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https://www.readbyqxmd.com/read/29330979/early-versus-delayed-laparoscopic-cholecystectomy-for-acute-cholecystitis
#1
Sadaf Khalid, Zahid Iqbal, Afsar Ali Bhatti
BACKGROUND: Laparoscopic cholecystectomy is considered the gold standard for the management of acute cholecystitis but controversy surrounds the timings of the surgery. Studies are available favouring both early and delayed laparoscopic cholecystectomy. The objective of this study was to compare early versus delayed laparoscopic cholecystectomy for acute cholecystitis. METHODS: This quasi-experimental study included 180 patients irrespective of their age and sex presented at department of Surgery, Lahore General Hospital between January to December 2014 with a diagnosis of acute cholecystitis were assigned randomly to early laparoscopic cholecystectomy within 24 h of admission or to initial conservative treatment followed by delayed laparoscopic cholecystectomy, 6-12 weeks later...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#2
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29324496/efficacy-of-ultrasound-guided-serratus-plane-block-on-postoperative-quality-of-recovery-and-analgesia-after-video-assisted-thoracic-surgery-a-randomized-triple-blind-placebo-controlled-study
#3
Do-Hyeong Kim, Young Jun Oh, Jin Gu Lee, Donghun Ha, Young Jin Chang, Hyun Jeong Kwak
BACKGROUND: The optimal regional technique for analgesia and improved quality of recovery after video-assisted thoracic surgery (a procedure associated with considerable postoperative pain) has not been established. The main objective in this study was to compare quality of recovery in patients undergoing serratus plane block (SPB) with either ropivacaine or normal saline on the first postoperative day. Secondary outcomes were analgesic outcomes, including postoperative pain intensity and opioid consumption...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29321129/novel-reversible-model-of-atherosclerosis-and-regression-using-oligonucleotide-regulation-of-the-ldl-receptor
#4
Debapriya Basu, Yunying Hu, Lesley-Ann Huggins, Adam E Mullick, Mark J Graham, Tomasz A Wietecha, Shelley L Barnhart, Allison Mogul, Katharina Pfeiffer, Andreas Zirlik, Edward A Fisher, Karin E Bornfeldt, Florian Willecke, Ira J Goldberg
Rationale: Animal models have been used to explore factors that regulate atherosclerosis. More recently, they have been used to study the factors that promote loss of macrophages and reduction in lesion size after lowering of plasma cholesterol levels. However, current animal models of atherosclerosis regression require challenging surgeries, time-consuming breeding strategies, and/or methods that block liver lipoprotein secretion. Objective: We sought to develop a more direct and time-effective method to create and then reverse hypercholesterolemia as well as atherosclerosis via transient knockdown of the hepatic LDL receptor (LDLR) followed by its rapid restoration...
January 10, 2018: Circulation Research
https://www.readbyqxmd.com/read/29319657/sciatic-nerve-entanglement-around-a-femoral-prosthesis-during-closed-reduction-of-a-dislocated-total-hip-prosthesis-the-role-of-metal-suppression-mri-a-case-report
#5
Zoe B Cheung, Anik V Patel, Nicholas DeBellis, Douglas B Unis, Carlos L Benitez
CASE: A 68-year-old woman who had undergone a right total hip arthroplasty presented with a right posterior hip dislocation, and subsequently developed an ipsilateral sciatic nerve palsy after closed reduction. Magnetic resonance imaging (MRI) with metal suppression demonstrated sciatic nerve entanglement around the prosthetic femoral neck. A sciatic nerve release was performed, resulting in poor early neurologic recovery. CONCLUSION: Sciatic nerve entanglement following closed reduction of a dislocated total hip prosthesis is a rare injury...
January 10, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29316845/rho-inhibitor-vx-210-in-acute-traumatic-subaxial-cervical-spinal-cord-injury-design-of-the-spinal-cord-injury-rho-inhibition-investigation-spring-clinical-trial
#6
Michael G Fehlings, Kee D Kim, Bizhan Aarabi, Marco Rizzo, Lisa M Bond, Lisa McKerracher, Alexander Vaccaro, David O Okonkwo
Traumatic spinal cord injury (SCI) is associated with a lifetime of disability stemming from loss of motor, sensory, and autonomic functions; these losses, along with increased comorbid sequelae, negatively impact health outcomes and quality of life. Early decompression surgery after SCI can enhance patient outcomes but does not directly facilitate neural repair and regeneration. Currently, there are no FDA-approved pharmacologic therapies to augment motor function and functional recovery in individuals with traumatic SCI...
January 9, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29315129/relative-contributions-of-adductor-canal-block-and-intrathecal-morphine-to-analgesia-and-functional-recovery-after-total-knee-arthroplasty-a-randomized-controlled-trial
#7
Abhijit Biswas, Anahi Perlas, Meela Ghosh, KiJinn Chin, Ahtsham Niazi, Barjind Pandher, Vincent Chan
BACKGROUND AND OBJECTIVES: Effective postoperative analgesia may enhance early rehabilitation after orthopedic surgery. This randomized double-blind trial investigates the relative contributions of adductor canal block and low-dose intrathecal morphine (ITM) to postoperative analgesia and functional recovery after total knee arthroplasty. METHODS: Two-hundred one patients undergoing elective unilateral total knee arthroplasty under spinal anesthesia were randomized to 3 groups...
January 9, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29313724/early-enteral-nutrition-is-associated-with-faster-post-esophagectomy-recovery-in-chinese-esophageal-cancer-patients-a-retrospective-cohort-study
#8
Hongyu Han, Meixia Pan, Yang Tao, Runzhong Liu, Zhiliang Huang, Korinne Piccolo, Caiyun Zhong, Ranyi Liu
We retrospectively examined a large cohort of esophageal carcinoma patients who received early enteral nutrition (EEN) to clarify the validity of EEN compared with total parenteral nutrition (TPN). Included were a total of 665 consecutive patients with histologically confirmed carcinoma of the esophagus or esophagogastric junction; and all patients underwent esophagectomy. The patients were divided into two groups: TPN (n = 262) and EEN (n = 403). The TPN group consisted of patients who only received intravenous nutrition support after operation...
January 9, 2018: Nutrition and Cancer
https://www.readbyqxmd.com/read/29311349/early-detection-of-subclinical-myocardial-damage-in-chronic-aortic-regurgitation-and-strategies-for-timely-treatment-of-asymptomatic-patients
#9
REVIEW
Joe K T Lee, Anna Franzone, Jonas Lanz, George C M Siontis, Stefan Stortecky, Christoph Gräni, Eva Roost, Stephan Windecker, Thomas Pilgrim
A series of hemodynamic and pathological responses occur in chronic aortic regurgitation, which eventually result in myocardial fibrosis and irreversible left ventricular dysfunction. According to guidelines, valvular surgery is recommended with the development of symptoms, left ventricular systolic dysfunction, or left ventricular dilatation. The optimal timing of surgical intervention has recently been questioned with documentation of irreversible myocardial damage resulting in incomplete left ventricular recovery and adverse clinical outcomes after surgery...
January 9, 2018: Circulation
https://www.readbyqxmd.com/read/29310504/the-effect-of-electromagnetic-fields-on-postoperative-pain-and-locomotor-recovery-in-dogs-with-acute-severe-thoracolumbar-intervertebral-disc-extrusion-a-randomized-placebo-controlled-prospective-clinical-trial
#10
Natalia Zidan, Joe Fenn, Emily Griffith, Peter J Early, Chris L Mariani, Karen R Munana, Julien Guevar, Natasha Olby
Spinal cord injury (SCI) due to acute intervertebral disc extrusions (IVDE) is common in dogs and is treated by surgical decompression. Dogs with sensorimotor complete injuries have an incomplete recovery. Pulsed electromagnetic fields (PEMF) reduce postoperative pain through anti-inflammatory effects and there is growing evidence for neuroprotective effects. This randomized, controlled clinical trial evaluated the effect of PEMF on post-operative pain and neurologic recovery in dogs with surgically treated sensorimotor complete SCI due to acute IVDE...
January 8, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29304735/effect-of-single-dose-dexmedetomidine-on-postoperative-recovery-after-ambulatory-ureteroscopy-and-ureteric-stenting-a-double-blind-randomized-controlled-study
#11
I I Shariffuddin, W H Teoh, S Wahab, C Y Wang
BACKGROUND: Ambulatory surgery has recently gain popularity, as it is a good method of optimizinghospital resources utilization. To support ambulatory surgery, anaesthetic goals nowrevolve around patients' early recovery with minimal pain and nausea, expedientdischarge home and prompt resumption of activities of daily living. In this study, weevaluated the effect of a single pre-induction dose of dexmedetomidine on anaestheticrequirements, postoperative pain and clinical recovery after ambulatory ureteroscopy andureteric stenting under general anaesthesia...
January 5, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29304004/effects-of-fluoxetine-on-hippocampal-neurogenesis-and-neuroprotection-in-the-model-of-global-cerebral-ischemia-in-rats
#12
Marina Khodanovich, Alena Kisel, Marina Kudabaeva, Galina Chernysheva, Vera Smolyakova, Elena Krutenkova, Irina Wasserlauf, Mark Plotnikov, Vasily Yarnykh
A selective serotonin reuptake inhibitor, fluoxetine, has recently attracted a significant interest as a neuroprotective therapeutic agent. There is substantial evidence of improved neurogenesis under fluoxetine treatment of brain ischemia in animal stroke models. We studied long-term effects of fluoxetine treatment on hippocampal neurogenesis, neuronal loss, inflammation, and functional recovery in a new model of global cerebral ischemia (GCI). Brain ischemia was induced in adult Wistar male rats by transient occlusion of three main vessels originating from the aortic arch and providing brain blood supply...
January 5, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29303803/postoperative-eras-interventions-have-the-greatest-impact-on-optimal-recovery-experience-with-implementation-of-eras-across-multiple-hospitals
#13
Mary-Anne Aarts, Ori D Rotstein, Emily A Pearsall, J Charles Victor, Allan Okrainec, Marg McKenzie, Stuart A McCluskey, Lesley Gotlib Conn, Robin S McLeod
BACKGROUND: Enhanced recovery after surgery (ERAS) programs incorporate evidence-based practices to minimize perioperative stress, gut dysfunction, and promote early recovery. However, it is unknown which components have the greatest impact. OBJECTIVE: This study aims to determine which components of ERAS programs have the largest impact on recovery for patients undergoing colorectal surgery. METHODS: An iERAS program was implemented in 15 academic hospitals...
January 4, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29302749/simultaneous-repair-of-congenital-heart-defects-and-pectus-excavatum-in-young-children
#14
Junke Wang, Quan Wang, Zhengxia Pan
PURPOSE: The present study was undertaken to summarize our experience with the concurrent repair of pectus excavatum (PE) and congenital heart defects in young children over the past 15 years. METHODS: A retrospective study was conducted that included patients who underwent combined repair of PE and a congenital heart defect in a large clinical center between 2002 and 2017. Intraoperative and postoperative patient characteristics, postoperative complications and surgical outcomes were recorded...
January 5, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29302723/second-generation-of-a-fast-track-liver-resection-programme
#15
Nicolai A Schultz, Peter N Larsen, B Klarskov, L M Plum, Hans-Jørgen Frederiksen, Henrik Kehlet, Jens G Hillingsø
BACKGROUND: Recent developments in perioperative pathophysiology and care have documented evidence-based, multimodal rehabilitation (fast-track) to hasten recovery and decrease morbidity and hospital stay in several major surgical procedures. The aim of this study was to investigate the effect over time of a modified previously published fast-track programme in unselected patients undergoing open or laparoscopic liver resection. METHODS: A prospective study includes the first 121 consecutive patients following an updated fast-track programme for liver resection...
January 4, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29298257/telephone-based-intervention-to-improve-rehabilitation-engagement-after-spinal-stenosis-surgery-a-prospective-lagged-controlled-trial
#16
Richard L Skolasky, Anica M Maggard, Stephen T Wegener, Lee H Riley
BACKGROUND: Spine surgery outcomes are variable. Patients who participate in and take responsibility for their recovery have improved health outcomes. Interventions to increase patient involvement in their care may improve health outcomes after a surgical procedure. We conducted a prospective interventional trial to compare the effectiveness of health behavior change counseling with usual care to improve health outcomes after lumbar spine surgical procedures. METHODS: In this study, 122 patients with lumbar spinal stenosis undergoing a decompression surgical procedure from December 2009 through August 2012 were enrolled...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29289365/thoracoscopic-versus-transaxillary-approach-to-first-rib-resection-in-thoracic-outlet-syndrome
#17
Henrik Nuutinen, Teemu Riekkinen, Voitto Aittola, Kimmo Mäkinen, Jussi M Kärkkäinen
BACKGROUND: This study assessed the feasibility of fully endoscopic thoracoscopic first rib resection (FRR) in the treatment of neurogenic thoracic outlet syndrome by comparing early outcomes of the thoracoscopic technique against the traditional transaxillary FRR. METHODS: Between 2009 and 2016, 60 consecutive FRRs were performed on 47 patients with neurogenic thoracic outlet syndrome (13 bilateral procedures). The first 30 procedures were performed using the traditional transaxillary technique, and the novel thoracoscopic technique was used in the next 30 operations with the same indications for operative repair...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29288312/factors-predicting-the-recovery-of-unilateral-vocal-fold-paralysis-after-thyroidectomy
#18
Yong-Sug Choi, Young-Hoon Joo, Young-Hak Park, Sang-Yeon Kim, Dong-Il Sun
BACKGROUND: We used voice analysis and clinicopathological factors to explore the prognosis of unilateral vocal fold paralysis after thyroid surgery. METHODS: The medical records of 63 females who developed unilateral vocal fold paralysis after thyroidectomy were reviewed. All patients were divided into two groups: those who recovered from vocal fold paralysis and those who did not. We analyzed clinical parameters and voice analysis results in a search for correlations with recovery from paralysis...
December 30, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29285101/proteomic-changes-of-cd4-cd25-forkhead-box-p3-regulatory-t-cells-in-a-30-day-rat-model-of-sepsis-survival
#19
Yuxia Jiao, Siqi Tan, Junyu Xiong
Sepsis is defined as life threatening organ dysfunction arising from a dysregulated host response to infection. The outcomes of sepsis include early mortality, delayed mortality and recovery, and depend on the inflammatory response. Previous studies have demonstrated that regulatory T cells (Tregs) are important in determining the outcome of sepsis, as their suppressive function serves a role in maintaining immune homeostasis. However, Treg-mediated immunosuppression during the course of sepsis remains unclear and little is known about the survival of patients following diagnosis...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29284879/a-comparison-of-dexmedetomidine-and-clonidine-in-attenuating-the-hemodynamic-responses-at-various-surgical-stages-in-patients-undergoing-elective-transnasal-transsphenoidal-resection-of-pituitary-tumors
#20
Summaira Jan, Zulfiqar Ali, Yasir Nisar, Imtiaz Ahmad Naqash, Syed Amer Zahoor, Shabir Ahmad Langoo, Khan Azhar
Background: Transsphenoidal approach to pituitary tumors is a commonly performed procedure with the advantage of a rapid midline access to the sella with minimal complications. It may be associated with wide fluctuations in hemodynamic parameters due to intense noxious stimulus at various stages of the surgery. As duration of the surgery is short and the patients have nasal packs, it is prudent to use an anesthestic technique with an early predictable recovery. Materials and Methods: A total of 60 patients of either sex between 18 and 65 years of age, belonging to the American Society of Anesthesiologists I and II who were undergoing elective transnasal transsphenoidal pituitary surgery were chosen for this study...
October 2017: Anesthesia, Essays and Researches
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