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Site marking in Surgery

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https://www.readbyqxmd.com/read/28422917/an-adapted-clavien-dindo-scoring-system-in-trauma-as-a-clinically-meaningful-non-mortality-endpoint
#1
David N Naumann, Laura E Vincent, Nicola Pearson, Alastair Beaven, Iain M Smith, Kieran Smith, Emma Toman, Helen R Dorrance, Keith Porter, Charles E Wade, Bryan A Cotton, John B Holcomb, Mark J Midwinter
BACKGROUND: There is no consensus on reporting non-mortality trauma complications in a graded manner. The Clavien-Dindo scale of complications was originally for elective surgery, and requires adaptation to provide meaningful data for trauma patients. In particular the original score does not account for those treated without surgery. We report an adapted Clavien-Dindo in trauma (ACDiT) scale and apply it to patients managed operatively and non-operatively. METHODS: A combined prospective and retrospective international multi-center observational study was undertaken to apply the ACDiT scale to 484 trauma patients at 3 university teaching hospitals (Birmingham, England (n=303); Houston, Texas (n=113); and Glasgow, Scotland (n=68))...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28414687/disseminated-cryptococcal-disease-with-diffuse-pulmonary-infiltrates-in-a-non-hiv-host
#2
M Hughes, K Trivedi, M Rudrappa
INTRODUCTION: We present a case of disseminated Cryptococcus in a non-HIV host, where the primary manifestation was pulmonary with diffuse pulmonary infiltrates. This patient was on high dose corticosteroids for autoimmune hemolytic anemia. CASE: A 79 year old Caucasian man with a history of autoimmune hemolytic anemia on 100 mg of prednisone daily, coronary artery disease s/p bypass surgery, ischemic cardiomyopathy, chronic obstructive pulmonary disease, sleep apnea, chronic kidney disease, and history of bilateral pulmonary emboli presented to Hematology/Oncology clinic with symptoms of productive cough, worsening shortness of breath, hemoptysis...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28411232/wnt5a-regulates-adipose-tissue-angiogenesis-via-anti-angiogenic-vegfa165b-in-obese-humans
#3
Shakun Karki, Doan Ngo, Melissa G Farb, Song-Young Park, Samantha M Saggese, Naomi M Hamburg, Brian Carmine, Donald T Hess, Kenneth Walsh, Noyan Gokce
Experimental studies suggest that Wingless-related integration site 5a (WNT5A) is a pro-inflammatory secreted protein that is associated with metabolic dysfunction in obesity. Impaired angiogenesis in fat has been implicated in the development of adipose tissue capillary rarefaction, hypoxia, inflammation and metabolic dysfunction. We recently demonstrated that impaired adipose tissue angiogenesis is associated with overexpression of anti-angiogenic factor VEGF-A165b in human fat and the systemic circulation...
April 14, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28408327/morbidity-and-mortality-after-surgery-for-nonmalignant-colorectal-polyps
#4
Anne F Peery, Nicholas J Shaheen, Katherine S Cools, Todd H Baron, Mark Koruda, Joseph A Galanko, Ian S Grimm
BACKGROUND & AIMS: Despite evidence that most non-malignant colorectal polyps can be managed endoscopically, a substantial proportion of patients with a non-malignant colorectal polyp are still sent to surgery. Risks associated with this surgery are not well characterized. We aimed to describe 30-day post-operative morbidity and mortality and to explore risk factors for adverse events in patients undergoing surgical resection for non-malignant colorectal polyps. METHODS: We analyzed data collected prospectively as part of the National Surgical Quality Improvement Program...
April 10, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28402343/use-of-allograft-with-platelet-concentrate-in-the-treatment-of-multiple-miller-class-iii-gingival-recession-defects-report-of-three-cases
#5
Yumi Ogata, Minh Bui, Terrence J Griffin, Yong Hur
Three patients with multiple Miller Class III recession defects with substantial bone loss were treated with hard tissue augmentation with the goal to prevent future recessions. The surgery involved a full-thickness mucoperiosteal coronally advanced flap, bone grafting, and primary flap closure. Freeze-dried bone allograft (FDBA) in combination with plasma rich in growth factors (PRGF) was grafted during the procedure. After more than 6 months, the treated sites showed soft tissue maturation and esthetic tissue blending...
May 2017: International Journal of Periodontics & Restorative Dentistry
https://www.readbyqxmd.com/read/28396193/changing-medicare-utilization-of-minimally-invasive-procedures-for-the-treatment-of-chronic-venous-insufficiency
#6
Anand M Prabhakar, Alexander S Misono, Rahul A Sheth, Andrew B Rosenkrantz, Jennifer Hemingway, Danny R Hughes, Richard Duszak
PURPOSE: To examine changes in the utilization of procedures related to treatment of chronic venous insufficiency (CVI) in the Medicare population. MATERIALS AND METHODS: Service-specific claims data for phlebectomy, sclerotherapy, and radiofrequency (RF) and laser ablation were identified by using Medicare Physician Supplier Procedure Summary master files from 2005 through 2014. Longitudinal national utilization rates were calculated by using annual Medicare enrollment data from 2005 through 2013...
April 7, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28392834/should-nurses-be-allowed-to-perform-the-pre-operative-surgical-site-marking-instead-of-surgeons-a-prospective-feasibility-study-at-a-swiss-primary-care-teaching-hospital
#7
Judit Schäfli-Thurnherr, Annette Biegger, Christopher Soll, Gian A Melcher
BACKGROUND: Surgical site marking is one important cornerstone for the principles of safe surgery suggested by the WHO. Generally it is recommended that the attending surgeon performs the surgical site marking. Particularly in the case of same day surgery, this recommendation is almost not feasible. Therefore we systematically monitored, whether surgical site marking can be performed by trained nursing staff. The aim of the study was to find out whether surgical site marking can be carried out reliably and correctly by nurses...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28385346/timing-of-surgical-antimicrobial-prophylaxis-a-phase-3-randomised-controlled-trial
#8
Walter P Weber, Edin Mujagic, Marcel Zwahlen, Marcel Bundi, Henry Hoffmann, Savas D Soysal, Marko Kraljević, Tarik Delko, Marco von Strauss, Lukas Iselin, Richard X Sousa Da Silva, Jasmin Zeindler, Rachel Rosenthal, Heidi Misteli, Christoph Kindler, Peter Müller, Ramon Saccilotto, Andrea Kopp Lugli, Mark Kaufmann, Lorenz Gürke, Daniel Oertli, Evelin Bucheli-Laffer, Julia Landin, Andreas F Widmer, Christoph A Fux, Walter R Marti
BACKGROUND: Based on observational studies, administration of surgical antimicrobial prophylaxis (SAP) for the prevention of surgical site infection (SSI) is recommended within 60 min before incision. However, the precise optimum timing is unknown. This trial compared early versus late administration of SAP before surgery. METHODS: In this phase 3 randomised controlled superiority trial, we included general surgery adult inpatients (age ≥18 years) at two Swiss hospitals in Basel and Aarau...
April 3, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28384791/association-of-surgical-treatment-systemic-therapy-and-survival-in-patients-with-abdominal-visceral-melanoma-metastases-1965-2014-relevance-of-surgical-cure-in-the-era-of-modern-systemic-therapy
#9
Gary B Deutsch, Devin C Flaherty, Daniel D Kirchoff, Mariel Bailey, Sarah Vitug, Leland J Foshag, Mark B Faries, Anton J Bilchik
Importance: Systemic therapy for metastatic melanoma has evolved rapidly during the last decade, and patient treatment has become more complex. Objective: To evaluate the survival benefit achieved through surgical resection of melanoma metastatic to the abdominal viscera in patients treated in the modern treatment environment. Design, Setting, and Participants: This retrospective review of the institutional melanoma database from the John Wayne Cancer Institute at Providence St Johns Health Center, a tertiary-level melanoma referral center, included 1623 patients with melanoma diagnosed as having potentially resectable abdominal metastases before (1969-2003) and after (2004-2014) advances in systemic therapy...
April 5, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28377206/ablative-therapy-for-oligometastatic-non-small-cell-lung-cancer
#10
REVIEW
Oscar Juan, Sanjay Popat
The oligometastatic state represents a distinct entity among those with metastatic disease and consists of patients with metastases limited in number and location, representing an intermediate state between locally confined and widely metastatic cancer. Although similar, "oligorecurrence" (limited number of metachronous metastases under conditions of a controlled primary lesion) and "oligoprogressive" (disease progression at a limited number of sites with disease controlled at other disease sites) states are distinct entities...
March 14, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28369014/a-comparative-analysis-of-rhbmp-2-dbm-vs-icbg-for-secondary-alveolar-bone-grafts-in-patients-with-cleft-lip-and-palate-review-of-501-cases
#11
Jeffrey A Hammoudeh, Artur Fahradyan, Daniel D Gould, Fan Liang, Thomas Imahiyerobo, Leo Urbinelli, JoAnna T Nguyen, William Magee, Stephen Yen, Mark M Urata
BACKGROUND: Alveolar cleft reconstruction using iliac crest bone graft(ICBG) is considered standard of care for children with complete cleft lip and palate at the time of mixed dentition. Harvesting bone may result in donor site morbidity, additional operating time and length of hospitalization. Recombinant human bone morphogenetic protein(rhBMP)-2 with a demineralized bone matrix(DBM) was used as an alternative bone source for alveolar cleft reconstruction. We investigate the outcomes of rhBMP-2/DBM versus ICBG for alveolar cleft reconstruction by reviewing postoperative surgical complications and cleft closure...
March 31, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28364165/post-mastectomy-cancer-recurrence-with-and-without-a-continuous-paravertebral-block-in-the-immediate-postoperative-period-a-prospective-multi-year-follow-up-pilot-study-of-a-randomized-triple-masked-placebo-controlled-investigation
#12
Daphna M Finn, Brian M Ilfeld, Jonathan T Unkart, Sarah J Madison, Preetham J Suresh, Nav Parkash S Sandhu, Nicholas J Kormylo, Nisha Malhotra, Vanessa J Loland, Mark S Wallace, Cindy H Wen, Anya C Morgan, Anne M Wallace
PURPOSE: Retrospective studies have associated perioperative regional anesthesia/analgesia during mastectomy for breast cancer with a decreased incidence of cancer recurrence. However, to date, no prospective data from a randomized controlled trial have been reported. In a previous study we found that extending a single-injection paravertebral block with a multiple-day perineural local anesthetic infusion improves analgesia. This follow-up study investigates the rates of cancer recurrence for the single-injection and multiple-day infusion treatments...
March 31, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28363438/reducing-surgical-site-infections-after-hysterectomy-metronidazole-plus-cefazolin-compared-with-cephalosporin%C3%A2-alone
#13
Sara R Till, Daniel M Morgan, Ali A Bazzi, Mark D Pearlman, Zaid Abdelsattar, Darrell A Campbell, Shitanshu Uppal
BACKGROUND: Organisms that are isolated from vaginal cuff infections and pelvic abscesses after hysterectomy frequently include anaerobic vaginal flora. Metronidazole has outstanding coverage against nearly all anaerobic species, which is superior to both cefazolin and second-generation cephalosporins. Cefazolin plus metronidazole has been demonstrated to reduce infectious morbidity compared with either cefazolin or second-generation cephalosporins in other clean-contaminated procedures, which include both as colorectal surgery and cesarean delivery...
March 28, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28357585/uneven-cerebral-hemodynamic-change-as-a-cause-of-neurological-deterioration-in-the-acute-stage-after-direct-revascularization-for-moyamoya-disease-cerebral-hyperperfusion-and-remote-ischemia-caused-by-the-watershed-shift
#14
Xian-Kun Tu, Miki Fujimura, Sherif Rashad, Shunji Mugikura, Hiroyuki Sakata, Kuniyasu Niizuma, Teiji Tominaga
Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is the standard surgical treatment for moyamoya disease (MMD). The main potential complications of this treatment are cerebral hyperperfusion (CHP) syndrome and ischemia, and their managements are contradictory to each other. We retrospectively investigated the incidence of the simultaneous manifestation of CHP and infarction after surgery for MMD. Of the 162 consecutive direct revascularization surgeries performed for MMD, we encountered two adult cases (1...
March 29, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28321296/improving-surgical-and-anaesthesia-practice-review-of-the-use-of-the-who-safe-surgery-checklist-in-felege-hiwot-referral-hospital-ethiopia
#15
Ryan Ellis, Ahmad Izzuddin Mohamad Nor, Iona Pimentil, Zebenaye Bitew, Jolene Moore
Development of surgical and anaesthetic care globally has been consistently reported as being inadequate. The Lancet Commission on Global Surgery highlights the need for action to address this deficit. One such action to improve global surgical safety is the introduction of the WHO Surgical Checklist to Operating Rooms (OR) around the world. The checklist has a growing body of evidence supporting its ability to assist in the delivery of safe anaesthesia and surgical care. Here we report the introduction of the Checklist to a major Ethiopian referral hospital and low-resource setting and highlight the success and challenges of its implementation over a one year period...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28321172/gastrointestinal-stromal-tumor-of-the-stomach-with-axillary-lymph-node-metastasis-a-case-report
#16
Naoki Kubo, Nobumichi Takeuchi
Gastrointestinal stromal tumors (GISTs) are the most common type of gastrointestinal mesenchymal tumors, although metastasis to the perigastric lymph nodes is relatively rare, compared with liver or peritoneal metastasis. In this report, we describe a case of stomach GIST with a solitary simultaneous metastasis in the left axillary lymph node. A 68-year-old man was diagnosed with a large upper-stomach GIST, and computed tomography and positron emission tomography revealed masses in the left axilla and right mediastinum...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28318537/cardiac-magnetic-resonance-imaging-in-suspected-blunt-cardiac-injury-a-prospective-pilot-cohort-study
#17
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
#18
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
#19
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
#20
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
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