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https://www.readbyqxmd.com/read/29145011/preparation-of-morselised-bone-for-impaction-grafting-using-a-blender-method
#1
Mark Ruddy, David P FitzPatrick, Kenneth T Stanton
Impaction bone grafting is a method of restoring bone stock to patients suffering significant bone loss due to revision total hip surgery. The procedure requires morselised bone (MB) to be impacted into the site of bone loss in order to stabilise the prosthesis with the aim of the long term resorption and reintegration of the impacted bone graft. Currently, the method for producing MB requires the use of expensive surgical bone mills or manually-intensive rongeurs that can produce a limited variety of particle sizes and may have a low throughput...
November 9, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29145010/the-use-of-hardened-bone-cement-as-an-impaction-grafting-extender-for-revision-hip-arthroplasty
#2
Mark Ruddy, David P FitzPatrick, Kenneth T Stanton
Impaction bone grafting is a method of restoring bone stock to patients who have suffered significant bone loss due to revision total hip surgery. The procedure requires morsellised cancellous bone (MCB) to be impacted into the site of bone loss in order to stabilise the prosthesis with the aim of long term resorption and reintegration of the impacted bone graft. Due to financial cost and the potential to transmit disease, the use of supplementary material, known as an extender, is frequently used to increase the graft material volume...
November 13, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29135883/an-analysis-of-the-incidence-and-outcomes-of-major-vs-minor-neurological-decline-after-complex-adult-spinal-deformity-surgery-a-sub-analysis-of-scoli-risk-1-study
#3
So Kato, Michael G Fehlings, Stephen J Lewis, Lawrence G Lenke, Christopher I Shaffrey, Kenneth M C Cheung, Leah Carreon, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Khaled M Kebaish, Christopher P Ames, Yong Qiu, Yukihiro Matsuyama, Benny T Dahl, Hossein Mehdian, Ferran Pellisé, Sigurd H Berven
STUDY DESIGN: A sub-analysis from a prospective, multicenter, international cohort study in 15 sites (Scoli-RISK-1). OBJECTIVE: To report detailed information regarding the severity of neurological decline related to complex adult spine deformity (ASD) surgery and to examine outcomes based on severity. SUMMARY OF BACKGROUND DATA: The basis of post-operative neurological decline after ASD surgeries can occur due to nerve root(s) or spinal cord dysfunction...
November 10, 2017: Spine
https://www.readbyqxmd.com/read/29134168/anatomical-region-segmentation-for-objective-surgical-skill-assessment-with-operating-room-motion-data
#4
Yangming Li, Randall A Bly, R Alex Harbison, Ian M Humphreys, Mark E Whipple, Blake Hannaford, Kris S Moe
Background  Most existing objective surgical motion analysis schemes are limited to structured surgical tasks or recognition of motion patterns for certain categories of surgeries. Analyzing instrument motion data with respect to anatomical structures can break the limit, and an anatomical region segmentation algorithm is required for the analysis. Methods  An atlas was generated by manually segmenting the skull base into nine regions, including left/right anterior/posterior ethmoid sinuses, frontal sinus, left and right maxillary sinuses, nasal airway, and sphenoid sinus...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29129636/inflammation-mediated-muscle-metabolic-dysregulation-local-and-remote-to-the-site-of-major-abdominal-surgery
#5
Krishna K Varadhan, Dumitru Constantin-Teodosiu, Despina Constantin, Paul L Greenhaff, Dileep N Lobo
BACKGROUND & AIMS: Postoperative hyperglycaemia is common in patients having major surgery and is associated with adverse outcomes. This study aimed to determine whether bacteraemia contributed to postoperative systemic inflammation, and whether increases in the expression of muscle mRNAs and proteins reflecting increased muscle inflammation, atrophy and impaired carbohydrate oxidation were evident at the time of surgery, and both local and distant to the site of trauma, and could be associated with impaired glucoregulation...
November 2, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29127558/effect-of-dexamethasone-dose-and-route-on-the-duration-of-interscalene-brachial-plexus-block-for-outpatient-arthroscopic-shoulder-surgery-a-randomized-controlled-trial
#6
Darren Holland, Ryan J J Amadeo, Scott Wolfe, Linda Girling, Faylene Funk, Mark Collister, Emily Czaplinski, Celeste Ferguson, Jeff Leiter, Jason Old, Peter MacDonald, Brenden Dufault, Thomas C Mutter
PURPOSE: Dexamethasone prolongs the duration of interscalene block, but the benefits of higher doses and perineural vs intravenous administration remain unclear. METHODS: This factorial design, double-blinded trial randomized 280 adult patients undergoing ambulatory arthroscopic shoulder surgery at a single centre in a 1:1:1:1 ratio. Patients received ultrasound-guided interscalene block with 30 mL 0.5% bupivacaine and 4 mg or 8 mg dexamethasone by either the perineural or intravenous route...
November 10, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29124549/benefit-of-surgical-resection-of-the-primary-tumor-in-patients-undergoing-chemotherapy-for-stage-iv-colorectal-cancer-with-unresected-metastasis
#7
Sean Maroney, Carlos Chavez de Paz, Mark E Reeves, Carlos Garberoglio, Elizabeth Raskin, Maheswari Senthil, Jukes P Namm, Naveenraj Solomon
PURPOSE: Resection of the primary tumor in patients with unresected metastatic colorectal cancer is controversial, and often performed only for palliation of symptoms. Our goal was to determine if resection of the primary tumor in this patient population is associated with improved survival. METHODS: This is a retrospective cohort study of the National Cancer Data Base from 2004 to 2012. The study population included all patients with synchronous metastatic colorectal adenocarcinoma who were treated with systemic chemotherapy...
November 9, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29121400/dexamethasone-as-an-adjuvant-to-peripheral-nerve-block
#8
REVIEW
Carolyne Pehora, Annabel Me Pearson, Alka Kaushal, Mark W Crawford, Bradley Johnston
BACKGROUND: Peripheral nerve block (infiltration of local anaesthetic around a nerve) is used for anaesthesia or analgesia. A limitation to its use for postoperative analgesia is that the analgesic effect lasts only a few hours, after which moderate to severe pain at the surgical site may result in the need for alternative analgesic therapy. Several adjuvants have been used to prolong the analgesic duration of peripheral nerve block, including perineural or intravenous dexamethasone. OBJECTIVES: To evaluate the comparative efficacy and safety of perineural dexamethasone versus placebo, intravenous dexamethasone versus placebo, and perineural dexamethasone versus intravenous dexamethasone when added to peripheral nerve block for postoperative pain control in people undergoing surgery...
November 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29093615/less-common-etiologies-of-exocrine-pancreatic-insufficiency
#9
REVIEW
Vikesh K Singh, Mark E Haupt, David E Geller, Jerry A Hall, Pedro M Quintana Diez
Exocrine pancreatic insufficiency (EPI), an important cause of maldigestion and malabsorption, results from primary pancreatic diseases or secondarily impaired exocrine pancreatic function. Besides cystic fibrosis and chronic pancreatitis, the most common etiologies of EPI, other causes of EPI include unresectable pancreatic cancer, metabolic diseases (diabetes); impaired hormonal stimulation of exocrine pancreatic secretion by cholecystokinin (CCK); celiac or inflammatory bowel disease (IBD) due to loss of intestinal brush border proteins; and gastrointestinal surgery (asynchrony between motor and secretory functions, impaired enteropancreatic feedback, and inadequate mixing of pancreatic secretions with food)...
October 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29073928/safety-of-tubal-ligation-by-minilaparotomy-provided-by-clinical-officers-versus-assistant-medical-officers-study-protocol-for-a-noninferiority-randomized-controlled-trial-in-tanzanian-women
#10
Mark A Barone, Zuhura Mbuguni, Japhet Ominde Achola, Carmela Cordero, Joseph Kanama, Projestine S Muganyizi, Jamilla Mwanga, Caitlin Shannon, Leopold Tibyehabwa
BACKGROUND: Female sterilization by tubal ligation is a safe, extremely effective, and permanent way to limit childbearing. It is the most popular modern contraceptive method worldwide. The simplest way to provide tubal ligation is by a procedure called minilaparotomy, generally performed with the client under local anesthesia with systemic sedation and analgesia. In Tanzania, unmet need for family planning is high and has declined little in the past decade. Access to tubal ligation is limited throughout the country, in large part because of a lack of trained providers...
October 26, 2017: Trials
https://www.readbyqxmd.com/read/29067426/effect-of-robotic-assisted-vs-conventional-laparoscopic-surgery-on-risk-of-conversion-to-open-laparotomy-among-patients-undergoing-resection-for-rectal-cancer-the-rolarr-randomized-clinical-trial
#11
RANDOMIZED CONTROLLED TRIAL
David Jayne, Alessio Pigazzi, Helen Marshall, Julie Croft, Neil Corrigan, Joanne Copeland, Phil Quirke, Nick West, Tero Rautio, Niels Thomassen, Henry Tilney, Mark Gudgeon, Paolo Pietro Bianchi, Richard Edlin, Claire Hulme, Julia Brown
Importance: Robotic rectal cancer surgery is gaining popularity, but limited data are available regarding safety and efficacy. Objective: To compare robotic-assisted vs conventional laparoscopic surgery for risk of conversion to open laparotomy among patients undergoing resection for rectal cancer. Design, Setting, and Participants: Randomized clinical trial comparing robotic-assisted vs conventional laparoscopic surgery among 471 patients with rectal adenocarcinoma suitable for curative resection conducted at 29 sites across 10 countries, including 40 surgeons...
October 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29049808/cold-inducible-ribonucleic-acid-binding-protein-attenuates-acute-kidney-injuries-after-deep-hypothermic-circulatory-arrest-in-rats
#12
Lei Yu, Tianxiang Gu, Yu Liu, Xuan Jiang, Enyi Shi
OBJECTIVES: Cold-inducible ribonucleic acid-binding protein (CIRP) has been identified to play a role in the antiapoptotic effect of hypothermia. We sought to investigate the renoprotection of CIRP in a rat model of deep hypothermic circulatory arrest. METHODS: Overexpression and knockdown of CIRP were achieved in vivo by directly injecting lentivirus vectors containing packaging lentivirus (pL)/internal ribosome entry site (IRES)/green fluorescent protein (GFP)-CIRP or pL/short hairpin RNA (shRNA)/F-cold inducible RNA binding protein (F-CIRP)-A into the renal parenchyma of rats 7 days before deep hypothermic circulatory arrest under the ultrasound guidance...
August 14, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28993602/triple-phase-helical-computed-tomography-of-an-arterio-hepatic-venous-shunt-in-a-hepatic-tumor-in-a-dog
#13
Kenji Kutara, Toshiaki Konno, Hirotaka Kondo, Hinako Yamazoe, Satoru Matsunaga
A 10-year-old French bulldog presented with an abdominal tumor. Triple-phase helical computed tomography was performed, revealing a hepatic tumor, an enlarged hepatic lymph node, and no masses in other organs. The hepatic tumor demonstrated marked enhancement, similar to that of the aorta in the arterial phase. The tumor had rich vascularization and a hepatic arterio-venous shunt formed between the hepatic artery and middle hepatic vein. The hepatic tumor was surgically removed and histological diagnosis revealed a hepatic carcinoid tumor...
October 7, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28991115/preventing-adverse-events-in-cataract-surgery-recommendations-from-a-massachusetts-expert-panel
#14
Karen C Nanji, Sarah A Roberto, Michael G Morley, Joseph Bayes
Massachusetts health care facilities reported a series of cataract surgery-related adverse events (AEs) to the state in recent years, including 5 globe perforations during eye blocks performed by 1 anesthesiologist in a single day. The Betsy Lehman Center for Patient Safety, a nonregulatory Massachusetts state agency, responded by convening an expert panel of frontline providers, patient safety experts, and patients to recommend strategies for mitigating patient harm during cataract surgery. The purpose of this article is to identify contributing factors to the cataract surgery AEs reported in Massachusetts and present the panel's recommended strategies to prevent them...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28988451/evolving-trends-in-sinus-surgery-what-is-the-impact-of-balloon-sinus-dilation
#15
Peter F Svider, Spencer Darlin, Michael Bobian, Vibhav Sekhsaria, Richard J Harvey, Stacey T Gray, Soly Baredes, Adam J Folbe, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Balloon dilation (BD) represents a minimally invasive alternative to endoscopic sinus surgery (ESS). Although BD was introduced in 2006, distinct Current Procedural Terminology (CPT) codes were not available until 2011, making prior analysis of population-based trends difficult. Our objectives were to evaluate these trends and compare any changes to the use of traditional ESS techniques. Geographic trends also were evaluated. METHODS: Medicare Part B national datasets encompassing procedures from 2011 to 2015 were obtained...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28982261/time-to-institutional-review-board-approval-with-local-versus-central-review-in-a-multicenter-pragmatic-trial
#16
Mark D Neuman, Lakisha J Gaskins, Tracy Ziolek
BACKGROUND/AIMS: Central institutional review board (IRB) review will be required for National Institutes of Health-funded multisite human subjects research as of January 2018, with similar requirements extending to most US multisite human research in 2020. Nonetheless, little is known regarding the relative efficiency of central versus local IRB review for multicenter studies. We compared the amount of time required for central versus local IRB review and approval for sites in one ongoing multicenter randomized trial...
October 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28980388/incidence-and-risk-factors-for-parastomal-bulging-in-patients-with-ileostomy-or-colostomy-a-register-based-study-using-data-from-the-danish-stoma-database-capital-region
#17
Rune M Andersen, Tobias W Klausen, Anne K Danielsen, Anders Vinther, Ismail Gögenur, Thordis Thomsen
AIM: To investigate incidence and risk factors for parastomal bulging, a clinically important complication, in patients with an ileostomy or colostomy. METHOD: The Danish Stoma Database Capital Region prospectively collects data on patients with a stoma up to a year after surgery. Stoma care nurses clinically assessed the main outcome, parastomal bulging. We linked data from the Stoma Database to data from the Danish Anaesthesia Database. Cumulative incidence of parastomal bulging over the first year was calculated with death and stoma reversal as competing risks...
October 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28968293/standardizing-descemet-membrane-endothelial-keratoplasty-graft-preparation-method-in-the-eye-bank-experience-of-527-descemet-membrane-endothelial-keratoplasty-tissues
#18
Mohit Parekh, Mattia Baruzzo, Elisa Favaro, Davide Borroni, Stefano Ferrari, Diego Ponzin, Alessandro Ruzza
PURPOSE: To share the experience and provide a standardized protocol for Descemet membrane endothelial keratoplasty (DMEK) graft preparation. METHODS: A retrospective study based on 527 prestripped DMEK tissues that were prepared between 2014 and 2017. The experience of using different instruments and techniques has been described, and a standardized technique for preparing DMEK grafts has been identified. The tissues in general were prepared by superficially tapping the endothelial side with a Moria trephine (9...
December 2017: Cornea
https://www.readbyqxmd.com/read/28963868/use-of-bone-grafts-or-modified-bilateral-sagittal-split-osteotomy-technique-in-large-mandibular-advancements-reduces-the-risk-of-persisting-mandibular-inferior-border-defects
#19
Julio Cifuentes, Nicolás Yanine, Daniel Jerez, Ariel Barrera, Jimoh Olubanwo Agbaje, Constantinus Politis
PURPOSE: Healing of the inferior border of the mandible can be compromised in large advancements, leaving an unesthetic defect at the inferior border. The objective of this study was to compare different bilateral sagittal split osteotomy (BSSO) techniques to prevent the incidence of lower border mandibular defects. MATERIALS AND METHODS: The authors undertook a retrospective multicenter cohort study comparing 3 BSSO techniques for advancements greater than 5 mm: traditional non-grafted BSSO (group A), traditional grafted BSSO (group B), and modified BSSO (group C)...
September 11, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28952193/lymphatic-mapping-of-the-upper-limb-with-lymphedema-before-lymphatic-supermicrosurgery-by-mirroring-of-the-healthy-limb
#20
Stefano Gentileschi, Maria Servillo, Roberta Albanese, Francesca De Bonis, Girolamo Tartaglione, Marzia Salgarello
INTRODUCTION: Supermicrosurgical lymphatic-venous anastomosis (LVA) can improve limbs lymphedema. We describe a technique that we employ for preoperative lymphatic mapping of the upper limb (UL), when indocyanine green (ICG) lymphography shows only dermal backflow (DB) and no lymphatic vessel is detectable. PATIENTS AND METHODS: Sixteen patients undergoing LVA for unilateral UL lymphedema, showing "stardust" or "diffuse" DB pattern, were included. Demographic, clinical data, and limbs measurements were recorded...
September 27, 2017: Microsurgery
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