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Preoperative medicine

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https://www.readbyqxmd.com/read/28069021/preoperative-optimization-of-patient-expectations-improves-long-term-outcome-in-heart-surgery-patients-results-of-the-randomized-controlled-psy-heart-trial
#1
Winfried Rief, Meike C Shedden-Mora, Johannes A C Laferton, Charlotte Auer, Keith J Petrie, Stefan Salzmann, Manfred Schedlowski, Rainer Moosdorf
BACKGROUND: Placebo effects contribute substantially to outcome in most fields of medicine. While clinical trials typically try to control or minimize these effects, the potential of placebo mechanisms to improve outcome is rarely used. Patient expectations about treatment efficacy and outcome are major mechanisms that contribute to these placebo effects. We aimed to optimize these expectations to improve outcome in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: In a prospective three-arm randomized clinical trial with a 6 month follow-up, 124 patients scheduled for CABG surgery were randomized to either a brief psychological pre-surgery intervention to optimize outcome expectations (EXPECT); or a psychological control intervention focusing on emotional support and general advice, but not on expectations (SUPPORT); or to standard medical care (SMC)...
January 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28062967/septal-cartilage-ethmoid-bone-composite-graft-a-new-and-improved-method-for-the-correction-underdeveloped-nasal-septum-in-patients-with-short-noses
#2
Soo Hyang Lee, Mun Geun Koo, Eun Taek Kang
BACKGROUND: Septal extension grafts are an effective means of extending nasal length in patients with a short nose. However, such grafts can be challenging in patients who only have small quantities of weak septal cartilage, such as some East Asian patients. We developed a rhinoplasty technique using ethmoid bone to create a cartilage-bone complex to overcome this issue, allowing adequate nasal lengthening. METHODS: Sixty-four women with short noses and inadequate septal cartilage determined by preoperative computed tomography underwent septal extension grafting with a cartilage-bone complex between January 2009 and December 2014...
January 7, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28052910/acupuncture-and-pc6-stimulation-for-the-prevention-of-postoperative-nausea-and-vomiting-in-patients-undergoing-elective-laparoscopic-resection-of-colorectal-cancer-a-study-protocol-for-a-three-arm-randomised-pilot-trial
#3
Kun Hyung Kim, Dae Hun Kim, Ji Min Bae, Gyung Mo Son, Kyung Hee Kim, Seung Pyo Hong, Gi Young Yang, Hee Young Kim
INTRODUCTION: This study aims to assess the feasibility of acupuncture and a Pericardium 6 (PC6) wristband as an add-on intervention of antiemetic medication for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing elective laparoscopic colorectal cancer resection. METHODS AND ANALYSIS: A total of 60 participants who are scheduled to undergo elective laparoscopic resection of colorectal cancer will be recruited. An enhanced recovery after surgery protocol using standardised antiemetic medication will be provided for all participants...
January 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28048264/su-d-207b-02-early-grade-classification-in-meningioma-patients-combining-radiomics-and-semantics-data
#4
T Coroller, W Bi, M Abedalthagafi, A Aizer, W Wu, N Greenwald, R Beroukhim, O Al-Mefty, S Santagata, I Dunn, B Alexander, R Huang, H Aerts
PURPOSE: The clinical management of meningioma is guided by its grade and biologic behavior. Currently, diagnosis of tumor grade follows surgical resection and histopathologic review. Reliable techniques for pre-operative determination of tumor behavior are needed. We investigated the association between imaging features extracted from preoperative gadolinium-enhanced T1-weighted MRI and meningioma grade. METHODS: We retrospectively examined the pre-operative MRI for 139 patients with de novo WHO grade I (63%) and grade II (37%) meningiomas...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28039503/does-postoperative-erythropoietin-reduce-transfusions-and-hemodynamic-instability-following-liposuction-either-alone-or-associated-with-abdominoplasty-or-mammaplasty-a-comparative-prospective-study-of-50-consecutive-patients
#5
Rodrigo G Rosique, Marina J F Rosique, Mariana Quintino Rabelo
INTRODUCTION: Erythropoietin (EPO) is a hematopoietic growth factor and an alternative to avoid blood transfusion in high-blood-loss surgeries. We evaluate EPO efficacy to reduce clinically relevant anemia and dehydration in patients undergoing liposuction. METHODS: We prospectively evaluated 50 consecutive patients subjected to liposuction greater than 2.5 L and alternately assigned into two comparable groups (25 patients each), except for the postoperative administration of erythropoietin (4000 UI per day subcutaneously) during five consecutive days...
December 30, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28039501/comparison-of-dexamethasone-dimenhydrinate-and-dexamethasone-ondansetron-in-prevention-of-nausea-and-vomiting-in-postoperative-patients
#6
Nurcan Kizilcik, Sevgi Bilgen, Ferdi Menda, Hatice Türe, Bilgehan Aydın, Elif Cigdem Kaspar, Ozge Koner
INTRODUCTION: Postoperative Nausea and Vomiting is one of the most common problems after implementation of general anesthesia. The incidence can reach 80% in high-risk patients, depending on the type of surgery. In our study, we aimed to compare dexamethasone-dimenhydrinate and dexamethasone-ondansetron combinations in prevention of nausea and vomiting in postoperative patients. METHOD: Sixty 18-65-year-olds ASAI-II females who underwent rhinoplasty were included in the study...
December 30, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28036234/tension-regulation-at-the-suture-lines-for-repair-of-neglected-achilles-tendon-laceration
#7
Elsayed Ibraheem Elsayed Massoud
BACKGROUND: Operative intervention is the preferred option for management of the neglected laceration of the Achilles tendon. However, the commonly used techniques rarely follow the principles of the regenerative medicine for the restoration of the lost tissue. This study postulated that incorporation of the autogenous tendon graft would properly progress when the interplay between mechanical loading and healing phases was correctly applied. METHODS: A prospective study included 15 patients who were treated for neglected Achilles tendon laceration using the technique of lengthening of the proximal tendon stump...
December 1, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/28033510/sentinel-node-detection-in-early-breast-cancer-with-intraoperative-portable-gamma-camera-uk-experience
#8
Debashis Ghosh, Nikolaos V Michalopoulos, Timothy Davidson, Fred Wickham, Norman R Williams, Mohammed R Keshtgar
PURPOSE: Access to nuclear medicine department for sentinel node imaging remains an issue in number of hospitals in the UK and many parts of the world. Sentinella(®) is a portable imaging camera used intra-operatively to produce real time visual localisation of sentinel lymph nodes. METHODS: Sentinella(®) was tested in a controlled laboratory environment at our centre and we report our experience on the first use of this technology from UK. Moreover, preoperative scintigrams of the axilla were obtained in 144 patients undergoing sentinel node biopsy using conventional gamma camera...
December 26, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28032176/minimal-undermining-suspension-technique-must-combined-eyebrow-and-mid-face-lift-via-temporal-access
#9
Alessandro Gualdi, Janos Cambiaso-Daniel, Jonatann Gatti, Dario Bertossi, Giorgio Pietramaggiori, Saja S Scherer, Paul Wurzer, David B Lumenta
BACKGROUND: Less downtime following esthetic interventions leads to the popularity of injectable solutions for facial rejuvenation treatments. Surgical interventions for esthetic purposes are usually associated with higher complication rates and longer recovery times when compared to less invasive treatments. Here we present for the first time a minimally invasive surgical technique for a simultaneous mid-face and eyebrow lift using one small temporal incision. MATERIALS AND METHODS: We prospectively studied patients who underwent facial rejuvenation using a minimal undermining suspension technique (MUST) in an outpatient setting...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28032161/psychological-and-psychiatric-traits-in-post-bariatric-patients-asking-for-body-contouring-surgery
#10
Chiara Pavan, Massimo Marini, Eleonora De Antoni, Carlotta Scarpa, Tito Brambullo, Franco Bassetto, Annapina Mazzotta, Vincenzo Vindigni
BACKGROUNDS: Obese patients, mainly females, feel uncomfortable and unsatisfied with their physical appearance; they have a wrong perception of their image and consequently diminish their self-esteem, sometimes showing difficulties in functional areas such as work, relationship, social activity. Beside health concerns, improving their appearance and body image are often common motives for weight loss in obese individuals and after weight loss about 30% of bariatric surgery patients undergo plastic surgical correction of excessive skin...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28032151/the-effect-of-the-short-and-floating-columellar-strut-graft-and-septocolumellar-suture-on-nasal-tip-projection-and-rotation-in-primary-open-approach-rhinoplasty
#11
Hakan Şirinoğlu
OBJECTIVE: The maintenance of desired tip projection and rotation is an important goal in rhinoplasty. In this study, the effects of the columellar strut graft and septocolumellar sutures were evaluated in a follow-up period of 1 year. PATIENTS AND METHODS: In half of 44 patients, nasal tip was constructed with basic tip maneuvers and two septocolumellar sutures (Group-1, Suture Group), whereas in the remaining 22 patients, a columellar strut graft was added for tip support (Group-2, Suture + Graft Group)...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28028671/anesthesia-considerations-for-patients-with-an-implanted-deep-brain-stimulator-undergoing-surgery-a-review-and-update
#12
Tze Yeng Yeoh, Pirjo Manninen, Suneil K Kalia, Lashmi Venkatraghavan
PURPOSE: Deep brain stimulation (DBS) can be an effective treatment option for patients with essential tremor and Parkinson's disease. This review provides an overview on the functioning of neurostimulators and recent advances in this technology and presents an updated guide on the anesthetic management of patients with an implanted neurostimulator undergoing surgery or medical intervention. SOURCE: A search was conducted on MEDLINE®, EMBASE™, and Cochrane Database of Systematic Reviews databases to identify studies published in English from 1974 to December 2015...
December 27, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28027262/evidence-based-medicine-management-of-acute-lower-extremity-trauma
#13
Roberto D Lachica
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Select and design flaps for the acutely injured lower limb based on wound location, size, and complexity. 2. Select and design tissue-specific flaps based on the functional demand of the zone of injury. 3. Understand the indications for using a flap with a skin component versus a muscle-only flap. 4. Understand the preoperative vascular assessment for lower extremity flap reconstruction. 5. Recognize and manage risk factors to decrease complications and improve flap survival...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28027261/evidence-based-medicine-the-evaluation-and-treatment-of-pressure-injuries
#14
Joseph A Ricci, Lauren R Bayer, Dennis P Orgill
LEARNING OBJECTIVE: After studying this article, the participant should be able to: 1. Discuss the approach to and rationale for pressure injury management, including specific techniques for prevention and preoperative evaluation. 2. Develop a management algorithm for these wounds that includes operative and nonoperative modalities. 3. Understand how to identify and manage the complications of surgical intervention for pressure injuries, including recurrence. SUMMARY: Pressure injuries are a common problem associated with great morbidity and cost, often presenting as complex challenges for plastic surgeons...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28027260/evidence-based-medicine-liposuction
#15
Christopher T Chia, Ryan M Neinstein, Spero J Theodorou
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Review the appropriate indications and techniques for suction-assisted lipectomy body contouring surgery. 2. Accurately calculate the patient limits of lidocaine for safe dosing during the tumescent infiltration phase of liposuction. 3. Determine preoperatively possible "red flags" or symptoms and signs in the patient history and physical examination that may indicate a heightened risk profile for a liposuction procedure...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28027257/evidence-based-medicine-reduction-mammaplasty
#16
Richard Greco, Barrett Noone
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Understand the multiple reduction mammaplasty techniques available for patients and describe the advantages and disadvantages associated with each. 2. Describe the indications for the treatment of macromastia in patients younger than 18 years. 3. Identify the preoperative indications for breast imaging before surgery. 4. Describe the benefits of breast infiltration with local anesthesia with epinephrine before surgery...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28027252/evidence-based-medicine-face-lift
#17
Brian M Derby, Mark A Codner
LEARNING OBJECTIVES: After studying this article, the participants should be able to: 1. Describe pertinent surgical anatomy relevant to safe and effective face-lifting techniques. 2. Identify key aspects of facial aging. 3. Incorporate risk-reduction strategies during preoperative assessment. 4. Tailor their approach to face lifting based on patient anatomy. 5. Identify and treat complications after face-lift surgery. 6. Incorporate use of valid patient outcomes assessment tools in their practice to facilitate standardized outcomes reporting in the face-lift literature...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28012874/management-of-high-risk-corneal-transplantation
#18
REVIEW
Antonio Di Zazzo, Ahmad Kheirkhah, Tulio B Abud, Sunali Goyal, Reza Dana
The cornea is the most commonly transplanted tissue in medicine. The main cause of corneal graft failure is allograft rejection. The incidence of graft rejection depends on the presence of high-risk characteristics, most notably corneal neovascularization. Although corneal grafting has a high success rates in the absence of these risk factors, high-risk keratoplasty is associated with low success rates because of a high incidence of immune-mediated graft rejection. To improve the survival of high-risk corneal transplantation, various preoperative, intraoperative, and postoperative measures can be considered...
December 21, 2016: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28008461/lower-leg-augmentation-with-fat-grafting-mri-and-histological-examination
#19
Violeta Skorobac Asanin, Jelena Sopta
INTRODUCTION: Nowadays, there is an increasing demand for contouring of the entire lower leg, in addition to corrections at the level of the muscle only. Accordingly, it becomes advantageous to use fat tissue for this purpose, for its availability in high quantities, potential for its easy implantation in all leg parts, biological compatibility, low antigen potential, and minimal donor morbidity. METHODS: Forty-eight female patients, aged 20-54 (47.1 % younger than 35 and 52...
December 23, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28008429/applications-of-patient-specific-3d-printing-in-medicine
#20
Martin Heller, Heide-Katharina Bauer, Elisabeth Goetze, Matthias Gielisch, Klaus E Roth, Philipp Drees, Gerrit S Maier, Bernhard Dorweiler, Ahmed Ghazy, Meik Neufurth, Werner E G Müller, Heinz C Schröder, Xiaohong Wang, Christian-Friedrich Vahl, Bilal Al-Nawas
Already three decades ago, the potential of medical 3D printing (3DP) or rapid prototyping for improved patient treatment began to be recognized. Since then, more and more medical indications in different surgical disciplines have been improved by using this new technique. Numerous examples have demonstrated the enormous benefit of 3DP in the medical care of patients by, for example, planning complex surgical interventions preoperatively, reducing implantation steps and anesthesia times, and helping with intraoperative orientation...
2016: International Journal of Computerized Dentistry
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