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https://www.readbyqxmd.com/read/28109210/surgical-repair-of-moderate-ischemic-mitral-regurgitation-a-systematic-review-and-meta-analysis
#1
Mahesh Anantha Narayanan, Saurabh Aggarwal, Yogesh N V Reddy, Venkata M Alla, Janani Baskaran, Arun Kanmanthareddy, Rakesh M Suri
Introduction Moderate mitral regurgitation (MR) of ischemic etiology has been associated with worse outcomes after coronary artery bypass grafting (CABG). Studies comparing concomitant mitral valve replacement/repair (MVR/Re) with CABG and standalone CABG have reported conflicting results. We performed a systematic review and meta-analysis of the published literature. Patients and Methods We searched using PubMed, Cochrane, EMBASE, CINAHL, and Google scholar databases from January 1960 to June 2016 for clinical trials comparing CABG to CABG + MVR/Re for moderate MR...
January 21, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28109195/fungal-periprosthetic-joint-infection-following-total-elbow-arthroplasty-a-case-report-and-review-of-the-literature
#2
Cory A Kwong, Shannon K T Puloski, Kevin A Hildebrand
BACKGROUND: With improving surgical techniques for total elbow arthroplasty clinical outcomes have improved and its utilization continues to increase. Despite these advances, complication rates remain as high as 24%. Of these complications periprosthetic joint infection is one of the most common and morbid. The rheumatoid elbow remains a leading indication for total elbow arthroplasty. Patients with this condition frequently require immunosuppressive therapy, which places them at higher risk of both typical and atypical infections...
January 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28109160/antibiotics-for-infection-prevention-after-excision-of-the-cervical-transformation-zone
#3
REVIEW
Chumnan Kietpeerakool, Bandit Chumworathayi, Jadsada Thinkhamrop, Butsakorn Ussahgij, Pisake Lumbiganon
BACKGROUND: Excision of the transformation zone of the cervix is the most commonly used approach to treat cervical precancerous lesions (cervical intraepithelial neoplasia (CIN)) to reduce the risk of developing cervical cancer. As the excision of the transformation zone leaves a raw area on the cervix, there is a risk of infection following the procedure. The incidence of infection after cold knife conization (CKC) is 36%, whereas the incidence for large loop excision of the transformation zone (LLETZ, also known as loop electrical excision procedure (LEEP)) is much lower (0...
January 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28108938/preoperative-work-up-for-definition-of-lymph-node-risk-involvement-in-early-stage-endometrial-cancer-5-year-follow-up
#4
Pietro Cignini, Salvatore Giovanni Vitale, Antonio Simone Laganà, Antonio Biondi, Valentina Lucia La Rosa, Giuseppe Cutillo
This prospective cohort study aimed to analyze the accuracy of magnetic resonance imaging (MRI) and hysteroscopic excisional biopsy (HEB) for predicting the low- and high-risk patients with endometrial carcinoma for nodal involvement at preoperative evaluation. From January 2005 to December 2006, all patients with a diagnosis of endometrial carcinoma were prospectively included in the study and underwent pelvic MRI and HEB. The pelvic MRI (without contrast) was aimed to evaluate the extent of myometrial invasion (MI < 50%, MI ≥ 50%), the possible involvement of cervical stroma, the ovarian, and lymph nodes status...
January 20, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28108855/causes-of-poor-outcome-in-patients-admitted-with-good-grade-subarachnoid-haemorrhage
#5
Vladimír Beneš, Lubomír Jurák, Radim Brabec, Nina Nechanická, Miroslav Šercl, Ladislav Endrych, Pavel Buchvald, Petr Suchomel
BACKGROUND: Surgical risk in patients with unruptured aneurysms is well known. The relative impact of surgery and natural history of subarachnoid haemorrhage (SAH) on patients in good clinical condition (World Federation of Neurological Surgeons [WFNS] grades 1 and 2) is less well quantified. The aim of this study was to determine causes of poor outcome in patients admitted in good grade SAH. METHODS: A retrospective study of prospectively collected data among WFNS-1 and -2 patients: demographics, SAH and aneurysm-related data, surgical complications and outcome as assesed by the Glasgow Outcome Scale (GOS)...
January 20, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28108796/a-clinical-decision-rule-for-the-use-of-ultrasound-in-children-presenting-with-acute-inflammatory-neck-masses
#6
Farahnaz Golriz, George S Bisset, Beth D'Amico, Andrea T Cruz, Kiyetta H Alade, Wei Zhang, Lane F Donnelly
OBJECTIVE: To identify the association between clinical and ultrasound findings and surgical drainage in children with inflammatory neck masses and to create a clinical decision rule that allows for reduction of unnecessary use of ultrasound in inflammatory neck masses. MATERIALS AND METHODS: We reviewed data on patients ≤18 years who visited our emergency department between 2012 and 2014 with inflammatory neck swelling and who underwent ultrasound examinations of the neck...
January 21, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28108774/-hip-dislocation-after-revision-arthroplasty-risk-assessment-and-treatment-strategies
#7
P M Prodinger, J Schauwecker, H Mühlhofer, N Harrasser, F Pohlig, C Suren, R von Eisenhart-Rothe
With a dislocation rate of up to 35% after revision total hip arthroplasty (THA), instability is one of the major causes why this procedure fails. Independent factors for patients at risk are age, sex, and the type of revision needed. The surgical approach, implant choice, and positioning of the components are factors that the surgeon can influence to keep the dislocation rate low. Large femoral heads or double mobility (DM) cups can increase the stability of the joint. After detailed failure analysis, targeted use of different technical innovations enhances stability in revision THA and prevents further revisions...
January 20, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28108568/the-role-of-day-one-postoperative-review-of-intraocular-pressure-in-modern-vitrectomy-surgery
#8
Nicholas Brennan, Ian Reekie, Eric Ezra, Keith Barton, Ananth Viswanathan, Mahiul Mk Muqit
BACKGROUND: With the introduction of sutureless 23-gauge (23G) vitrectomy, the risks for elevated intraocular pressure (IOP) and the need for day 1 review of IOP are less certain. AIMS: To assess current practice for postoperative review in the vitreoretinal service at a large tertiary referral centre; to assess whether day 1 review detected complications altering patient management; to identify risk factors for IOP spikes postvitrectomy. METHODS: Retrospective, consecutive case note review of all patients undergoing 23G vitrectomy at the study institution between April and June 2013...
January 20, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28108426/membrane-surface-area-volume-ratio-in-chronic-subdural-haematomas-critical-size-and-potential-post-operative-target
#9
Appukutty Manickam, Laurence Ag Marshman, Ross Johnston
BACKGROUND: It is unknown why some chronic subdural haematomas (CSDH) grow and require surgery, whilst others spontaneously resolve. Although a relatively small CSDH volume (V) reduction may induce resolution, V% reduction is often unreliable in predicting resolution. Whilst CSDH evolve distinctive inner and outer neo- membranes (IM and OM), the OM likely dominates the dynamic growth-resorption equilibrium. If other factors remain constant, one previous hypothesis is that resorption could fail as the surface area (SA):V ratio decreases when CSDH exceed a 'critical size'...
January 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28108069/predictors-of-operative-failure-in-parathyroidectomy-for-primary-hyperparathyroidism
#10
David C Cron, Steven R Kapeles, Elizabeth A Andraska, Sebastian T Kwon, Peter S Kirk, Brendan L McNeish, Christopher S Lee, David T Hughes
INTRODUCTION: Many adjuncts guide surgical decision making in parathyroidectomy, yet their independent associations with outcome are poorly characterized. We examined a broad range of perioperative factors and used multivariate techniques to identify independent predictors of operative failure (persistent disease) after parathyroidectomy. METHODS: This was a retrospective review of 2239 patients with primary hyperparathyroidism who underwent parathyroidectomy at a single-center from 1999 to 2014...
January 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28108064/stent-and-leaflet-stresses-in-a-26-mm-first-generation-balloon-expandable-transcatheter-aortic-valve
#11
Yue Xuan, Kapil Krishnan, Jian Ye, Danny Dvir, Julius M Guccione, Liang Ge, Elaine E Tseng
OBJECTIVE: Transcatheter aortic valve replacement is established therapy for high-risk and inoperable patients with severe aortic stenosis, but questions remain regarding long-term durability. Valve design influences durability. Increased leaflet stresses in surgical bioprostheses have been correlated with degeneration; however, transcatheter valve leaflet stresses are unknown. From 2007 to 2014, a majority of US patients received first-generation balloon-expandable transcatheter valves...
December 23, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28108027/a-postoperative-scoring-system-for-distant-recurrence-in-node-positive-cervical-cancer-patients-after-radical-hysterectomy-and-pelvic-lymph-node-dissection-with-para-aortic-lymph-node-sampling-or-dissection
#12
Young-Jae Lee, Dae-Yeon Kim, Shin-Wha Lee, Jeong-Yeol Park, Dae-Shik Suh, Jong-Hyeok Kim, Yong-Man Kim, Young-Tak Kim, Joo-Hyun Nam
OBJECTIVE: To identify risk factors for distant recurrence in node-positive cervical cancer patients who underwent radical hysterectomy and pelvic lymph node dissection (PLND) with para-aortic lymph node sampling (PALNS) or para-aortic lymph node dissection (PALND). METHODS: A total of 299 patients in whom lymph node metastasis was confirmed after radical surgery at Asan Medical Center for stage IA2 to IIB cervical cancer from February 2001 to December 2012 were identified...
January 17, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28107600/the-predictive-and-prognostic-role-of-serum-neopterin-and-tryptophan-breakdown-in-prostate-cancer
#13
Renate Pichler, Josef Fritz, Isabel Heidegger, Eberhard Steiner, Zoran Culig, Helmut Klocker, Dietmar Fuchs
The Interferon-gamma induced enzymes indoleamine 2,3-dioxygenase and GTP-cylohydrolase are key players in tumor immune escape mechanisms. We quantified serum levels of neopterin and tryptophan breakdown (tryptophan, kynurenine and kynurenine-to-tryptophan ratio) in addition to prostate-specific antigen (PSA) in newly diagnosed prostate cancer (PCa) patients (n=100) before radical prostatectomy (RP) as well as at time of biochemical recurrence (BCR) after RP (n=50) in comparison to healthy men (n=49). Effects of biomarkers on the risk of PCa diagnosis on transrectal biopsy, worse histopathological characteristics of the RP specimens and cancer-specific survival (CSS) after BCR were investigated...
January 20, 2017: Cancer Science
https://www.readbyqxmd.com/read/28107276/the-effect-of-deep-versus-moderate-neuromuscular-block-on-surgical-conditions-and-postoperative-respiratory-function-in-bariatric-laparoscopic-surgery-a-randomized-double-blind-clinical-trial
#14
Sam Baete, Gerd Vercruysse, Margot Vander Laenen, Pieter De Vooght, Jeroen Van Melkebeek, Dimitri Dylst, Maud Beran, Jan Van Zundert, René Heylen, Willem Boer, Sam Van Boxstael, Tom Fret, Hans Verhelst, Cathy De Deyne, Frank Jans, Pascal Vanelderen
BACKGROUND: In recent literature, it has been suggested that deep neuromuscular block (NMB) improves surgical conditions during laparoscopy; however, the evidence supporting this statement is limited, and this was not investigated in laparoscopic bariatric surgery. Moreover, residual NMB could impair postoperative respiratory function. We tested the hypotheses that deep NMB could improve the quality of surgical conditions for laparoscopic bariatric surgery compared with moderate NMB and investigated whether deep NMB puts patients at risk for postoperative respiratory impairment compared with moderate NMB...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28107274/the-sluscore-a-novel-method-for-detecting-hazardous-hypotension-in-adult-patients-undergoing-noncardiac-surgical-procedures
#15
Wolf H Stapelfeldt, Hui Yuan, Jefferson K Dryden, Kristen E Strehl, Jacek B Cywinski, Jesse M Ehrenfeld, Pamela Bromley
BACKGROUND: It has been suggested that longer-term postsurgical outcome may be adversely affected by less than severe hypotension under anesthesia. However, evidence-based guidelines are unavailable. The present study was designed to develop a method for identifying patients at increased risk of death within 30 days in association with the severity and duration of intraoperative hypotension. METHODS: Intraoperative mean arterial blood pressure recordings of 152,445 adult patients undergoing noncardiac surgery were analyzed for periods of time accumulated below each one of the 31 thresholds between 75 and 45 mm Hg (hypotensive exposure times)...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28107242/an-in-vitro-biomechanical-study-evaluating-cervical-extension-plates-for-stabilizing-degenerated-adjacent-levels
#16
Kamran Majid, Mark Moldavsky, Saif Khalil, Manasa Gudipally
STUDY DESIGN: To evaluate the biomechanical stability of 2 extender plates in a human cervical cadaveric model. OBJECTIVES: To evaluate 2 extender plates, placed adjacent to initially implanted plates and to compare their biomechanical stability with traditional techniques. SUMMARY OF BACKGROUND DATA: Traditionally, adjacent level degeneration is surgically treated by removing the previously implanted plate and extending the instrumentation to the new degenerated level...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28107241/polytrauma-patients-with-associated-spine-fractures-an-assessment-of-surgical-intervention-on-patient-outcome
#17
Steven R Niedermeier, Safdar N Khan
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To examine perioperative characteristics among polytraumatized patients with operative, unstable spine fractures with and without concomitant operative long bone injuries. SUMMARY OF BACKGROUND DATA: Treatment of polytrauma patients has delicate and time-sensitive protocols to ensure successful recovery. The literature defines standards for vertebral injury and surgical intervention...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28107239/management-of-pharyngeal-fistulas-after-anterior-cervical-spine-surgery-a-treatment-algorithm-for-severe-complications
#18
Christian Simon, Carl H Fürstenberg, Markus Eichler, Stefan Rohde, Cem Bulut, Bernd Wiedenhöfer
STUDY DESIGN: This study is a retrospective database query to identify all anterior spinal approaches. OBJECTIVES: The objectives were to assess all patients with pharyngocutaneous fistulas (PCFs) after anterior cervical spine surgery. SUMMARY OF BACKGROUND DATA: Patients with the diagnosis of PCFs were treated at the University of Heidelberg Spine Medical Center, Spinal Cord Injury Unit and Department of Otolaryngology (Germany), between 2005 and 2011...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28107231/national-database-research-in-spine-surgery-limitations-in-the-current-literature
#19
Arjun S Sebastian
Many of the studies in the spine surgical literature using national databases have been directed at examining adverse events, readmission rates, cost, and risk factors for poorer outcomes. Although such studies allow for assessment of large cohorts taken from multiple institutions, they are limited by data collection methods, short-term follow-up, and minimal assessment of functional outcomes. Furthermore, few studies are directed at producing actionable practice changes to improve patient care. Recent work aimed at producing databases with more relevance to spine surgery represent exciting developments to the rapidly growing field of health outcomes research...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#20
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
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