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Preoperative medicine

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https://www.readbyqxmd.com/read/28625807/evidence-for-altered-levels-of-immunoglobulin-d-in-the-nasal-airway-mucosa-of-patients-with-chronic-rhinosinusitis
#1
Jin-Young Min, Jayakar V Nayak, Kathryn E Hulse, Whitney W Stevens, Paul A Raju, Julia H Huang, Lydia A Suh, Griet A Van Roey, James E Norton, Roderick G Carter, Caroline P E Price, Ava R Weibman, Ali R Rashan, Eliver E Ghosn, Zara M Patel, Tetsuya Homma, David B Conley, Kevin C Welch, Stephanie Shintani-Smith, Anju T Peters, Leslie C Grammer, Kathleen E Harris, Atsushi Kato, Peter H Hwang, Robert C Kern, Leonore A Herzenberg, Robert P Schleimer, Bruce K Tan
BACKGROUND: Immunoglobulin D (IgD) is an enigmatic antibody isotype best known when co-expressed with IgM on naïve B cells. However, elevated soluble IgD (sIgD) and increased IgD(+)IgM(-) B cell populations have been described in the human upper respiratory mucosa. OBJECTIVE: We assessed whether levels of sIgD and IgD(+) B cells are altered in nasal tissue from patients with chronic rhinosinusitis (CRS). We further characterized IgD(+) B cell populations and explored clinical and local inflammatory factors associated with tissue sIgD levels...
June 15, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28619465/a-systematic-review-of-soft-to-hard-tissue-ratios-in-orthognathic-surgery-part-iv-3d-analysis-is-there-evidence
#2
Sergio Olate, Carlos Zaror, Maurice Y Mommaerts
OBJECTIVE: The objective of this study was to determine the soft-to-hard tissue ratio using 3D analysis in different types of orthognathic surgery. MATERIAL AND METHODS: A systematic search for relevant studies published in different languages through December 2016 was performed in the Medline, Embase, Lilacs, Scopus, and Science Direct databases. Additional studies were identified by reference analysis. The methodological quality of the included studies was evaluated using the method proposed by the Effective Public Health Practice Project...
May 17, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28607678/choosing-wisely-a-quality-improvement-initiative-to-decrease-unnecessary-preoperative-testing
#3
John Matulis, Stephen Liu, John Mecchella, Frederick North, Alison Holmes
Dartmouth-Hitchcock Medical Center is a rural, academic medical center in the northeastern United States; its General Internal Medicine (GIM) division performs about 900 low and intermediate surgical risk preoperative evaluations annually. Routine preoperative testing in these evaluations is widely considered a low-value service. Our baseline data sample showed unnecessary testing rates of approximately 36%. A multi-disciplinary team used a micro-systems approach to analyze the existing process and formulate a rapid cycle improvement strategy...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28593553/prenatal-diagnosis-of-spina-bifida-from-intracranial-translucency-to-intrauterine-surgery
#4
Waldo Sepulveda, Amy E Wong, Francisco Sepulveda, Juan L Alcalde, Juan C Devoto, Felipe Otayza
Accurate and timely prenatal diagnosis of spina bifida (SB) is a major goal of modern antenatal care. Prenatal screening for open SB should be first performed at the time of routine first-trimester ultrasound by examining the posterior fossa for obliteration or non-visualization of the fourth ventricle ("intracranial translucency") and cisterna magna. The second step of screening is the second-trimester anatomy scan, at which time the features of the Chiari type II malformation should be looked for, including ventriculomegaly, scalloping of the frontal bones ("lemon" sign), and backward and caudal displacement of the cerebellar vermis with obliteration of the cisterna magna ("banana" sign)...
June 7, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28593490/stenotic-breast-malformation-and-its-reconstructive-surgical-correction-a-new-concept-from-minor-deformity-to-tuberous-breast
#5
Marco Klinger, Francesco Klinger, Silvia Giannasi, Alessandra Veronesi, Valeria Bandi, Barbara Banzatti, Barbara Catania, Valeriano Vinci, Andrea Lisa, Guido Cornegliani, Micol Giaccone, Fabio Caviggioli, Luca Maione
BACKGROUND: Several classification systems have been reported to define the spectrum of tuberous breast deformity, and a range of surgical techniques has been described. In this paper, we proposed a new classification including tuberous breast and minor deformity based on stenosis type, glandular trophism and ptosis adapting surgical planning to different breast types. METHODS: A total of 246 patients meeting our definition for stenotic breasts asking for surgery were analyzed in this study...
June 7, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28593488/optimizing-patient-selection-for-direct-to-implant-immediate-breast-reconstruction-using-wise-pattern-skin-reducing-mastectomy-in-large-and-ptotic-breasts
#6
Amir Inbal, Eyal Gur, Benjamin T Lemelman, Daphna Barsuk, Tehilla Menes, David Leshem, Yoav Barnea
BACKGROUND: Immediate breast reconstruction in large and ptotic breasts is challenging, often requiring skin-reducing procedures. The Wise-pattern skin-reducing mastectomy (WPSRM) technique provides reliable one-stage implant coverage using the pectoralis muscle and a de-epithelialized inferiorly based dermal flap. However, de-vascularization may result in mastectomy skin flap necrosis. We aimed to critically evaluate and isolate patients at high risk of complications using this procedure...
June 7, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28591818/yokukansan-for-the-treatment-of-preoperative-anxiety-and-postoperative-delirium-in-colorectal-cancer-patients-a-retrospective-study
#7
Saho Wada, Hironobu Inoguchi, Takatoshi Hirayama, Yutaka J Matsuoka, Yosuke Uchitomi, Hiroki Ochiai, Shunsuke Tsukamoto, Dai Shida, Yukihide Kanemitsu, Ken Shimizu
Background: Yokukansan (YKS), a Japanese traditional herbal medicine for neurosis and insomnia, is speculated to be useful for perioperative psychiatric symptoms in cancer patients, but there exists little empirical evidence. This study provides preliminary data about the efficacy, feasibility, and side effects of YKS for the treatment of preoperative anxiety and postoperative delirium in cancer patients. Methods: We retrospectively reviewed the medical records of colorectal cancer patients who took YKS for preoperative anxiety, evaluating the following: (1) patient characteristics, (2) feasibility of taking YKS, (3) changes in preoperative anxiety based on the Clinical Global Impression (CGI) scale and Edmonton Symptom Assessment System-revised (ESAS-r-anxiety), (4) incidence of postoperative delirium and (5) YKS-related side effects...
June 7, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28589402/the-preoperative-assessment-and-optimization-of-patients-undergoing-major-urological-surgery
#8
REVIEW
Helen W Cui, Benjamin W Turney, John Griffiths
PURPOSE OF REVIEW: Improving patient outcomes from major urological surgery requires not only advancement in surgical technique and technology, but also the practice of patient-centered, multidisciplinary, and integrated medical care of these patients from the moment of contemplation of surgery until full recovery. This review examines the evidence for recent developments in preoperative assessment and optimization that is of relevance to major urological surgery. RECENT FINDINGS: Current perioperative medicine recommendations aim to improve the short-term safety and long-term effectiveness of surgical treatments by the delivery of multidisciplinary integrated medical care...
July 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28584743/benign-and-malignant-thyroid-gland-diseases-in-the-patients-with-primary-hyperparathyroidism
#9
Mehmet Celik, Sibel Guldiken, Semra Ayturk, Buket Yilmaz Bulbul, Ebru Tastekin, Nuray Can, Atakan Sezer, Funda Ustun, Ahmet Kucukarda
INTRODUCTION: This study aimed to evaluate concurrently detected thyroid pathologies in the patients who underwent surgery for primary hyperparathyroidism (PHPT). MATERIALS AND METHODS: In this study, we retrospectively analyzed the files of the patients who underwent surgery for PHPT between 2012 and 2015. Pre- and post-operative laboratory examination results and preoperative radiological and nuclear medicine findings of the patients were retrospectively recorded...
April 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28575906/-preoperative-evaluation-of-adult-patients-before-elective-non-cardiothoracic-surgery
#10
(no author information available yet)
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e.g. blood chemistry, ECG, spirometry, chest x-ray) can contribute to a reduction of perioperative risk is often not very well known or controversial. Similarly, there is considerable uncertainty among anaesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28573343/-preoperative-evaluation-of-adult-patients-before-elective-noncardiothoracic-surgery-joint-recommendation-of-the-german-society-of-anesthesiology-and-intensive-care-medicine-the-german-society-of-surgery-and-the-german-society-of-internal-medicine
#11
B Zwissler
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e. g. blood chemistry, ECG, spirometry, chest x‑ray) can contribute to a reduction of perioperative risk is often not very well known or is controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication...
June 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28573091/virtual-reality-and-augmented-reality-in-plastic-surgery-a-review
#12
REVIEW
Youngjun Kim, Hannah Kim, Yong Oock Kim
Recently, virtual reality (VR) and augmented reality (AR) have received increasing attention, with the development of VR/AR devices such as head-mounted displays, haptic devices, and AR glasses. Medicine is considered to be one of the most effective applications of VR/AR. In this article, we describe a systematic literature review conducted to investigate the state-of-the-art VR/AR technology relevant to plastic surgery. The 35 studies that were ultimately selected were categorized into 3 representative topics: VR/AR-based preoperative planning, navigation, and training...
May 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28569457/advances-in-radioguided-surgery-in-oncology
#13
Renato A Valdés Olmos, Sergi Vidal-Sicart, Gianpiero Manca, Giuliano Mariani, Luisa F León-Ramírez, Domenico Rubello, Francesco Giammarile
The sentinel lymph node (SLN) biopsy is probably the most well known radioguided technique in surgical oncology. Today SLN biopsy reduces the morbidity associated with lymphadenectomy and increases the identification rate of occult lymphatic metastases by offering the pathologist the lymph nodes with the highest probability of containing metastatic cells. These advantages may result in a change in clinical clinical management both in melanoma and breast cancer patients. The SLN evaluation by pathology currently implies tumour burden stratification for further prognostic information...
June 1, 2017: Quarterly Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28561149/-preoperative-evaluation-and-arrangements-the-elderly-patient
#14
Cynthia Olotu-Steffen, Simone Gurlit, Rainer Kiefmann
With a constantly growing portion of elderly within our population and the advances of modern medicine, surgery on aged and very aged patients has become a daily hospital routine. Due to the physical and mental features of ageing these patients face special perioperative risks. They display a higher rate of complications, morbidity and cognitive deficits which might in the end lead to persisting need of care. Even in the healthy elderly, most organ functions are "physiologically" instable or deficient and the homeostasis of health and disease is fragile...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28547894/internal-fixation-of-complicated-acetabular-fractures-directed-by-preoperative-surgery-with-3d-printing-models
#15
Zhao-Jie Liu, Jian Jia, Yin-Guang Zhang, Wei Tian, Xin Jin, Yong-Cheng Hu
The purpose of this article is to evaluate the efficacy and feasibility of preoperative surgery with 3D printing-assisted internal fixation of complicated acetabular fractures. A retrospective case review was performed for the above surgical procedure. A 23-year-old man was confirmed by radiological examination to have fractures of multiple ribs, with hemopneumothorax and communicated fractures of the left acetabulum. According to the Letounel and Judet classification, T-shaped fracture involving posterior wall was diagnosed...
May 26, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28541602/three-dimensional-printing-in-cardiology-current-applications-and-future-challenges
#16
Hongxing Luo, Jarosław Meyer-Szary, Zhongmin Wang, Robert Sabiniewicz, Yuhao Liu
Three-dimensional (3D) printing has attracted a huge interest in recent years. Broadly speaking, it refers to the technology which converts a predesigned virtual model to a touchable object. In clinical medicine, it usually converts a series of two-dimensional medical images acquired through computed tomography, magnetic resonance imaging or 3D echocardiography into a physical model. Medical 3D printing consists of three main steps: image acquisition, virtual reconstruction and 3D manufacturing. It is a promising tool for preoperative evaluation, medical device design, hemodynamic simulation and medical education, it is also likely to reduce operative risk and increase operative success...
May 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28540125/project-heaven-preoperative-training-in-virtual-reality
#17
Kiratipath Iamsakul, Alexander V Pavlovcik, Jesus I Calderon, Lance M Sanderson
A cephalosomatic anastomosis (CSA; also called HEAVEN: head anastomosis venture) has been proposed as an option for patients with neurological impairments, such as spinal cord injury (SCI), and terminal medical illnesses, for which medicine is currently powerless. Protocols to prepare a patient for life after CSA do not currently exist. However, methods used in conventional neurorehabilitation can be used as a reference for developing preparatory training. Studies on virtual reality (VR) technologies have documented VR's ability to enhance rehabilitation and improve the quality of recovery in patients with neurological disabilities...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28536929/inferior-pedicle-reduction-mammoplasty-with-or-without-tourniquet-a-comparative-study
#18
Canser Yilmaz Demir, Yılmaz Sultanoglu, Omer Faruk Kocak, Muhammet Eren Ersoz
OBJECTIVE: To compare the perioperative findings of inferior pedicle reduction mammoplasty (IPRM) performed with or without a tourniquet. METHODS: This study was carried out in the plastic and reconstructive surgery department at a tertiary care center on a total of 42 consecutive women scheduled for IPRM. Patients in Group I (n = 21) underwent surgery using a tourniquet, whereas patients in Group II (n = 21) were operated on without a tourniquet. Levels of hemoglobin (Hb), hematocrit (Hct), Hct/Hb ratio, and platelet counts were noted preoperatively and on postoperative 24th and 48th h...
May 23, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28534323/-era-of-enhanced-recovery-after-surgery-and-robotic-gastric-cancer-surgery
#19
Yanbing Zhou
Enhanced recovery after surgery (ERAS) has been rapidly developing by combining several techniques with evidence-based adjustments, including preoperative education, preoperative carbohydrate loading, epidural or regional anesthesia, early initiation of enteral nutrition, ambulation and multi-modal pain management. The core part of ERAS is to reduce and reverse surgical stress and therefore greatly improve clinical outcome. Under the guidance of ERAS, perioperative management of robotic gastric cancer operation should follow the basic principles of ERAS and clinical pathway to maximize the advantages of the robotic surgery...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28532933/clinical-outcomes-of-femtosecond-laser-assisted-cataract-surgery-versus-conventional-phacoemulsification-surgery-for-hard-nuclear-cataracts
#20
Xinyi Chen, Yinhui Yu, Xiaohui Song, Yanan Zhu, Wei Wang, Ke Yao
PURPOSE: To compare the outcomes between femtosecond laser-assisted cataract surgery (femtosecond group) and conventional phacoemulsification cataract surgery (conventional group) in patients with hard nuclear cataract. SETTING: Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China. DESIGN: Prospective consecutive nonrandomized comparative cohort study. METHODS: According to the Emery-Little classification, cataract patients with a grade 4 or 5 hard nuclei were assigned to 1 of the 2 groups...
April 2017: Journal of Cataract and Refractive Surgery
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