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Site marking in Surgery

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https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#1
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
#2
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
#3
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/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
#4
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/27855236/vandetanib-induces-a-marked-anti-tumor-effect-and-amelioration-of-ectopic-cushing-s-syndrome-in-a-medullary-thyroid-carcinoma-patient
#5
Hashem Bseiso, Naama Lev-Cohain, David J Gross, Simona Grozinsky-Glasberg
: A 55-year-old woman diagnosed with sporadic MTC underwent total thyroidectomy 20 years ago. After the first surgery, elevated calcitonin levels in parallel with local disease persistence were noted and therefore she underwent repeated neck dissections. During follow-up, multiple foci of metastatic disease were noted in the neck and mediastinal lymph nodes, lungs and bones; however, the disease had an indolent course for a number of years, in parallel with a calcitonin doubling time of more than two years and without significant symptoms...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27852723/regional-versus-general-anesthesia-for-promoting-independence-after-hip-fracture-regain-protocol-for-a-pragmatic-international-multicentre-trial
#6
Mark D Neuman, Susan S Ellenberg, Frederick E Sieber, Jay S Magaziner, Rui Feng, Jeffrey L Carson
INTRODUCTION: Hip fractures occur 1.6 million times each year worldwide, with substantial associated mortality and losses of independence. At present, anaesthesia care for hip fracture surgery varies widely within and between countries, with general anaesthesia and spinal anaesthesia representing the 2 most common approaches. Limited randomised evidence exists regarding potential short-term or long-term differences in outcomes between patients receiving spinal or general anaesthesia for hip fracture surgery...
November 15, 2016: BMJ Open
https://www.readbyqxmd.com/read/27830100/scrotal-involvement-with-testicular-nonseminomatous-germ-cell-tumour
#7
C G O'Leary, J A Allen, F O'Brien, A Tuthill, D G Power
A 37-year-old male presented with a traumatic injury to the scrotal region necessitating emergency surgery. Evacuation of a haematoma and bilateral orchidectomy were performed. A left sided nonseminomatous germ cell tumour (NSGCT), predominantly yolk sac, was identified. Microscopic margins were positive for tumour. Initial tumour markers revealed an AFP of 22,854 ng/mL, HCG of <1 mIU/mL, and LDH of 463 IU/L. Eight weeks after surgery, AFP levels remained elevated at 11,646 ng/mL. Computed tomography (CT) scanning demonstrated left inguinal adenopathy, 1...
2016: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/27826775/analysis-of-lesion-localisation-at-colonoscopy-outcomes-from-a-multi-centre-u-k-study
#8
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/27825917/intraoperative-hypothermia-and-surgical-site-infections-in-patients-with-class-1-clean-wounds-a-case-control-study
#9
Michael J Brown, Timothy B Curry, Joseph A Hyder, Elie F Berbari, Mark J Truty, Darrell R Schroeder, Andrew C Hanson, Daryl J Kor
BACKGROUND: Numerous surgical quality metrics focus on prevention of unintentional perioperative hypothermia due, in part, to the association between hypothermia and surgical site infections (SSI). However, few studies have comprehensively evaluated the relationship between these metrics and SSI. In this study, we evaluated individual components of one set of hypothermia metrics to determine their association with SSI. METHODS: Patients with clean (Type 1) wounds who developed a SSI within thirty days after surgery from January 2003-December 2012 in one of five surgical specialties were matched to specialty specific controls without SSI...
November 4, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27825007/effect-of-tailored-dose-dense-chemotherapy-vs-standard-3-weekly-adjuvant-chemotherapy-on-recurrence-free-survival-among-women-with-high-risk-early-breast-cancer-a-randomized-clinical-trial
#10
Theodoros Foukakis, Gunter von Minckwitz, Nils-Olof Bengtsson, Yvonne Brandberg, Birgitta Wallberg, Tommy Fornander, Brigitte Mlineritsch, Sabine Schmatloch, Christian F Singer, Günther Steger, Daniel Egle, Eva Karlsson, Lena Carlsson, Sibylle Loibl, Michael Untch, Mats Hellström, Hemming Johansson, Harald Anderson, Per Malmström, Michael Gnant, Richard Greil, Volker Möbus, Jonas Bergh
Importance: Standard dosing of chemotherapy based on body surface area results in marked interpatient variation in pharmacokinetics, toxic effects, and efficacy. Whether tailored dosing can improve outcomes is unknown, as is the role of dose-dense adjuvant chemotherapy. Objective: To determine whether tailored dose-dense adjuvant chemotherapy improves the outcomes of early breast cancer compared with a standard 3-weekly chemotherapy schedule. Design, Setting, and Participants: A randomized, open-label, phase 3 trial of women aged 65 years and younger who had surgery for nonmetastatic node-positive or high-risk node-negative breast cancer at 86 sites in Sweden, Germany, and Austria between February 20, 2007, and September 14, 2011...
November 8, 2016: JAMA: the Journal of the American Medical Association
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
#11
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/27807114/long-term-outcome-of-step-cut-ulnar-shortening-osteotomy-for-ulnar-impaction-syndrome
#12
Loukia K Papatheodorou, Mark E Baratz, Sofia Bougioukli, Tyler Ruby, Robert W Weiser, Dean G Sotereanos
BACKGROUND: Extra-articular ulnar shortening osteotomy is a common procedure for the surgical treatment of ulnar impaction syndrome. Several techniques for this osteotomy have been developed to avoid the morbidity associated with a standard transverse osteotomy. However, these techniques require special instrumentation and are expensive. The purpose of this study was to evaluate the outcome of step-cut ulnar shortening osteotomy without special jigs for ulnar impaction syndrome. METHODS: A retrospective study of 164 consecutive patients who underwent step-cut ulnar shortening osteotomy between 2000 and 2010 was performed...
November 2, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27801299/letter-from-the-editor-in-chief
#13
Mark M Levinson Md
Twenty years ago, I presented a new vision for medical publishing. The Heart Surgery Forum was inaugurated in August of 1995 as a multimedia scientific publication communicating over the new "Information Highway" known as the graphical Web.  In the early days of HTML and HTTP, new ideas could evolve and disseminate quickly to a community that spanned the globe. The HSF began as a "Labor of Love" for my profession and my colleagues as a dynamic tool for the betterment of themselves and their patients. Included in the original HSF Web site was a novel means to present interesting cases using color photos, movies, text and graphics, which was groundbreaking in 1995...
October 21, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27797291/everolimus-eluting-stents-or-bypass-surgery-for-left-main-coronary-artery-disease
#14
Gregg W Stone, Joseph F Sabik, Patrick W Serruys, Charles A Simonton, Philippe Généreux, John Puskas, David E Kandzari, Marie-Claude Morice, Nicholas Lembo, W Morris Brown, David P Taggart, Adrian Banning, Béla Merkely, Ferenc Horkay, Piet W Boonstra, Ad J van Boven, Imre Ungi, Gabor Bogáts, Samer Mansour, Nicolas Noiseux, Manel Sabaté, José Pomar, Mark Hickey, Anthony Gershlick, Pawel Buszman, Andrzej Bochenek, Erick Schampaert, Pierre Pagé, Ovidiu Dressler, Ioanna Kosmidou, Roxana Mehran, Stuart J Pocock, A Pieter Kappetein
Background Patients with obstructive left main coronary artery disease are usually treated with coronary-artery bypass grafting (CABG). Randomized trials have suggested that drug-eluting stents may be an acceptable alternative to CABG in selected patients with left main coronary disease. Methods We randomly assigned 1905 eligible patients with left main coronary artery disease of low or intermediate anatomical complexity to undergo either percutaneous coronary intervention (PCI) with fluoropolymer-based cobalt-chromium everolimus-eluting stents (PCI group, 948 patients) or CABG (CABG group, 957 patients)...
October 31, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27790874/preoperative-colonic-cancer-tattooing-using-the-near-infrared-fluorescence-laparoscopic-imaging-system
#15
Yoshiaki Ozawa, Masahiko Murakami, Makoto Watanabe, Sota Yoshizawa, Satoru Goto, Koji Otsuka, Takeshi Aoki
INTRODUCTION: To identify a colorectal cancer tumor site for surgery, preoperative endoscopic marking methods, such as India ink tattooing or clipping, are generally performed. However, India ink tattooing causes problems such as impaired surgical view because of adverse events, ink leakage into the peritoneal cavity, and peritonitis or adhesion ileus as a result of leakage. The clipping method requires checking by palpation, which is unsuitable for laparoscopic surgery. MATERIALS AND SURGICAL TECHNIQUES: We devised a preoperative marking method for colorectal cancer surgery (laparotomy) by applying the fluorescent dye indocyanine green...
November 2016: Asian Journal of Endoscopic Surgery
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
#16
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/27787483/managing-complications-in-endoscopic-procedures-bleeding-from-a-biopsy-site
#17
Nikita N Machado, Terence J Jackson, Husayn A Ladhani, Jeffrey M Marks
Bleeding related to endoscopic biopsies is relatively uncommon and tends to be a self limiting process. This article aims to identify those groups of patients that are at a higher risk at the time of the pre procedural evaluation, and to review the current guidelines regarding high risk patients( with special consideration for those who are anticoagulated). It also reviews current strategies for diagnosis, initial evaluation and management of a post procedural bleed. These include all the tools in an endoscopist's armamentarium (thermal, mechanical and chemical) for local control, as well as a discussion about the more severe bleeds that might require interventional radiology or salvage surgery...
October 27, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27779369/analysis-of-clinical-characteristics-and-prognosis-of-patients-with-anaplastic-lymphoma-kinase-positive-and-surgically-resected-lung-adenocarcinoma
#18
Hong Tao, Yiran Cai, Liang Shi, Junfang Tang, Zhidong Liu, Zitong Wang, Lianqi Bai, Zhe Liu
BACKGROUND: Recent research into lung cancer-related driver genes has identified a distinctive molecular subtype of non-small cell lung cancer (NSCLC) - anaplastic lymphoma kinase (ALK)-positive NSCLC. We evaluated the clinical features and survival rates of ALK-positive lung adenocarcinoma patients who had undergone surgery but had not received ALK inhibitor therapy, along with the characteristics of patients with distant metastases. METHODS: Clinical data of 40 patients with ALK-positive, postsurgical lung adenocarcinoma were retrospectively analyzed...
October 24, 2016: Thoracic Cancer
https://www.readbyqxmd.com/read/27762665/sutures-possess-strong-regenerative-capacity-for-calvarial-bone-injury
#19
Shery Park, Hu Zhao, Mark Urata, Yang Chai
Repair of calvarial bony defects remains challenging for craniofacial surgeons. Injury experiments on animal calvarial bones are widely used to study healing mechanisms and test tissue engineering approaches. Previously, we identified Gli1+ cells within the calvarial sutures as stem cells supporting calvarial bone turnover and injury repair. In this study, we tested the regenerative capacity of the suture region compared with other areas of calvarial bone. Injuries were made to mouse sagittal sutures or other areas of the calvarial bone at varying distances from the suture...
December 1, 2016: Stem Cells and Development
https://www.readbyqxmd.com/read/27757357/reconstruction-after-anterior-chest-wall-keloid-resection-using-internal-mammary-artery-perforator-propeller-flaps
#20
Rei Ogawa, Shimpei Ono, Satoshi Akaishi, Teruyuki Dohi, Takeshi Iimura, Junichi Nakao
: It is difficult to completely resect huge anterior chest wall keloids and then close the wound directly. We report here our retrospective analysis of our case series of patients with such keloids who underwent reconstruction with internal mammary artery perforator (IMAP) pedicled propeller flaps and then received postoperative high-dose-rate superficial brachytherapy. METHODS: All consecutive patients with large/severe keloids on the anterior chest wall who underwent keloid resection followed by reconstruction with IMAP-pedicled propeller flaps and then high-dose-rate superficial brachytherapy in our academic hospital were identified...
September 2016: Plastic and Reconstructive Surgery. Global Open
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