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https://www.readbyqxmd.com/read/28318537/cardiac-magnetic-resonance-imaging-in-suspected-blunt-cardiac-injury-a-prospective-pilot-cohort-study
#1
Aidan Jc Burrell, David M Kaye, Mark C Fitzgerald, David J Cooper, James L Hare, Benedict T Costello, Andrew J Taylor
INTRODUCTION: The aim of this study was to evaluate the incidence and severity of blunt cardiac injury (BCI) as determined by cardiac magnetic resonance imaging (CMR), and to compare this to currently used diagnostic methods in severely injured patients. MATERIALS AND METHODS: We conducted a prospective, pilot cohort study of 42 major trauma patients from July 2013 to Jan 2015. The cohort underwent CMR within 7 days, enrolling 21 patients with evidence of chest injury and an elevated Troponin I compared to 21 patients without chest injury who acted as controls...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28303519/siewert-iii-adenocarcinoma-treatment-update
#2
REVIEW
Alberto Di Leo, Andrea Zanoni
Siewert III cancer, although representing around 40% of EGJ cancers and being the EGJ cancer with worst prognosis, does not have a homogenous treatment, has few dedicated studies, and is often not considered in study protocols. Although staged as an esophageal cancer by the TNM 7th ed., it is considered a gastric cancer by new TNM 8th ed. Our aim was to consolidate the current literature on the indications and treatment options for Siewert III adenocarcinoma. A review of the literature was performed to better delineate treatment indications (according to stage, surgical margins, type of lymphatic spread and lymphadenectomy) and treatment strategy...
March 16, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28300284/predictors-and-variability-of-drug-eluting-vs-bare-metal-stent-selection-in-contemporary-percutaneous-coronary-intervention-insights-from-the-prism-study
#3
Ali Shafiq, Kensey Gosch, Amit P Amin, Henry H Ting, John A Spertus, Adam C Salisbury
Drug-eluting stents (DES) reduce risk of in-stent restenosis after percutaneous coronary intervention (PCI) but require dual antiplatelet therapy (DAPT) for a longer term than bare-metal stents (BMS). Few studies have examined clinical predictors of DES vs BMS, and variability in provider selection between DES and BMS in clinical practice has not been well described. These insights can inform our understanding of current practice and may identify opportunities to improve decision-making stent selection decinsion-making...
March 16, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28270910/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-prevention-of-postoperative-infection-within-an-enhanced-recovery-pathway-for-elective-colorectal-surgery
#4
Stefan D Holubar, Traci Hedrick, Ruchir Gupta, John Kellum, Mark Hamilton, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Colorectal surgery (CRS) patients are an at-risk population who are particularly vulnerable to postoperative infectious complications. Infectious complications range from minor infections including simple cystitis and superficial wound infections to life-threatening situations such as lobar pneumonia or anastomotic leak with fecal peritonitis. Within an enhanced recovery pathway (ERP), there are multiple approaches that can be used to reduce the risk of postoperative infections...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28255210/postpartum-varicose-veins-supplementation-with-pycnogenol-or-elastic-compression-a-12-month-follow-up
#5
Gianni Belcaro, Mark Dugall, Roberta Luzzi, Edmondo Ippolito, M Rosaria Cesarone
This open registry aimed to evaluate the clinical evolution of postpartum varicose veins (VVs), in healthy women after the second pregnancy, how these veins regain shape and competence, and possible treatments. The registry included two groups of women: (1) those who used elastic compression stockings, and (2) who used an oral venotonic agent (Pycnogenol, 100 mg/d). A total of 12 evaluation targets were established. Minor symptoms were scored in an analogue scale line. A visual analogue scale line evaluated the overall satisfaction relative to elastic compression or Pycnogenol...
March 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28254373/dosing-antibiotic-prophylaxis-during-cardiopulmonary-bypass-a-higher-level-of-complexity-a-structured-review
#6
REVIEW
Fathima Paruk, Fekade B Sime, Jeffrey Lipman, Jason A Roberts
In highly invasive procedures such as open heart surgery, the risk of post-operative infection is particularly high due to exposure of the surgical field to multiple foreign devices. Adequate antibiotic prophylaxis is an essential intervention to minimise post-operative morbidity and mortality. However, there is a lack of clear understanding on the adequacy of traditional prophylactic dosing regimens, which are rarely supported by data. The aim of this structured review is to describe the relevant pharmacokinetic/pharmacodynamic (PK/PD) considerations for optimal antibiotic prophylaxis for major cardiac surgery including cardiopulmonary bypass (CPB)...
February 27, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28250848/tissue-specific-methylation-profile-in-obese-patients-with-type-2-diabetes-before-and-after-roux-en-y-gastric-bypass
#7
REVIEW
Priscila Sala, Raquel Susana Matos de Miranda Torrinhas, Danielle Cristina Fonseca, Graziela Rosa Ravacci, Dan Linetzky Waitzberg, Daniel Giannella-Neto
Eating habits, lifestyles, and exposure to specific environmental factors can greatly impact the risk of developing type 2 diabetes (T2D), influence the genome epigenetically, and affect the expression of genes, including genes related to glycemic control, at any stage of life. The epigenetic mechanism underlying obesity and T2D pathogenesis remains poorly understood. Conventional strategies for the treatment of obesity and its comorbidities often have poor long-term adherence, and pharmacological interventions are limited...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28249808/potential-for-osseous-regeneration-of-platelet-rich-fibrin-a-comparative-study-in-mandibular-third-molar-impaction-sockets
#8
Mathew P Varghese, Suvy Manuel, L K Surej Kumar
PURPOSE: This study investigated the potential of platelet-rich fibrin (PRF) for osseous regeneration and soft tissue healing in mandibular third molar impaction sockets. MATERIALS AND METHODS: A prospective in vivo study was performed. Randomization was performed after extraction. On one side, the socket was sutured primarily (control site); on the other side, autologous PRF gel was placed and then the socket was sutured (test site). Postoperatively, grid periapical radiographs were obtained at periodic intervals (weeks 1, 4, and 16) and digitalized...
February 4, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28249654/transoral-robotic-surgery-for-management-of-cervical-unknown-primary-squamous-cell-carcinoma-updates-on-efficacy-surgical-technique-and-margin-status
#9
Mathew Geltzeiler, Sean Doerfler, Meghan Turner, William Greer Albergotti, Mark Kubik, Seungwon Kim, Robert Ferris, Umamaheswar Duvvuri
IMPORTANCE: Management of cervical unknown primary squamous cell carcinoma (CUP) has evolved with the introduction of transoral robotic surgery (TORS). OBJECTIVES: 1. To describe the efficacy of TORS lingual and palatine tonsillectomy in identifying the primary site of malignancy. 2. To explore how the extent of surgery affects diagnostic yield. 3. To report margin status of TORS resections. DESIGN, SETTING AND PARTICIPANTS: A retrospective, single-center cohort study utilizing a prospectively collected database of CUP patients in a high-volume tertiary referral center...
March 2017: Oral Oncology
https://www.readbyqxmd.com/read/28248041/-urinary-bladder-substitution-using-combined-membrane-based-on-secretions-of-human-mesenchymal-stem-cells-and-type-i-collagen
#10
V I Kirpatovckii, D M Kamalov, A Yu Efimenko, P I Makarevich, G D Sagaradze, O A Makarevich, P P Nimiritskii, E O Osidak, S P Domogatskii, V K Karpov, Z H A Akopyan, V A Tkachuk, A A Kamalov
AIM: Despite the widespread use of intestinal cystoplasty, urinary bladder substitution remains a challenging problem due to the complexity of operations and the potentially high risk of complications. A promising alternative may be bio-engineered collagen-based matrices containing stem cells or their secretions. MATERIAL AND METHODS: To evaluate the effectiveness of this bladder substitution modality, an experiment was conducted on 14 male rabbits. The animals underwent resection of urinary bladder, and the formed defect was substituted with a membrane of type I collagen (series 1, 5 rabbits) or a membrane of the same composition containing a conditioned medium with secretion of mesenchymal stem/stromal cells derived from human adipose tissue (series 2, 5 rabbits)...
December 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28241234/laparoscopic-total-pancreatectomy-with-islet-autotransplantation-and-intraoperative-islet-separation-as-a-treatment-for-patients-with-chronic-pancreatitis
#11
Caleb J Fan, Kenzo Hirose, Christi M Walsh, Michael Quartuccio, Niraj M Desai, Vikesh K Singh, Rita R Kalyani, Daniel S Warren, Zhaoli Sun, Marie N Hanna, Martin A Makary
Importance: Pain management of patients with chronic pancreatitis (CP) can be challenging. Laparoscopy has been associated with markedly reduced postoperative pain but has not been widely applied to total pancreatectomy with islet autotransplantation (TPIAT). Objective: To examine the feasibility of using laparoscopic TPIAT (L-TPIAT) in the treatment of CP. Design, Setting, and Participants: Thirty-two patients with CP presented for TPIAT at a tertiary hospital from January 1, 2013, through December 31, 2015...
February 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28214485/outcome-of-peripheral-venous-reconstructions-during-tumor-resection
#12
Philip Y Sun, Mark D Fleming, Kendall Stauffer, Manju Kalra, Gustavo Oderich, Thomas Bower, Peter Gloviczki, Randall R DeMartino
OBJECTIVE: Peripheral venous reconstruction surgery may be necessary for appropriate oncologic resection; however, the operative approach and surgical outcomes are not well described. We report our experience with these complex reconstructions to identify best practice. METHODS: We retrospectively reviewed all adult patients who underwent peripheral vein reconstruction for tumor resection at Mayo Clinic, Rochester (2000-2015). Patients were classified into three subgroups by the location: iliac (IL), lower extremity (LE), and upper extremity (UE)...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214482/catheter-directed-ultrasound-assisted-thrombolysis-is-a-safe-and-effective-treatment-for-pulmonary-embolism-even-in-high-risk-patients
#13
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28209412/injectable-chondroplasty-enzymatic-reshaping-of-cartilage-grafts
#14
J R Gandy, A Foulad, K K Chao, B J F Wong
OBJECTIVE/HYPOTHESIS: To develop an injection-based enzymatic technique that selectively softens cartilage tissue for reshaping cartilaginous structures in the head and neck. MATERIALS AND METHODS: Two groups were formed using fresh rabbit ears: (1) whole rabbit ear group; (2) composite graft group (2.5mm×3.0cm specimens sectioned from the central region of the pinna). Subperichondrial injections using three enzymes (hyaluronidase, pronase, and collagenase II) in sequence were performed for the experimental specimens from both groups...
February 10, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28203570/multifocal-gastric-ulcers-caused-by-diffuse-large-b-cell-lymphoma-in-a-patient-with-significant-weight-loss
#15
Mark A Gromski, Jennifer L Peng, Jiehao Zhou, Howard C Masuoka, Attaya Suvannasankha, Suthat Liangpunsakul
Primary gastrointestinal (GI) lymphoma is a heterogeneous disease with varied clinical presentations. The stomach is the most common GI site and accounts for 70% to 75% of GI lymphomas. We present a patient with gastric diffuse large B cell lymphoma (DLBCL) who presented with significant weight loss, early satiety, and multifocal ulcerated gastric lesions. Esophagoduodenoscopy should be performed in patients presenting with warning symptoms as in our case. Diagnosis is usually made by endoscopic biopsies. Multiple treatment modalities including surgery, radiotherapy, and chemotherapy have been used...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28187092/incidence-of-venous-thromboembolism-by-type-of-gynecologic-malignancy-and-surgical-modality-in-the-national-surgical-quality-improvement-program
#16
Ashley Graul, Nawar Latif, Xiaochen Zhang, Lorraine T Dean, Mark Morgan, Robert Giuntoli, Robert Burger, Sarah Kim, Emily Ko
BACKGROUND: Women with gynecologic cancer are at higher risk of venous thromboembolism (VTE) due to malignancy, pelvic surgery, increased age, and frequently comorbidities. The rate of VTE among different gynecologic cancers and relative to benign gynecologic surgeries has not been reported in a nationally representative cohort. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database, gynecologic surgeries were identified retrospectively from 2006 to 2012...
March 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28185972/optimizing-sellar-reconstruction-after-pituitary-surgery-with-free-mucosal-graft-results-in-the-first-50-consecutive-patients
#17
Maria Peris-Celda, Mark Chaskes, Daniel D Lee, Tyler J Kenning, Carlos D Pinheiro-Neto
BACKGROUND: Postoperative CSF leak after endoscopic pituitary surgery ranges from 1.9-10% in different series. Vascularized flaps have reduced the incidence of leak, however it carries nasal morbidity. This paper presents a technique for sellar reconstruction with free mucosal graft from the nasal cavity floor including inferior meatus mucosa. This technique aims to standardize sellar reconstruction without the use of the nasoseptal flap and keeping the advantage of mucosal coverage of the defect in all cases...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28183466/early-clinical-outcomes-after-transcatheter%C3%A2-aortic-valve-replacement-using-a-novel-self-expanding-bioprosthesis%C3%A2-in%C3%A2-patients-with-severe%C3%A2-aortic%C3%A2-stenosis-who-are-suboptimal%C3%A2-for%C3%A2-surgery-results-of-the-evolut-r-u-s-study
#18
Jeffrey J Popma, Michael J Reardon, Kamal Khabbaz, J Kevin Harrison, G Chad Hughes, Susheel Kodali, Isaac George, G Michael Deeb, Stan Chetcuti, Robert Kipperman, John Brown, Hongyan Qiao, James Slater, Mathew R Williams
OBJECTIVES: This study sought to evaluate this transcatheter aortic valve (TAV) bioprosthesis in patients who are poorly suitable for surgical aortic valve (AV) replacement. BACKGROUND: A novel self-expandable TAV bioprosthesis was designed to provide a low-profile delivery system, conformable annular sealing, and the ability to resheath and reposition during deployment. METHODS: The Evolut R U.S. study included 241 patients with severe aortic stenosis who were deemed to be at least high risk for surgery treated at 23 clinical sites in the United States...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28166705/high-tibial-osteotomy-combined-with-cancellous-bone-graft-and-osteochondral-autograft-transplantation-in-a-patient-with-massive-osteochondral-defects-in-the-medial-femoral-condyle
#19
Takehiko Matsushita, Shu Watanabe, Daisuke Araki, Tomoyuki Matsumoto, Koji Takayama, Masahiro Kurosaka, Ryosuke Kuroda
Treatment of massive osteochondral defects of the medial femoral condyle is challenging. A 46-year-old man who had a medial femoral condyle fracture on his left knee underwent osteosynthesis in a hospital, but the pain remained and the patient was referred to our hospital 8 months after the surgery. Radiographs showed a varus alignment of the leg, and magnetic resonance image showed a massive necrotic area in the medial femoral condyle. The patient received high tibial osteotomy (HTO) combined with iliac cancellous bone graft and an osteochondral autograft transplantation...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28148463/complications-in-total-shoulder-and-reverse-total-shoulder-arthroplasty-by-body-mass-index
#20
Oke Anakwenze, Alex Fokin, Mary Chocas, Mark T Dillon, Ronald A Navarro, Edward H Yian, Anshuman Singh
INTRODUCTION: The purpose of this study was to identify the effects of body mass index (BMI) on long-term outcomes (revision rate, 1-year mortality rate, 3-year surgical site infection rate, and 90-day inpatient all-cause readmission rate) after total shoulder arthroplasty (TSA) and reverse TSA (RTSA). METHODS: A large shoulder arthroplasty registry was used to review outcomes after TSA and RTSA. The registry monitors patient's revision, mortality, infection, and readmission rates...
January 30, 2017: Journal of Shoulder and Elbow Surgery
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