Bum-Joon Kim, Sung-Kon Ha, Sang-Dae Kim, Dong-Jun Lim, Se-Hoon Kim
STUDY DESIGN: Retrospective clinical and radiographic study. OBJECTIVE: To examine the efficacy and safety of vertebrectomy and expandable cage placement by a single-stage posterior approach for unstable mid and lower lumbar burst fractures (below the L3). SUMMARY OF BACKGROUND DATA: Patients with unstable mid and lower lumbar burst fractures require surgical treatment to relieve pain, address paralysis, and stabilize the spine to prevent further segmental deformity...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323706/comparison-of-open-versus-percutaneous-pedicle-screw-fixation-using-the-sextant-system-in-the-treatment-of-traumatic-thoracolumbar-fractures
#16
Hongwei Wang, Yue Zhou, Changqing Li, Jun Liu, Liangbi Xiang
STUDY DESIGN: We retrospectively reviewed 100 patients who were posterior stabilized without graft fusion. Using the Sextant system, 22 patients underwent minimally invasive short-segment 4-pedicle screw fixation (MIF4) and 39 patients underwent minimally invasive short-segment combined with intermediate screws fixation, that is, 6-pedicle screw fixation (MIF6). The conventional open posterior short-segment 4-pedicle screw fixation (OPF4) technique was used in 39 patients. OBJECTIVE: To evaluate the feasibility, safety, and efficacy of percutaneous pedicle screw fixation using the Sextant system in the treatment of traumatic thoracolumbar fractures compared with the conventional open posterior short-segment pedicle screw fixation technique...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323694/assessment-of-paraspinal-muscle-cross-sectional-area-after-lumbar-decompression-minimally-invasive-versus-open-approaches
#17
Lacey E Bresnahan, Justin S Smith, Alfred T Ogden, Steven Quinn, George R Cybulski, Narina Simonian, Raghu N Natarajan, Richard D Fessler, Richard G Fessler
STUDY DESIGN: A retrospective, blinded analysis of imaging studies. SUMMARY OF BACKGROUND DATA: To evaluate changes in paraspinal muscle cross-sectional area (CSA) after surgical treatment for lumbar stenosis and to compare these changes between minimally invasive and standard open approaches. The open approach to lumbar stenosis is effective, but it involves retraction and resection of muscle from the spinous process, which can result in ischemia and denervation of paraspinal musculature and may lead to muscle atrophy and pain...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#18
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#19
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323644/pediatric-acute-compartment-syndrome
#20
Kristin S Livingston, Michael P Glotzbecker, Benjamin J Shore
Pediatric acute compartment syndrome (PACS) is a clinical entity that must be carefully differentiated from the adult version (ie, acute compartment syndrome). Healthcare providers must understand the variable etiologies of PACS, of which trauma is the most common but can also include vascular insult, infection, surgical positioning, neonatal phenomena, overexertion, and snake and insect bites. In addition to the unique etiologies of PACS, providers must also recognize the different signs and symptoms of PACS...
March 17, 2017: Journal of the American Academy of Orthopaedic Surgeons
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