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https://www.readbyqxmd.com/read/28931184/-modern-interdisciplinary-management-of-a-uretero-iliac-artery-fistula-case-report
#1
D Benedix, F Meyer, F Fischbach, A Janitzky, Z Halloul
Introduction Abnormal links between the arterial system and other luminal systems are a challenge to those in charge of their adequate diagnostic and therapeutic management. Objective Scientific case report on an individual who underwent successful treatment combining vascular-surgical and interventional radiology techniques for a rare right uretero-iliac artery fistula based on personal clinical experience, a selective literature research and a detailed discussion of current recommendations for diagnostic workup and subsequent treatment...
September 20, 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28930960/prehospital-administration-of-freeze-dried-plasma-is-it-the-solution-for-trauma-casualties
#2
Amir Shlaifer, Maya Siman-Tov, Irina Radomislensky, Kobi Peleg, Avi Shina, Erez Nachum Baruch, Elon Glassberg, Avraham Yitzhak
BACKGROUND: Hemorrhage is the leading cause of possible preventable death in the battlefield. There is an increasing evidence for the effectiveness of blood component therapy in general, and plasma infusion in particular but their use is less applicable in the prehospital setting due to logistic difficulties. Israeli Defense Force has implemented the use of freeze-dried plasma (FDP) at the point of injury (POI), this adoption of FDP use entailed doubts regarding the feasibility and effectiveness of this practice...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930955/comparison-of-compensatory-reserve-and-arterial-lactate-as-markers-of-shock-and-resuscitation
#3
Michael Craig Johnson, Abdul Alarhayem, Victor Convertino, Robert Carter, Kevin Chung, Ronald Stewart, John Myers, Daniel Dent, Lilian Liao, Ramon Cestero, Susannah Nicholson, Mark Muir, Martin Schwaca, David Wampler, Mark DeRosa, Brian J Eastridge
BACKGROUND: During traumatic hemorrhage, the ability to identify shock and intervene before decompensation is paramount to survival. Lactate is extremely sensitive to shock, and its clearance has been demonstrated a useful gauge of shock and resuscitation status. Though lactate can be measured in the field, logistical constraints render it impractical in certain environments. The compensatory reserve represents a new clinical measurement reflecting the remaining capacity to compensate for hypoperfusion...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930944/negative-ct-can-safely-rule-out-clinically-significant-intra-abdominal-injury-in-the-asymptomatic-patient-after-blunt-trauma-prospective-evaluation-of-1193-patients
#4
Elizabeth Benjamin, Jayun Cho, Gustavo Recinos, Evren Dilektasli, Lydia Lam, John Brunner, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Computed tomography of the abdomen and pelvis (CTAP) is highly specific for injury identification and commonly used in the evaluation of blunt trauma patients. Despite this, there is no consensus on the required clinical observation period after negative imaging, often impacting patient flow and hospital cost. The purpose of this study was to evaluate the use of CTAP after blunt trauma and the need for observation following negative imaging. METHODS: A prospective analysis at a large level I trauma center was conducted from 11/2014-5/2015...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930941/thoracic-irrigation-prevents-retained-hemothorax-a-prospective-propensity-scored-analysis
#5
Nathan W Kugler, Thomas W Carver, David Milia, Jasmeet S Paul
BACKGROUND: Thoracic trauma resulting in hemothorax (HTx) is typically managed with thoracostomy tube (TT) placement; however, up to 20% of patients develop retained HTx which may necessitate further intervention for definitive management. While optimal management of retained HTx has been extensively researched, little is known about prevention of this complication. We hypothesized thoracic irrigation at the time of TT placement would significantly decrease the rate of retained HTx necessitating secondary intervention...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930925/conical-modification-of-forearm-free-flaps-for-single-stage-reconstruction-after-total-orbital-exenteration
#6
Chad A Purnell, Elbert E Vaca, Marco F Ellis
BACKGROUND: Orbital exenteration is a significant reconstructive challenge for plastic surgeons. Options described for these defects range from healing by secondary intention to free tissue transfer. The authors present our preferred reconstruction of orbital defects with free forearm-based flaps, which provides quality soft tissue and orbital contouring in 1 stage to consistently allow placement of bone-anchored implants for eventual orbital prosthesis. METHODS: This conical shape of the orbit is deconstructed into a "Pac-Man" type shaped flap that leaves adequate depth for a prosthesis...
September 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#7
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28930833/readmission-due-to-infection-following-total-hip-and-total-knee-procedures-a-retrospective-study
#8
Nadine Zawadzki, Yao Wang, Hui Shao, Emelline Liu, Chao Song, Michele Schoonmaker, Lizheng Shi
Policymakers have expanded readmissions penalty programs to include elective arthroplasties, but little is known about the risk factors for readmissions following these procedures. We hypothesized that infections after total hip arthroplasty (THA) and total knee arthroplasty (TKA) lead to excess readmissions and increased costs. This study aims to evaluate the proportion of readmissions due to infections following THA and TKA.Healthcare Cost and Utilization Project-State Inpatient Databases were used for the study...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28930814/neurologic-and-functional-morbidity-in-critically-ill-children-with-bronchiolitis
#9
Steven L Shein, Katherine N Slain, Jason A Clayton, Bryan McKee, Alexandre T Rotta, Deanne Wilson-Costello
OBJECTIVES: Neurologic and functional morbidity occurs in ~30% of PICU survivors, and young children may be at particular risk. Bronchiolitis is a common indication for PICU admission among children less than 2 years old. Two single-center studies suggest that greater than 10-25% of critical bronchiolitis survivors have neurologic and functional morbidity but those estimates are 20 years old. We aimed to estimate the burden of neurologic and functional morbidity among more recent bronchiolitis patients using two large, multicenter databases...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28929921/clinical-implications-of-interictal-epileptiform-discharges-in-cognitive-functioning-in-cec-syndrome-with-evolution-into-epileptic-encephalopathy
#10
Paolo Bonanni, Susanna Negrin, Lisa Antoniazzi, Martina Da Rold, Franco Fabbro, Anna Serafini
In epileptic encephalopathies (EE), interictal epileptiform discharges (IEDs) contribute to cognitive impairment. The EE process has been studied in a patient affected by epilepsy with occipital calcification and celiac disease (CEC syndrome) by combining the administration of brain area stimulus specific (visual and auditory) reaction times (RT) during continuous EEG monitoring with the off-line reconstruction of auditory and visual evoked potentials (EP). Visual RT and VEP were abnormal only if recorded concomitantly to the IEDs...
September 20, 2017: Neurocase
https://www.readbyqxmd.com/read/28929802/a-study-of-outcomes-of-patients-treated-at-a-uk-major-trauma-centre-for-moderate-or-severe-injuries-one-to-three-years-after-injury
#11
Stephen Spreadborough, Kate Radford, Roshan das Nair, Adam Brooks, Miriam Duffy
OBJECTIVE: To assess return to work outcomes of major trauma patients treated at a level 1 UK major trauma centre and evaluate factors associated with improved outcomes. DESIGN: Cross-sectional cohort design. SUBJECTS: In total, 99 patients at one, two or three years post-discharge from a Major Trauma Centre with an injury severity score above 9, in full-time work or education prior to injury, aged 18-70 and discharged between April 2012 and June 2015...
September 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28929424/aphasia-as-a-predictor-of-stroke-outcome
#12
REVIEW
Ronald M Lazar, Amelia K Boehme
PURPOSE OF REVIEW: Aphasia is a common feature of stroke, affecting 21-38% of acute stroke patients and an estimated 1 million stroke survivors. Although stroke, as a syndrome, is the leading cause of disability in the USA, less is known about the independent impact of aphasia on stroke outcomes. RECENT FINDINGS: During the acute stroke period, aphasia has been found to increase length of stay, inpatient complications, overall neurological disability, mortality, and to alter discharge disposition...
September 19, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28929118/natriuretic-peptide-system-activation-in-acute-heart-failure-patients-with-diabetes
#13
Filipe M Cunha, Joana Pereira, Pedro Marques, Helena Moreira, Pedro Rodrigues, Maria João Pinto, Patrícia Lourenço, Paulo Bettencourt
BACKGROUND: Elevated B-type natriuretic peptide (BNP) is a hallmark in heart failure (HF). Diabetic patients with chronic HF seem to have higher BNP than nondiabetics. We studied, in acute HF, if BNP levels are different between diabetics and nondiabetics. METHODS: From a prospectively recruited population of acute HF patients, we selected a convenience sample. In pair-matched analysis, each diabetic patient was matched with a nondiabetic of the same age (±1 year), gender, and according to left ventricular systolic dysfunction...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28929070/comparative-study-of-management-of-attico-antral-csom-by-conventional-mastoidectomy-with-inside-out-technique
#14
Sudhakar Vaidya, Shobhit Gupta
This prospective study was undertaken to compare the different aspects of inside out and conventional mastoidectomy techniques in attico-antral type of chronic suppurative otitis media. 100 cases of unsafe ear selected in this study were divided in 2 groups-(1) Group A-50 patients operated by conventional technique of canal wall down mastoidectomy. (2) Group B-50 patients operated by inside out technique of canal wall down mastoidectomy. The patients in our series were regularly followed to assess the condition of the postoperative cavity for three months...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28929062/comparative-study-of-outcome-of-endoscopic-myringoplasty-in-active-and-inactive-mucosal-chronic-otitis-media-patients
#15
Mohd Tasleem, A Rahman, M Aslam
The objective of this study was to compare graft uptake and hearing improvement in active and inactive mucosal chronic otitis media patients after endoscopic myringoplasty. This is prospective study conducted at a government medical college and hospital from February 2014 to August 2015. A total of 40 active (wet) ears with mucoid discharge and 40 inactive (dry) ears (at least 6 weeks dry before surgery) with mucosal chronic otitis media were operated on by endoscopic myringoplasty by transcanal approach. Graft uptake and hearing gain rates 3 months after surgery were compared for both groups...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28929034/giant-cervical-goiter-with-posterior-mediastinal-extension
#16
Ashraf Zahra, Osama Abdallah, Gamal A Farag
Most cervico-mediastinal goiters are situated in the anterior mediastinal compartment, but according to the literature, 10-15 percent of them are located in the posterior mediastinum. Although most anterior mediastinal goiters can be removed by using the transcervical approach, cervico-mediastinal goiters in the posterior mediastinal may require additional extracervical incisions. We report the case of a huge cervico-mediastinal goiter extending from the neck retrotracheally to the posterior mediastinum. Surgical removal is the treatment of choice in such cases...
July 10, 2017: Curēus
https://www.readbyqxmd.com/read/28928918/arterial-thoracic-outlet-syndrome-secondary-to-hypertrophy-of-the-anterior-scalene-muscle
#17
Erion Qaja, Sara Honari, Robert Rhee
Thoracic outlet syndrome (TOS) was first introduced in literature by Peet et al. in 1956. Since then is has been studied extensively and subcategorized into at least four closely related syndrome. Neurogenic TOS due to the compression of brachial plexus, arterial TOS in cases of compression of the subclavian artery, venous TOS in cases of compression of the subclavian vein, and non-specific type of TOS. Neurogenic TOS is by far the most common consisting of 95% of the cases, followed by venous and lastly arterial...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28928578/comparison-of-spinal-anesthesia-and-paravertebral-block-in-inguinal-hernia-repair
#18
Ranjana Khetarpal, Veena Chatrath, Arminder Kaur, Reeta Jassi, Renu Verma
CONTEXT: Inguinal hernia repair (IHR) is a common surgical procedure which can be performed under general, regional, or peripheral nerve block anesthesia. AIM: The aim of our study was to compare the efficacy of paravertebral block (PVB) with spinal anesthesia (SA) for IHR with respect to postoperative analgesia, ambulation, and adverse effects. SETTINGS AND DESIGN: This was a prospective, single-blind randomized controlled trial. MATERIALS AND METHODS: Sixty American Society of Anesthesiologists Class I-II patients of 20-60 years scheduled for IHR were randomized by a computer-generated list into two groups of thirty each, to receive either PVB (Group PVB: at T12-L2 levels, 10 ml of 0...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928576/relative-efficacy-of-ultrasound-guided-ilioinguinal-iliohypogastric-nerve-block-versus-transverse-abdominis-plane-block-for-postoperative-analgesia-following-lower-segment-cesarean-section-a-prospective-randomized-observer-blinded-trial
#19
L Vamsee Kiran, T Sivashanmugam, V R Hemanth Kumar, N Krishnaveni, S Parthasarathy
BACKGROUND: Quality of postoperative analgesia after cesarean section makes difference to mother in child bonding, early ambulation, and discharge. Ilioinguinal iliohypogastric (ILIH) and transverse abdominis plane (TAP) block had been tried to reduce the opioid analgesics, but the relative efficacy is unknown. Hence, this study was designed to compare the efficacy of these two regional analgesic techniques in sparing postoperative rescue analgesic requirement following lower segment cesarean section (LSCS)...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928548/a-prospective-comparative-observational-study-of-clinical-efficacy-of-isobaric-ropivacaine-0-75-with-of-isobaric-bupivacaine-0-5-intrathecally-in-elective-inguinal-hernia-repair-surgeries
#20
Shivam Bipin Parekh, Suchita Shailesh Parikh, Harsha Patel, Malini Mehta
AIMS: To evaluate the efficacy of intrathecal isobaric Ropivacaine and its comparison with intrathecal isobaric Bupivacaine in elective inguinal hernia repair surgeries. SETTINGS AND DESIGN: A prospective, randomized study was conducted in a tertiary care hospital with 80 patients of ASA grade I-III undergoing elective inguinal hernia repair surgery under spinal anaesthesia. Ethical committee clearance and written consent taken. The patients were randomly divided into two equal groups to the Ropivicaine group (Group R) and to theBupivicaine group (Group B)...
July 2017: Anesthesia, Essays and Researches
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