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https://www.readbyqxmd.com/read/28927211/a-pivotal-randomized-clinical-trial-evaluating-the-safety-and-effectiveness-of-a-novel-hydrogel-dural-sealant-as-an-adjunct-to-dural-repair
#1
Michael J Strong, G Alexander West, Henry Woo, Daniel E Couture, John A Wilson, Lorenzo F Munoz, Charles L Rosen, Jeremy D Greenlee, Harry R van Loveren, Mark Iantosca, Clinton J Baird, Mark Smith, Matt McGirt, Jonathan Parish, Anthony L Asher
BACKGROUND: A watertight dural repair is critical to minimizing the risk of postoperative complications secondary to cerebrospinal fluid (CSF) leaks. OBJECTIVE: To evaluate the safety and efficacy of a novel hydrogel, Adherus Dural Sealant, when compared with control, DuraSeal Dural Sealant System, as an adjunct to standard methods of dural repair. METHODS: In this 17-center, prospective, randomized clinical trial designed as a noninferiority, single-blinded study, 124 patients received Adherus Dural Sealant (test sealant) and 126 received DuraSeal (control)...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28927207/surgical-approaches-to-the-temporal-horn-an-anatomic-analysis-of-white-matter-tract-interruption
#2
Paulo A S Kadri, Jean G de Oliveira, Niklaus Krayenbühl, Ugur Türe, Evandro P L de Oliveira, Ossama Al-Mefty, Guilherme C Ribas
BACKGROUND: Surgical access to the temporal horn is necessary to treat tumors and vascular lesions, but is used mainly in patients with mediobasal temporal epilepsy. The surgical approaches to this cavity fall into 3 primary categories: lateral, inferior, and transsylvian. The current neurosurgical literature has underestimated the interruption of involved fiber bundles and the correlated clinical manifestations. OBJECTIVE: To delineate the interruption of fiber bundles during the different approaches to the temporal horn...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28927188/measuring-the-quality-of-perioperative-care-in-cardiac-surgery
#3
Tim G Coulson, Daniel V Mullany, Christopher M Reid, Michael Bailey, David Pilcher
Quality of care is of increasing importance in health and surgical care. In order to maintain and improve quality, we must be able to measure it and identify variation. In this narrative review, we aim to identify measures used in the assessment of quality of care in cardiac surgery and to evaluate their utility. The electronic databases Pubmed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, and CINAHL were searched for original published studies using the terms 'cardiac surgery' and 'quality or outcome or process or structure' as either keywords in the title or text or MeSH terms...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28927136/low-risk-population-among-patients-with-tumor-node-metastasis-stage-iii-iv-oral-squamous-cell-carcinoma
#4
Tohru Ikeda, Sachiko Seki, Mutsunori Fujiwara, Masaaki Matsuura, Yuu Ozaki-Honda, Shuichi Fujita, Hisazumi Ikeda, Masahiro Umeda, Izumi Asahina
A novel system auxiliary to the Union for International Cancer Control classification may allow the prognosis of patients with malignant tumors at similar stages to be predicted, as currently this is challenging. The present study generated a novel system to predict populations at low risk among patients with stage III/IV oral squamous cell carcinoma (OSCC). A total of 41 patients who were diagnosed at stages III/IV OSCC and underwent surgical tumor resection were analyzed. Band-like or follicular lymphocyte infiltration, intraepithelial micro-abscess formation and natural killer (NK) cell infiltration were histopathologically evaluated...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28927041/anastomosis-in-the-absence-of-a-suprahyoid-release-following-circumferential-sleeve-resection-is-feasible-in-differentiated-thyroid-carcinoma-patients-with-tracheal-invasion
#5
Wanjun Chen, Shujuan Zou, Liang Wang, Changhua Wu, Zhiqi Wang, Ke Li, Shuguang Zhang
Invasion of the trachea is observed in ~6% of patients with differentiated thyroid carcinoma (DTC), and surgery is accepted as the treatment of choice. However, surgical procedures can be challenging and are associated with various risks. The authors of the present study performed a retrospective study of patients with DTC and tumor invasion of the trachea. Outcomes from patients that received circumferential sleeve resection (CSR) of the trachea followed by anastomosis in the absence of suprahyoid release (n=21; CSR group) and patients that underwent tangential resections [n=103; tangential 'shave' resection (TSR) group) were analyzed...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28927038/effects-of-neoadjuvant-chemotherapy-combined-with-radiotherapy-in-patients-with-advanced-esophageal-carcinoma
#6
Yu Liu, Deyao Xie, Chang Li, Chaoxi Lin, Jun Zhao
We analyzed the improvement of survival time and the effects of neoadjuvant chemotherapy combined with radiotherapy on treating patients with advanced esophageal carcinoma. Retrospectively, 43 patients were selected with esophageal carcinoma who were administered neoadjuvant chemotherapy combined with radiotherapy. According to gender, and tumor staging, the nearest neighbor matching was carried out. Eighty-six patients (1:2) who received neoadjuvant chemotherapy and 129 patients (1:3) who underwent surgery only were taken and compared for clinical outcomes...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28926874/-multicenter-epidemiological-investigation-of-hospitalized-elderly-young-and-middle-aged-patients-with-severe-burn
#7
Y Tang, L X Wang, W G Xie, Z A Shen, G H Guo, J J Chen, C M Han, L C Ren, Z G Chu, M F Yin, Y Wang, D X Zhang, Y S Huang, J P Zhang
Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28926683/salvage-rates-and-prognostic-factors-after-relapse-in-children-and-adolescents-with-malignant-peripheral-nerve-sheath-tumors
#8
Luca Bergamaschi, Gianni Bisogno, Carla Manzitti, Paolo D'Angelo, Giuseppe Maria Milano, Angela Scagnellato, Mirko Cappelletti, Stefano Chiaravalli, Patrizia Dall'Igna, Rita Alaggio, Antonio Ruggiero, Martina Di Martino, Maria Carmen Affinita, Marta Pierobon, Alberto Garaventa, Michela Casanova, Andrea Ferrari
BACKGROUND: Malignant peripheral nerve sheath tumor (MPNST) is one of the most common nonrhabdomyosarcoma soft tissue sarcomas encountered in pediatric age, and it is generally characterized by poor outcome, particularly for relapsing patients. MATERIALS AND METHODS: This study considered 73 patients <21 years of age with relapsing MPNST observed among 120 patients enrolled in Italian pediatric protocols from 1979 to 2004. With the aim of possibly establishing a risk-adapted stratification, patients' outcome was examined using univariate and multivariate analysis based on clinical features at onset, first-line treatments, clinical findings at the time of first relapse, and second-line treatments...
September 19, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28926381/total-elbow-arthroplasty-for-distal-humeral-fractures-a-ten-year-minimum-follow-up-study
#9
Raul Barco, Philipp N Streubel, Bernard F Morrey, Joaquin Sanchez-Sotelo
BACKGROUND: Total elbow arthroplasty is commonly considered for elderly patients with comminuted distal humeral fractures. Satisfactory short-term outcomes have been reported, but long-term outcomes are unknown. Our purpose was to assess the long-term outcomes of total elbow arthroplasty after distal humeral fracture and to determine differences between elbows with or without inflammatory arthritis at the time of fracture. METHODS: Forty-four total elbow arthroplasties were performed after distal humeral fracture; those patients were followed for a minimum of 10 years and were evaluated with regard to pain, motion, Mayo Elbow Performance Scores, complications, and reoperations...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28926319/case-246-mr-imaging-of-a-complex-cystic-mass-in-a-newborn-girl
#10
Aditi Shruti, George S Wu
History A 6-day-old female neonate presented to the outpatient pediatric surgery clinic for evaluation of a possible prenatal abdominal mass. The neonate was delivered at term via cesarean section due to macrosomia, with a reported birth weight of 11 lb 8.7 oz (5.23 kg). The patient's postnatal course was remarkable for resolving neonatal hyperbilirubinemia. A physical examination was remarkable for a palpable mass in the abdomen. Maternal risk factors included class II obesity, type 2 diabetes, and metabolic syndrome...
October 2017: Radiology
https://www.readbyqxmd.com/read/28926088/treatments-for-priapism-in-boys-and-men-with-sickle-cell-disease
#11
REVIEW
Francis I Chinegwundoh, Sherie Smith, Kofi A Anie
BACKGROUND: Sickle cell disease comprises a group of genetic haemoglobin disorders. The predominant symptom associated with sickle cell disease is pain resulting from the occlusion of small blood vessels by abnormally 'sickle-shaped' red blood cells. There are other complications, including chronic organ damage and prolonged painful erection of the penis, known as priapism. Severity of sickle cell disease is variable, and treatment is usually symptomatic. Priapism affects up to half of all men with sickle cell disease, however, there is no consistency in treatment...
September 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28926087/self-reported-function-more-informative-than-frailty-phenotype-in-predicting-adverse-postoperative-course-in-older-adults
#12
Alok Kapoor, Theofilos Matheos, Matthias Walz, Christine McDonough, Abiramy Maheswaran, Evan Ruppell, Deeqo Mohamud, Nicholas Shaffer, Yanhua Zhou, Shubjeet Kaur, Stephen Heard, Sybil Crawford, Howard Cabral, Daniel K White, Heena Santry, Alan Jette, Roger Fielding, Rebecca A Silliman, Jerry Gurwitz
BACKGROUND/OBJECTIVE: Current preoperative assessment tools such as the American College of Surgeons Surgical Risk Calculator (ACS Calculator) are suboptimal for evaluating older adults. The objective was to evaluate and compare the performance of the ACS Calculator for predicting risk of serious postoperative complications with the addition of self-reported physical function versus a frailty score. DESIGN: Prospective cohort. SETTING: Two tertiary care academic medical centers in Massachusetts...
September 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28925959/preventing-surgical-site-infections-using-a-natural-biodegradable-antibacterial-coating-on-surgical-sutures
#13
Jochen Reinbold, Ann-Kristin Uhde, Ingrid Müller, Tobias Weindl, Jürgen Geis-Gerstorfer, Christian Schlensak, Hans-Peter Wendel, Stefanie Krajewski
Surgical site infections (SSIs) are one of the most common nosocomial infections, which can result in serious complications after surgical interventions. Foreign materials such as implants or surgical sutures are optimal surfaces for the adherence of bacteria and subsequent colonization and biofilm formation. Due to a significant increase in antibiotic-resistant bacterial strains, naturally occurring agents exhibiting antibacterial properties have great potential in prophylactic therapies. The aim of this study was to develop a coating for surgical sutures consisting of the antibacterial substance totarol, a naturally occurring diterpenoid isolated from Podocarpustotara in combination with poly(lactide-co-glycolide acid) (PLGA) as a biodegradable drug delivery system...
September 19, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28925861/perioperative-pulmonary-medication-management
#14
Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: Pulmonary conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common conditions that warrant special consideration in the perioperative period. When these patients undergo surgical interventions, they have risk of complications such as bronchospasm, hypoxia, and even postoperative respiratory failure that warrants unplanned intensive care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are critical for maintaining stable homeostasis of these chronic conditions...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28925860/pharmacologic-and-perioperative-considerations-for-antihypertensive-medications
#15
Sher-Lu Pai, Ryan M Chadha, Joan M Irizarry Alvarado, Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: As the prevalence of hypertension continues to increase, physicians routinely encounter patients preoperatively receiving one or more cardiovascular medications to manage hypertension. Thus, the physician's knowledge of perioperative antihypertensive medication management is crucial to ensure patient safety. OBJECTIVE: We discuss the decisions to continue or stop antihypertensive medications to reduce the risk of perioperative complications. METHOD: We conducted a review of the original research studies, review articles, and editorials present on PubMed within the past 60 years...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28925332/spine-deformity-surgery-in-the-elderly-risk-factors-and-30-day-outcomes-are-comparable-in-posterior-versus-combined-approaches
#16
John K Yue, David C Sing, Sourabh Sharma, Pavan S Upadhyayula, Ethan A Winkler, Jeremy D Shaw, Lionel N Metz
Objectives Risk factors portending poor outcome following elective spine deformity fusion remain in need of characterization and stratification in the elderly population. Methods Cases aged ≥60 years who underwent elective posterior or anterior-posterior ('combined') fusion were extracted from the American College of Surgeons National Surgical Quality Improvement Program years 2007-2013 and analyzed by surgical cohort (posterior vs. combined). The 30-day outcomes included operation time, hospital length of stay (HLOS), perioperative complications, and discharge destination...
September 19, 2017: Neurological Research
https://www.readbyqxmd.com/read/28924922/assessing-the-non-tumorous-liver-implications-for-patient-management-and-surgical-therapy
#17
Pallavi Pandey, Ankur Pandey, Mary Dillhoff, Carl Schmidt, Ihab R Kamel, Timothy M Pawlik
INTRODUCTION: Hepatic resection is performed for various benign and malignant liver tumors. Over the last several decades, there have been improvements in the surgical technique and postoperative care of patients undergoing liver surgery. Despite this, liver failure following an extended hepatic resection remains a critical potential postoperative complication. Patients with underlying parenchymal liver diseases are at particular risk of liver failure due to impaired liver regeneration with an associated mortality risk as high as 60 to 90%...
September 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28924615/complications-implications-and-prevention-of-electrosurgical-injuries-corner-stone-of-diathermy-use-for-junior-surgical-trainees
#18
REVIEW
Manjunath Siddaiah-Subramanya, Kor Woi Tiang, Masimba Nyandowe
Diathermy is commonly used in modern-day surgery. The incidence of electrosurgical injuries related to diathermy is under reported, as it is difficult to ascertain the true impact on both patient and healthcare professionals. As junior surgical trainees, understanding of the mechanism and biophysics of the electrosurgical tools enables safer usage and contributes to improved outcome. Careful use of electrosurgical tools during operation and appropriate communication amongst staff members are pivotal to a safe surgical outcome...
October 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/28924477/a-new-paradigm-in-low-risk-papillary-microcarcinoma-active-surveillance
#19
Alex González Bóssolo, Michelle Mangual Garcia, Paula Jeffs González, Miosotis Garcia, Guillermo Villarmarzo, Jose Hernán Martinez
Classical papillary thyroid microcarcinoma (PTMC) is a variant of papillary thyroid carcinoma (PTC) known to have excellent prognosis. It has a mortality of 0.3%, even in the presence of distance metastasis. The latest American Thyroid Association guidelines state that although lobectomy is acceptable, active surveillance can be considered in the appropriate setting. We present the case of a 37-year-old female with a history of PTMC who underwent surgical management consisting of a total thyroidectomy. Although she has remained disease-free, her quality of life has been greatly affected by the sequelae of this procedure...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28924352/analysis-of-risk-factors-for-success-of-lumbar-spinal-stenosis-surgery
#20
Caroline Oliveira Brêtas, Larissa Furbino de Pinho Valentim, Nelson Elias, Igor Machado Cardoso, Joelmar César de Almeida, Charbel Jacob
OBJECTIVE: To identify the patient profile that obtains better clinical and quality of life improvement after lumbar spinal stenosis surgery, comparing the results in the pre and postoperative periods. METHODS: Thirty-seven patients with lumbar spine stenosis submitted to surgery were prospectively evaluated. Through the 36-Item Short Form General Health Survey (SF-36) questionnaire we performed a preoperative analysis to identify morbidities and social security benefit earning...
November 2016: Acta Ortopedica Brasileira
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