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https://www.readbyqxmd.com/read/27920582/surgeons-early-experience-with-the-acessa%C3%A2-procedure-gaining-proficiency-with-new-technology
#1
Kelli M Braun, Mark Sheridan, Erin Z Latif, Lexy Regush, Anet Maksymowicz, Laura Weins, Mohamed A Bedaiwy, Nerissa Tyson, Marilyn J Davidson, Barry H Sanders
PURPOSE: Successful adoption of a new surgical procedure varies among practicing surgeons, and skill acquisition depends on the surgeon's innate ability, the complexity of the technique, and training. We report intraoperative and near-term postoperative outcomes from the Acessa procedure conducted by minimally invasive gynecologic surgeons new to Acessa, and report the surgeons' experiences during the training period. PATIENTS AND METHODS: The study was designed as a postmarket, prospective, single-arm, multicenter analysis of operative and early postoperative outcomes after proctored surgical training with the Acessa device and procedure (laparoscopic ultrasound-guided radiofrequency volumetric thermal ablation of symptomatic fibroids) in premenopausal, menstruating women as conducted in community and university hospitals in the USA and Canada...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/27917662/validating-a-benchmarking-tool-for-audit-of-early-outcomes-after-operations-for-head-and-neck-cancer
#2
D Tighe, I Sassoon, M McGurk
INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regression equation predicting for all complications, previously validated internally at sites A-C, was tested on a fourth external validation sample (site D, 172 operations) using receiver operating characteristic curves, Hosmer-Lemeshow goodness of fit analysis and Brier scores...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27906851/silk-ligation-delay-for-the-random-pattern-flap
#3
Lei Liu, Chen Zhang, Haizhou Tong, Tao Song, Ningbei Yin, Haidong Li, Zhenmin Zhao
OBJECTIVE: The purpose of this study is to explore a silk ligation delay for the expanded and unexpanded random flaps to improve the vascularization and survival length of the flap. METHODS: Marked incision points 2 to 3 cm at every interval along the design line with methylene blue, each incision was about 3 mm long. A subepidermal tunnel was formed on the superfacial layer of dermis between every adjacent incision; another gap was done on the surface of the expander...
November 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#4
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27893030/development-and-initial-validation-of-the-risk-analysis-index-for-measuring-frailty-in-surgical-populations
#5
Daniel E Hall, Shipra Arya, Kendra K Schmid, Casey Blaser, Mark A Carlson, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason Johanning
Importance: Growing consensus suggests that frailty-associated risks should inform shared surgical decision making. However, it is not clear how best to screen for frailty in preoperative surgical populations. Objective: To develop and validate the Risk Analysis Index (RAI), a 14-item instrument used to measure surgical frailty. It can be calculated prospectively (RAI-C), using a clinical questionnaire, or retrospectively (RAI-A), using variables from the surgical quality improvement databases (Veterans Affairs or American College of Surgeons National Surgical Quality Improvement Projects)...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27865611/treatment-of-osteonecrosis-of-the-femoral-head-with-free-vascularized-fibular-grafting-results-of-7-6-year-follow-up
#6
Mehmet Bekir Ünal, Eren Cansu, Fatih Parmaksızoğlu, Hakan Cift, Serkan Gürcan
OBJECTIVES: The aim of this study was to determine long term follow up of the patients who had femoral head osteonecrosis and had been treated with free vascularized fibular grafting. PATIENTS AND METHODS: We retrospectively reviewed 28 hips of 21 patients who had undergone free vascularized fibular grafting for the treatment of osteonecrosis of femoral head. There were 16 male and 5 female patients. The mean age of the patients at the time of surgery was 30.7 years (between 15 and 53 years)...
November 16, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27863464/low-wall-shear-stress-is-associated-with-the-rupture-of-intracranial-aneurysm-with-known-rupture-point-case-report-and-literature-review
#7
Yisen Zhang, Linkai Jing, Ying Zhang, Jian Liu, Xinjian Yang
BACKGROUND: Few previous hemodynamic studies demonstrated the detailed features of rupture point of intracranial aneurysms. The hemodynamic simulation for the case that ruptured during angiography was even rare. In the present study, we studied the hemodynamic characteristics of a posterior communicating artery segment aneurysm that ruptured during angiography and detailed the hemodynamic features at the rupture point. CASE PRESENTATION: One 64-years-patient was 60-69 years old and suffered a subarachnoid hemorrhage within 24 h...
November 18, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27861753/screening-for-depression-in-cancer-patients-receiving-radiotherapy-feasibility-and-identification-of-effective-tools-in-the-nrg-oncology-rtog-0841-trial
#8
Lynne I Wagner, Stephanie L Pugh, William Small, Jeffrey Kirshner, Kulbir Sidhu, Martin J Bury, Albert S DeNittis, Tracy E Alpert, Binh Tran, Beatrice F Bloom, Julie Mai, Alexander Yeh, Kalika Sarma, Mark Becker, Jennifer James, Deborah Watkins Bruner
BACKGROUND: Brief tools are needed to screen oncology outpatients for depressive symptoms. METHODS: Patients starting radiotherapy for the first diagnosis of any tumor completed distress screening tools, including the 9-item Patient Health Questionnaire (PHQ-9), the 2-item Patient Health Questionnaire (PHQ-2), the National Comprehensive Cancer Network Distress Thermometer (NCCN-DT), and the Hopkins Symptom Checklist (HSCL) (25-item version). Patients exceeding validated cutoff scores and a systematic sample of patients whose screening was negative completed the Structured Clinical Interview for DSM-IV (SCID) mood disorder modules via telephone...
November 10, 2016: Cancer
https://www.readbyqxmd.com/read/27858249/a-review-of-the-application-of-vancomycin-powder-to-posterior-spinal-fusion-wounds-with-a-focus-on-side-effects-and-infection-a-prospective-study
#9
Evelyn P Murphy, Mark Curtin, Aseer Shafqat, Fergus Byrne, Mutaz Jadaan, Elias Rahall
INTRODUCTION: Deep wound infection after spinal surgery is a potentially devastating complication and is associated with higher morbidity, mortality and healthcare costs. Different measures including intraoperative application of vancomycin powder to wounds have been employed previously to decrease the infection rate. OBJECTIVES: The primary objective of this ongoing clinical study is to evaluate the systemic uptake of prophylactically applied vancomycin in instrumented spinal fusion surgery...
November 17, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27836507/use-of-a-multi-level-mixed-methods-approach-to-study-the-effectiveness-of-a-primary-care-progressive-return-to-activity-protocol-after-acute-mild-traumatic-brain-injury-concussion-in-the-military
#10
Emma Gregory, Therese A West, Wesley R Cole, Jason M Bailie, Karen L McCulloch, Mark L Ettenhofer, Amy Cecchini, Felicia M Qashu
The large number of U.S. service members diagnosed with concussion/mild traumatic brain injury each year underscores the necessity for clear and effective clinical guidance for managing concussion. Relevant research continues to emerge supporting a gradual return to pre-injury activity levels without aggravating symptoms; however, available guidance does not provide detailed standards for this return to activity process. To fill this gap, the Defense and Veterans Brain Injury Center released a recommendation for primary care providers detailing a step-wise return to unrestricted activity during the acute phase of concussion...
November 9, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27826775/analysis-of-lesion-localisation-at-colonoscopy-outcomes-from-a-multi-centre-u-k-study
#11
Susan J Moug, Spyridon Fountas, Mark S Johnstone, Adam S Bryce, Andrew Renwick, Lindsey J Chisholm, Kathryn McCarthy, Amy Hung, Robert H Diament, John R McGregor, Myo Khine, James D Saldanha, Khurram Khan, Graham Mackay, E Fiona Leitch, Ruth F McKee, John H Anderson, Ben Griffiths, Alan Horgan, Sonia Lockwood, Carly Bisset, Richard Molloy, Mark Vella
BACKGROUND: Colonoscopy is currently the gold standard for detection of colorectal lesions, but may be limited in anatomically localising lesions. This audit aimed to determine the accuracy of colonoscopy lesion localisation, any subsequent changes in surgical management and any potentially influencing factors. METHODS: Patients undergoing colonoscopy prior to elective curative surgery for colorectal lesion/s were included from 8 registered U.K. sites (2012-2014)...
November 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27812107/improving-coverage-and-compliance-in-mass-drug-administration-for-the-elimination-of-lf-in-two-endgame-districts-in-indonesia-using-micronarrative-surveys
#12
Alison Krentel, Rita Damayanti, Christiana Rialine Titaley, Nugroho Suharno, Mark Bradley, Timothy Lynam
BACKGROUND: As the Global Programme to Eliminate Lymphatic Filariasis (LF) approaches its 2020 goal, an increasing number of districts will enter the endgame phase where drug coverage rates from mass drug administration (MDA) are used to assess whether MDA can be stopped. As reported, the gap between reported and actual drug coverage in some contexts has overestimated the true rates, thus causing premature administration of transmission assessment surveys (TAS) that detect ongoing LF transmission...
November 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27810548/immediate-transoral-allogeneic-bone-grafting-for-large-mandibular-defects-less-morbidity-more-bone-a-paradigm-in-benign-tumor-mandibular-reconstruction
#13
James C Melville, Nader N Nassari, Issa A Hanna, Jonathan W Shum, Mark E Wong, Simon Young
PURPOSE: Reconstruction of hard tissue continuity defects caused by ablative tumor surgery has been traditionally reconstructed with autogenous bone grafts or microvascular free flaps. Although results have been predictable from these 2 methods of reconstruction, the morbidity associated with bone harvest is quite serious for the patient. Predictable results have been obtained with using a combination of 100% cadaver bone, bone marrow aspirate concentrate (BMAC), and recombinant human bone morphogenic protein in immediate reconstruction for benign tumor extirpations through the extraoral approach...
October 6, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27791002/context-specific-inhibition-of-translation-by-ribosomal-antibiotics-targeting-the-peptidyl-transferase-center
#14
James Marks, Krishna Kannan, Emily J Roncase, Dorota Klepacki, Amira Kefi, Cédric Orelle, Nora Vázquez-Laslop, Alexander S Mankin
The first broad-spectrum antibiotic chloramphenicol and one of the newest clinically important antibacterials, linezolid, inhibit protein synthesis by targeting the peptidyl transferase center of the bacterial ribosome. Because antibiotic binding should prevent the placement of aminoacyl-tRNA in the catalytic site, it is commonly assumed that these drugs are universal inhibitors of peptidyl transfer and should readily block the formation of every peptide bond. However, our in vitro experiments showed that chloramphenicol and linezolid stall ribosomes at specific mRNA locations...
October 25, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27789268/prevalence-of-surgical-site-infections-following-orthognathic-surgery-a-double-blind-randomized-controlled-trial-on-a-3-day-versus-1-day-postoperative-antibiotic-regimen
#15
Clayton M Davis, Curtis E Gregoire, Ian Davis, Thomas W Steeves
PURPOSE: The purpose of this study was to determine the effect of a 3- versus 1-day antibiotic regimen on the rate of surgical site infection (SSI) in patients undergoing orthognathic surgery at a department of oral and maxillofacial surgery in Halifax, Nova Scotia, Canada. MATERIALS AND METHODS: A prospective, randomized controlled trial was conducted. All patients received 1 day of intravenous antibiotics after surgery. Then, patients were randomly distributed into groups that received 2 days of additional antibiotics (group A) or placebo (group B)...
October 3, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27785538/cholinergic-pet-imaging-in-infections-and-inflammation-using-11-c-donepezil-and-18-f-feobv
#16
Nis Pedersen Jørgensen, Aage K O Alstrup, Frank V Mortensen, Karoline Knudsen, Steen Jakobsen, Line Bille Madsen, Dirk Bender, Peter Breining, Mikkel Steen Petersen, Mariane Høgsberg Schleimann, Frederik Dagnæs-Hansen, Lars C Gormsen, Per Borghammer
INTRODUCTION: Immune cells utilize acetylcholine as a paracrine-signaling molecule. Many white blood cells express components of the cholinergic signaling pathway, and these are up-regulated when immune cells are activated. However, in vivo molecular imaging of cholinergic signaling in the context of inflammation has not previously been investigated. METHODS: We performed positron emission tomography (PET) using the glucose analogue 18F-FDG, and 11C-donepezil and 18F-FEOBV, markers of acetylcholinesterase and the vesicular acetylcholine transporter, respectively...
October 26, 2016: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/27777600/effects-of-recall-time-on-cause-of-death-findings-using-verbal-autopsy-empirical-evidence-from-rural-south-africa
#17
Laith Hussain-Alkhateeb, Max Petzold, Mark Collinson, Stephen Tollman, Kathleen Kahn, Peter Byass
BACKGROUND: Verbal autopsy (VA) is a widely used technique for assigning causes to non-medically certified deaths using information gathered from a close caregiver. Both operational and cultural factors may cause delays in follow-up of deaths. The resulting time lag-from death to VA interview-can influence ways in which terminal events are remembered, and thus affect cause-of-death assignment. This study investigates the impact of recall period on causes of death determined by VA. METHODS: A total of 10,882 deaths from the Agincourt Health and Demographic Surveillance System (HDSS) with complete VAs, including recall period, were incorporated in this study...
2016: Emerging Themes in Epidemiology
https://www.readbyqxmd.com/read/27774614/blood-component-transfusion-and-wastage-rates-in-the-setting-of-massive-transfusion-in-three-regional-trauma-centers
#18
Nancy M Dunbar, Nicholas J Olson, Zbigniew M Szczepiorkowski, Eric D Martin, Ryan M Tysarcyk, Darrell J Triulzi, Louis H Alarcon, Mark H Yazer
BACKGROUND: The purpose of massive transfusion protocols (MTPs) is to provide large quantities of blood products rapidly to exsanguinating patients. The expected rates of blood product transfusion and wastage in this setting have not been defined. This study was undertaken to assess the transfusion and wastage rates for bleeding patients requiring emergency issue of blood components at three American Level I trauma centers. STUDY DESIGN AND METHODS: Three hospitals participated, all of which are Level I trauma centers that have MTPs in place where uncrossmatched red blood cells (RBCs) can be ordered with or without platelets (PLTs), plasma, and cryoprecipitate...
October 23, 2016: Transfusion
https://www.readbyqxmd.com/read/27769659/multiple-postoperative-complications-making-sense-of-the-trajectories
#19
Shara I Feld, Sarah E Tevis, Alexander G Cobian, Mark W Craven, Gregory D Kennedy
BACKGROUND: Many studies have evaluated predictors of postoperative complications, yet little is known about the development of multiple complications. The goal of this study was to assess complication timing in cascades of multiple complications and the risk of future complications given a patient's first complication. METHODS: This study includes 30-day, postoperative complications from the American College of Surgeons National Surgical Quality Improvement Program for all patients who underwent major inpatient and outpatient operative procedures from 2005-2013...
December 2016: Surgery
https://www.readbyqxmd.com/read/27760812/analysis-of-risk-factors-for-early-type-i-endoleaks-after-thoracic-endovascular-aneurysm-repair
#20
Yuji Kanaoka, Takao Ohki, Koji Maeda, Takeshi Baba
PURPOSE: To evaluate risk factors for early (<30 days) type I endoleak following thoracic endovascular aortic repair (TEVAR). METHODS: A retrospective study was conducted of 439 consecutive patients (mean age 74.0±10.0 years; 333 men) who underwent TEVAR at a single center between June 2006 and June 2013. Pathologies included 237 aortic arch aneurysms and 202 descending thoracic aortic aneurysms (dTAA). Maximum TAA diameter was 63.6±13.7 mm. Among the distal aortic arch aneurysms, 124 required coverage of the left subclavian artery (LSA), while the remaining 113 arch aneurysms had debranching (n=40), the chimney technique (n=52), and a branched stent-graft (n=13)...
October 19, 2016: Journal of Endovascular Therapy
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