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Preoperative medicine

Kathryn L Kreicher, Jeremy S Bordeaux
Importance: Cutaneous surgery is performed by otolaryngologists, plastic surgeons, oculoplastic surgeons, dermatologic surgeons, and some primary care physicians. Practice gaps exist among cutaneous surgeons, as do differences in how different physicians approach preoperative, intraoperative, and postoperative decision-making. Objective: To present the newest and best evidence to close common practice gaps in cutaneous surgery. Evidence Review: We performed a detailed search of peer-reviewed publications that were identified through a search of PubMed/MEDLINE (January 1, 2000, through June 30, 2016) using the literature search terms "cutaneous surgery," "Mohs micrographic surgery," "plastic surgery," in combination with "safety," "cost," "anesthesia," "anti-coagulation," "bleeding," "pain," "analgesia," "anxiety," or "infection," among others...
October 20, 2016: JAMA Facial Plastic Surgery
Qiuyu Wang, Chuan Cao, Rui Guo, Xiaoge Li, Lele Lu, Wenping Wang, Shirong Li
OBJECTIVE: To assess the prevalence of body dysmorphic disorder (BDD) in an aesthetic surgery setting in the region of Southwest China, and to ascertain the differences in terms of body images between patients in the aesthetic setting and general Chinese population. This study tracked patient satisfaction with their body image changes while undergoing aesthetic medical procedures to identify whether the condition of patients who were presenting with BDD symptoms or their psychological symptoms could be improved by enhancing their appearance...
October 19, 2016: Aesthetic Plastic Surgery
Abib Agbetoba, Amber Luong, Jin Keat Siow, Brent Senior, Claudio Callejas, Kornel Szczygielski, Martin J Citardi
BACKGROUND: Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull-base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. METHODS: Forty-five otorhinolaryngology trainees and 20 medical school students from 5 academic institutions were enrolled and randomized into 1 of 2 groups...
October 18, 2016: International Forum of Allergy & Rhinology
Elisa Tardelli, Sara Mazzarri, Domenico Rubello, Marta Gennaro, Lorenzo Fantechi, Valerio Duce, Antonella Romanini, Sotirios Chondrogiannis, Duccio Volterrani, Patrick M Colletti, Gianpiero Manca
Melanoma is an important public health problem, and its incidence is increasing worldwide. The disease status of regional lymph nodes is the most important prognostic factor in early-stage melanoma patients. Sentinel lymph node biopsy (SLNB) was introduced in the early 1990s as a less invasive procedure than complete lymph node dissection to allow histopathologic evaluation of the "sentinel lymph node" (SLN), which is the first node along the lymphatic pathway from a primary tumor. Sentinel lymph node biopsy has minimal complication risks compared with standard complete lymph node dissection...
October 5, 2016: Clinical Nuclear Medicine
Steven L Cohn, Suparna Dutta, Barbara A Slawski, Paul J Grant, Gerald W Smetana
Recent studies have shed light on preoperative risk assessment, medical therapy to reduce postoperative cardiac complications (beta-blockers, statins, and angiotensin II receptor blockers [ARBs]), perioperative management of patients with coronary stents on antiplatelet therapy, and perioperative bridging anticoagulation.
October 2016: Cleveland Clinic Journal of Medicine
Fufang Ni, Sai Luo, Dongmei Yu, Yangdong Zhu, Yong Shang, Yida Chen, Haiqian Xu, Qing Wang, Lijun Hao
BACKGROUND: The presence of mild or moderate medial epicanthus is typical in Asian patients. Numerous epicanthoplasty techniques have been described previously. However, these methods usually leave obvious scars in the medial canthal area. The aim of this report is to introduce a novel epicanthoplasty technique and a concomitant double eyelidplasty which avoid leaving scars in the medial canthal region. METHODS: From July 2013 to July 2015, 252 patients received epicanthoplasty and concomitant double eyelidplasty with this new technique...
October 4, 2016: Aesthetic Plastic Surgery
Josemberg Campos, Almino Ramos, Thomaz Szego, Bruno Zilberstein, Heládio Feitosa, Ricardo Cohen
Introduction: Even considering the advance of the medical treatment in the last 20 years with new and more effective drugs, the outcomes are still disappointing as the control of obesity and type 2 Diabetes Mellitus (T2DM) with a large number of patients under the medical treatment still not reaching the desired outcomes. Objective: To present a Metabolic Risk Score to better guide the surgical indication for T2DM patients with body mass index (BMI) where surgery for obesity is still controversial...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Yin Li
Enhanced recovery after surgery (ERAS) is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition and psychology. It aims to minimize surgical stress and maintain physiological function in perioperative care, thereby expediting recovery. ERAS theory has been clinically applied for nearly 20 years and it is firstly used in colorectal surgery, then widely used in other surgical fields. However, ERAS is not used commonly in esophagectomy because of its surgical complexity and high morbidity of postoperative complications, which limits the application of ERAS in the field of esophagectomy...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Peyman Sardari Nia, Samuel Heuts, Jean Daemen, Peter Luyten, Jindrich Vainer, Jan Hoorntje, Emile Cheriex, Jos Maessen
OBJECTIVES: Mitral valve repair performed by an experienced surgeon is superior to mitral valve replacement for degenerative mitral valve disease; however, many surgeons are still deterred from adapting this procedure because of a steep learning curve. Simulation-based training and planning could improve the surgical performance and reduce the learning curve. The aim of this study was to develop a patient-specific simulation for mitral valve repair and provide a proof of concept of personalized medicine in a patient prospectively planned for mitral valve surgery...
September 27, 2016: Interactive Cardiovascular and Thoracic Surgery
Soumia Meftah, Karima Belhaj, Siham Zahi, Laila Mahir, Fatima Lmidmani, Abdellatif El Fatimi
OBJECTIVE: Total hip arthroplasty (THA) is a surgical procedure which effectiveness and regularity of results are remarkable by providing: pain relief, improvement of function, and quality of life. The aim of our work is to compare the functional outcome and patient quality of life after total hip replacement according to indication: degenerative hip disease or inflammatory hip disease. MATERIAL/PATIENTS AND METHODS: Prospective study of 175 patients who underwent total hip arthroplasty (35 bilateral), followed in the Department of Physical Medicine and Rehabilitation, from January, 2011 to December, 2015...
September 2016: Annals of Physical and Rehabilitation Medicine
Fabinshy Thangarajah, Wolfram Malter, Stefanie Hamacher, Matthias Schmidt, Stefan Krämer, Peter Mallmann, Verena Kirn
OBJECTIVES: Since the introduction of the sentinel node technique for breast cancer in the 1990s patient's morbidity was reduced. Tracer uptake is known to be dependent from lymph node integrity and activity of macrophages. The aim of this study was to assess whether radioactivity of the tracer can predict sentinel lymph node metastases. Furthermore, a potential association with Ki-67 index was examined. Non-invasive prediction of lymph node metastases could lead to a further decrease of morbidity...
September 22, 2016: Breast: Official Journal of the European Society of Mastology
Rajendra Sawh-Martinez, Yassmin Parsaei, Robin Wu, Alexander Lin, Philipp Metzler, Christopher DeSesa, Derek M Steinbacher
PURPOSE: Virtual surgical planning (VSP) using computer-aided design and manufacturing (CAD-CAM) has been reported to aid in craniofacial reconstruction. The reported improvements have been related mainly to operative performance, with limited evaluations of the position and function of the temporomandibular joint (TMJ). This study analyzed the radiographic detail of postoperative outcomes related to the TMJ. MATERIALS AND METHODS: Patients who underwent mandibular reconstruction with and without VSP were analyzed...
August 25, 2016: Journal of Oral and Maxillofacial Surgery
Sampanna Jung Rayamajhi, Jeff Lee, Bhagwant Rai Mittal, Aaron Craig Jessop, Beth Chasen, Priya Bhosale
Insulinomas are rare neuroendocrine tumors which occur predominantly in the pancreas. Although majority of the insulinomas are benign, over-secretion of insulin by the tumor leads to debilitating hypoglycemic symptoms. The diagnosis is based on clinical and biochemical findings. After the diagnosis is made, the principal challenge lies in locating the tumor because most tumors are solitary and small in size. Locating the tumor is of paramount importance as complete surgical excision is the only curative treatment, and incomplete resection leads to persistence of symptoms...
September 17, 2016: Abdominal Radiology
Simon Maretti Tornbjerg, Nis Nissen, Martin Englund, Uffe Jørgensen, Jeppe Schjerning, L Stefan Lohmander, Jonas Bloch Thorlund
BACKGROUND: The relationship between meniscal tears and other joint pathologies with patient-reported symptoms is not clear. We investigated associations between structural knee pathologies identified at surgery with preoperative knee pain and function in patients undergoing arthroscopic meniscal surgery. METHODS: This study included 443 patients from the Knee Arthroscopy Cohort Southern Denmark (KACS), a prospective cohort following patients 18 years or older undergoing arthroscopic meniscal surgery at 4 hospitals between 1 February 2013 and 31 January 2014...
September 16, 2016: British Journal of Sports Medicine
Manish K Aghi, Clark C Chen, Maria Fleseriu, Steven A Newman, Joshua William Lucas, John S Kuo, Garni Barkhoudarian, Christopher J Farrell, Jason Sheehan, Mateo Ziu, Ian F Dunn
BACKGROUND: Nonfunctioning pituitary adenomas (NFPAs) are the most frequent pituitary tumors. OBJECTIVE: To create evidence-based guidelines for the initial management of NFPAs. METHODS: A multidisciplinary task force composed of physician volunteers and evidence-based medicine-trained methodologists conducted a systematic review of the literature relevant to the management of NFPAs. To ascertain the class of evidence for the posttreatment follow-ups, the task force used the Clinical Assessment evidence-based classification...
October 2016: Neurosurgery
Shangshan Li, Chunjun Liu, Dali Mu, Minqiang Xin, Su Fu, Lin Chen, Jie Luan
BACKGROUND: The range of the medial dissection forbidden zone, defined as the no-touch zone in this study, is of great importance in breast augmentation. Currently, 30 mm of the no-touch zone is marked and the pocket dissection does not pass medial to this zone, which lacks anatomical evidence. This study aimed to determine the optimal range of the no-touch zone in breast augmentation by precisely locating relevant anatomical structures. METHODS: Preoperative multidetector-row CT angiography (MDCTA) was performed in 36 Chinese female patients who were to receive breast reconstruction...
September 8, 2016: Aesthetic Plastic Surgery
Ping Ding, Shuli Liang, Shaohui Zhang, Junchen Zhang, Xiaohong Hu, Xiaoman Yu
BACKGROUND: The first prospective trial for resective surgery combined with corpus callosotomy (CCT) was performed to investigate the outcomes of the combined surgery in children with Lennox-Gastaut syndrome (LGS) without focal lesion on brain MRI. METHODS: This study enrolled 68 children with LGS and without focal lesion on brain MRI, of which 25 received medicine (medicine group) and 43 underwent surgery (surgery group), including 20 with exclusively resective surgery (exclusively resection subgroup) and 23 with resective surgery combined with CCT (combined CCT subgroup)...
November 2016: Acta Neurochirurgica
Metin Temel
BACKGROUND: This study aimed to present the long-term results of the consolidative technique otoplasty (CTO). METHODS: Patient age, sex, duration of follow-up, and how the deformity (bilateral-unilateral) occurred were determined. The kind of anesthesia, duration of surgery, surgical techniques used during the operation were reported, and the preoperative and postoperative distances between the ear and head were measured at four points (SUP: The highest point of the helix; SCA: the concha superior sticking points; ICA: stick point of Concha at the inferior; and lobular)...
September 9, 2016: Aesthetic Plastic Surgery
F Balck, S Kirschner, C Jeszenszky, M Lippmann, K-P Günther
Background: Total hip arthroplasty is one of the most successful operations in medicine. The clinical result after surgery and compliance during rehabilitation are influenced by the patient's expectations. There is a lack of a validated German instrument to record these expectations in a standardised manner. Patients: 193 patients from the Dresden Hip Register with osteoarthritis of the hip were surveyed with respect to their expectations before the operation. The study sample consists of 108 women and 85 men...
September 9, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Yahya Acar, Onur Tezel, Necati Salman, Erdem Cevik, Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás, Mustafa Z Mahmoud, Abdelmoneim Sulieman, Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H Lester Kirchner, Gregor Prosen, Ajda Anzic, Paul Leeson, Maryam Bahreini, Fatemeh Rasooli, Houman Hosseinnejad, Gabriel Blecher, Robert Meek, Diana Egerton-Warburton, Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević, Nadan Rustemović, Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim, Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung, Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić, Abiola Fasina, Anthony J Dean, Nova L Panebianco, Patricia S Henwood, Oliviero Fochi, Moreno Favarato, Ezio Bonanomi, Ivan Tomić, Youngrock Ha, Hongchuen Toh, Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Angela Hua, Sharon Kim, James Tsung, Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay, Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim, Ji-Han Lee, Jana Ambrozic, Katja Prokselj, Miha Lucovnik, Gabrijela Brzan Simenc, Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas, Sharad Mohite, Zoltan Narancsik, Hugon Možina, Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann, Chun-I Pan, Chien-Hung Wu, Sarah Pasquale, Stephanie J Doniger, Sharon Yellin, Gerardo Chiricolo, Maja Potisek, Borut Drnovšek, Boštjan Leskovar, Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi, Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic, Ana Godan Hauptman, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Vedran Radonic, Luka Bielen, Peh Wee Ming, Nur Hafiza Yezid, Fatahul Laham Mohammed, Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W Yus Haniff W Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan
A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
September 2016: Critical Ultrasound Journal
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