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Standards for General Surgery

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https://www.readbyqxmd.com/read/29682717/-use-of-c-response-protein-in-predicting-postoperative-anastomotic-leakage-in-patients-with-rectal-cancer
#1
Zejian Lyu, Deqing Wu, Guanfu Cai, Yuwen Luo, Zifeng Yang, Yanyun Zhai, Chuli Yao, Weixian Hu, Junjiang Wang, Yong Li
OBJECTIVE: To investigate the value and feasibility of C reactive protein (CRP) in predicting postoperative anastomotic leakage in rectal cancer patients with enhanced recovery after surgery (ERAS) for safer implementation of this ERAS. METHODS: A cohort study on serum CRP of 455 rectal cancer patients undergoing laparoscopic radical resection according to the ERAS procedure at Gastrointestinal Unit of General Surgery Department, Guangdong General Hospital from August 2014 to June 2017 was retrospectively carried out...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682703/-definition-and-diagnostic-criteria-of-anastomotic-leakage-after-sphincter-preserving-surgery-for-rectal-cancer
#2
Yingjiang Ye, Fan Liu
Anastomotic leakage is a common and severe postoperative complication foollowing sphincter-preserving surgery of rectal cancer. Many useful studies on anastomotic leakage were conducted both in our country and abroad. However, the lack of standardized and influential definition and diagnostic criteria is responsible for confusion in the literature. In this paper, the history of studies on the definition and diagnostic criteria of anastomotic leakage is reviewed, and the name evolution process of anastomotic leakage in domestic and foreign studies is introduced...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29678532/feasibility-and-benefit-of-incorporating-a-multimedia-cadaver-laboratory-training-program-into-a-didactics-curriculum-for-junior-and-senior-surgical-residents
#3
Erika Simmerman, Andrew Simmerman, Randi Lassiter, Ray King, Ben Ham, Bao-Ling Adam, Colville Ferdinand, Steven Holsten
OBJECTIVE: As operative experience in general surgery decreases and work hour limitations increase there is less exposure of surgical residents to advanced vascular and trauma exposures. Many institutions have demonstrated benefits of cadaver laboratory courses. We have incorporated a multimedia cadaver laboratory course into our general surgery residency didactics curriculum with the objective to demonstrate a benefit of the program as well as the feasibility of incorporation. STUDY DESIGN: This is a prospective study at a tertiary care institution including general surgery residents within our residency program...
April 17, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29676162/endoscopic-management-of-primary-obstructive-megaureter-a-systematic-review
#4
Alexander D Doudt, Chad R Pusateri, Matthew Christman
BACKGROUND: The gold standard treatment for primary obstructive megaureter (POM) with declining renal function, worsening obstruction, or recurrent infections is ureteral re-implantation with or without tapering. In infants, open surgery can be technically demanding and associated with significant morbidity. We conducted a systematic review of the literature with special interest in endoscopic management of POM and its outcomes. METHODS: A search was conducted of the MEDLINE/Ovid, PubMed, Embase, and Web of Science databases...
April 20, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29670988/reducing-complications-and-overall-healthcare-costs-of-hip-fracture-management-a-retrospective-study-on-the-application-of-a-diagnostic-therapeutic-pathway-in-the-cosenza-general-hospital
#5
M Loizzo, F Gallo, D Caruso
BACKGROUND: Diagnostic Therapeutic Pathways (DTPs) are multidisciplinary plans designed by each healthcare organization for a specific category of patients to reduce the variability of professional behaviors and to ensure greater safety and better overall healthcare outcomes. Hip fractures are a frequent traumatic injury, particularly in the elderly, and DTPs recommend early surgical intervention, often not done due to organizational challenges and bureaucracy. Medical conditions suggesting a delay are not frequent, however long waiting times not only increase the risk of complications and mortality, but also increase the number of diagnostic test and physician consultations...
May 2018: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/29668630/thoracolumbar-spinal-neurenteric-cyst-with-tethered-cord-syndrome-and-extreme-cervical-lordosis-in-a-child-a-case-report-and-literature-review
#6
Zhi Gang Lan, Seidu A Richard, Chuanfen Lei, Siqing Huang
RATIONALE: Neurenteric cysts, are rare benign tumors of the central nervous system that are mostly located in the spinal cord and predominantly seen in male children although adult form of the disorder also occurs. The etiology and treatment of this disorder is still a matter of debate. Our case further throws more light on the pathogenesis and treatment of this disorder. PATIENT CONCERNS: A 4-year-old boy presented with 5-month history of cervical lordosis and bilateral lower extremity pain that progressed to his abdomen and upper body...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29667417/review-of-duodenal-perforations-after-endoscopic-retrograde-cholangiopancreatography-in-hospital-puerta-de-hierro-from-1999-to-2014
#7
Elena Jiménez Cubedo, Javier López Monclús, José Luis Lucena de la Poza, Natalia González Alcolea, Pablo Calvo Espino, Arturo García Pavia, Victor Sánchez Turrión
INTRODUCTION: endoscopic retrograde cholangiopancreatography (ERCP) remains the gold standard in biliary and pancreatic pathology. Although the procedure has a significant morbidity and mortality rate. Algorithms are needed for the management and treatment of the associated complications. OBJECTIVE: to review the post-ERCP perforations treated in the Department of General Surgery of the Hospital Puerta de Hierro from 1999 to 2014. The results were evaluated according to the types of perforation and treatment...
April 18, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29667074/on-the-optimal-z-score-threshold-for-siscom-analysis-to-localize-the-ictal-onset-zone
#8
Liesbeth De Coster, Koen Van Laere, Evy Cleeren, Kristof Baete, Patrick Dupont, Wim Van Paesschen, Karolien E Goffin
BACKGROUND: In epilepsy patients, SISCOM or subtraction ictal single photon emission computed tomography co-registered to magnetic resonance imaging has become a routinely used, non-invasive technique to localize the ictal onset zone (IOZ). Thresholding of clusters with a predefined number of standard deviations from normality (z-score) is generally accepted to localize the IOZ. In this study, we aimed to assess the robustness of this parameter in a group of patients with well-characterized drug-resistant epilepsy in whom the exact location of the IOZ was known after successful epilepsy surgery...
April 17, 2018: EJNMMI Research
https://www.readbyqxmd.com/read/29665028/meta-analysis-evaluating-music-interventions-for-anxiety-and-pain-in-surgery
#9
REVIEW
A Y R Kühlmann, A de Rooij, L F Kroese, M van Dijk, M G M Hunink, J Jeekel
BACKGROUND: This study aimed to evaluate anxiety and pain following perioperative music interventions compared with control conditions in adult patients. METHODS: Eleven electronic databases were searched for full-text publications of RCTs investigating the effect of music interventions on anxiety and pain during invasive surgery published between 1 January 1980 and 20 October 2016. Results and data were double-screened and extracted independently. Random-effects meta-analysis was used to calculate effect sizes as standardized mean differences (MDs)...
April 17, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29663575/arthroplasty-implant-registries-over-the-past-five-decades-development-current-and-future-impact
#10
REVIEW
Henrik Malchau, Göran Garellick, Daniel Berry, William H Harris, Otto Robertson, Johan Kärrlholm, David Lewallen, Charles R Bragdon, Lars Lidgren, Peter Herberts
Local, regional and national registries have played an important role the development of hip and knee arthroplasty and the treatment of patients with various maladies of these joints. Four arthroplasty registries stand out as leading forces behind the drive to popularize the use of registries and pursue the concept of evidence based medicine. The Mayo registry, started by Mark Coventry, is recognized as the oldest continuing registry for arthroplasty. The Harris Registry at Massachusetts General Hospital, along with the Mayo Registry, has greatly contributed to the advancement of arthroplasty surgery and have served an important role of identifying poorly performing implants and techniques in the United States...
April 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29661386/association-between-intraoperative-opioid-administration-and-30-day-readmission-a-pre-specified-analysis-of-registry-data-from-a-healthcare-network-in-new-england
#11
D R Long, A L Lihn, S Friedrich, F T Scheffenbichler, K C Safavi, S M Burns, J C Schneider, S D Grabitz, T T Houle, M Eikermann
BACKGROUND: The use of intraoperative opioids may influence the rate of postoperative complications. This study evaluated the association between intraoperative opioid dose and the risk of 30-day hospital readmission. METHODS: We conducted a pre-specified analysis of existing registry data for 153 902 surgical cases performed under general anaesthesia at Massachusetts General Hospital and two affiliated medical centres. We examined the association between total intraoperative opioid dose (categorised in quintiles) and 30-day hospital readmission, controlling for several patient-, anaesthetist-, and case-specific factors...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29660009/critical-care-in-the-military-health-system-a-24-h-point-prevalence-study
#12
Raymond Fisher, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Background: Healthcare expenditures are a significant economic cost with critical care services constituting one of its largest components. The Military Health System (MHS) is the largest, global healthcare system of its kind. In this project, we sought to describe critical care services and the patients who receive them in the MHS. Methods: We surveyed 26 military treatment facilities (MTFs) representing 38 critical care services or intensive care units (ICUs)...
April 11, 2018: Military Medicine
https://www.readbyqxmd.com/read/29658394/management-of-staghorn-renal-stones
#13
Akif Diri, Banu Diri
Staghorn stones are large branching stones that fill part of all of the renal pelvis and renal calyces and they can be complete or partial depending on the level of occupancy of the collecting system. Although kidney stones are commoner in men, staghorn stones are less often reported in men compared to women and they are usually unilateral. Due to the significant morbidity and potential mortality attributed to staghorn stones, prompt assessment and treatment is mandatory. Conversely, conservative treatment has been shown to carry a mortality rate of 28% in 10-year period and 36% risk of developing significant renal impairment...
November 2018: Renal Failure
https://www.readbyqxmd.com/read/29657440/magnetic-growth-modulation-in-orthopaedic-and-spine-surgery
#14
REVIEW
Adam E M Eltorai, Carolina Fuentes
Purpose: To examine distraction-based methods for treatment of early onset scoliosis (EOS), focusing on the magnetically controlled growing rod system (MCGR) relative to traditional growing rod system (TGR). To briefly discuss internal magnetically controlled nails for bone lengthening as another application of magnetic growth modulation. Results: Relative to TGR, MCGR involves fewer complications related to infection and general anesthesia because of fewer successive surgeries required...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29649668/laparoscopic-vs-open-restorative-proctocolectomy-with-ipaa-for-ulcerative-colitis-impact-of-surgical-technique-on-creating-a-well-functioning-pouch
#15
Michela Mineccia, Francesca Cravero, Paolo Massucco, Luca Portigliotti, Franco Bertolino, Marco Daperno, Alessandro Ferrero
BACKGROUND: Patients with ulcerative colitis are often young, and proctocolectomy with restorative ileo-pouch anal anastomosis is a crucial act that can improve or worsen the quality of the rest of their lives. The literature is scant on long-term functional outcomes after laparoscopy. The purpose of this study was to investigate results in terms of pouch function after standardized total laparoscopic technique compared with open intervention. MATERIALS AND METHODS: This was a retrospective comparative study...
April 9, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29648645/does-human-endometrial-lgr5-gene-expression-suggest-the-existence-of-another-hormonally-regulated-epithelial-stem-cell-niche
#16
N Tempest, A M Baker, N A Wright, D K Hapangama
STUDY QUESTION: Is human endometrial leucine-rich repeat-containing G-protein-coupled receptor 5 (LGR5) gene expression limited to the postulated epithelial stem cell niche, stratum basalis glands, and is it hormonally regulated? SUMMARY ANSWER: LGR5 expressing cells are not limited to the postulated stem cell niche but LGR5 expression is hormonally regulated. WHAT IS KNOWN ALREADY: The human endometrium is a highly regenerative tissue; however, endometrial epithelial stem cell markers are yet to be confirmed...
April 10, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29644465/impact-of-one-to-one-tutoring-on-fundamentals-of-laparoscopic-surgery-fls-passing-rate-in-a-single-center-experience-outside-the-united-states-a-randomized-controlled-trial
#17
Federico Gheza, Paolo Raimondi, Leonardo Solaini, Federico Coccolini, Gian Luca Baiocchi, Nazario Portolani, Guido Alberto Massimo Tiberio
BACKGROUND: Outside the US, FLS certification is not required and its teaching methods are not well standardized. Even if the FLS was designed as "stand alone" training system, most of Academic Institution offer support to residents during training. We present the first systematic application of FLS in Italy. Our aim was to evaluate the role of mentoring/coaching on FLS training in terms of the passing rate and global performance in the search for resource optimization. METHODS: Sixty residents in general surgery, obstetrics & gynecology, and urology were selected to be enrolled in a randomized controlled trial, practicing FLS with the goal of passing a simulated final exam...
April 11, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29644264/laparoscopic-approach-to-the-management-of-penetrating-traumatic-diaphragmatic-injury
#18
Teo Li Tserng, Maria Benita Gatmaitan
Background: Traditionally, laparotomy/thoracotomy is the standard approach for thoracoabdominal injuries. However, it has a non-therapeutic rate of 12-40% and 40% morbidity. Laparoscopy, as a diagnostic and therapeutic modality, has evolved to be integral to general and subspecialty surgeons in the management of patients. However, its use in the field of trauma surgery has been limited. We present a case of traumatic diaphragmatic injury from a low velocity penetrating wound successfully repaired through laparoscopic approach...
August 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29643625/formulation-of-a-multivariate-predictive-model-for-difficult-intubation-a-double-blinded-prospective-study
#19
Anoop Kanwal Chhina, Richa Jain, Parshotam Lal Gautam, Jony Garg, Nidhi Singh, Anju Grewal
Background and Aims: Various models were devised for prediction of difficult intubation but have low positive predictive value, sensitivity and specificity. We aimed to predict difficult intubation from various airway predictive indices, in isolation and combination, and to formulate a multivariate model that can aid in accurate prediction of difficult intubation. Material and Methods: A prospective double blinded study was conducted on 500 adult patients scheduled for elective surgery under general anaesthesia...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643624/effectiveness-of-proseal-laryngeal-mask-airway-and-laryngeal-tube-suction-in-elective-non-laparoscopic-surgeries-of-up-to-ninety-minutes-duration-a-prospective-randomized-study
#20
Swapnil Verma, S P Sharma
Background and Aims: Proseal laryngeal mask airway (LMA) and laryngeal tube suction (LTS) are both supraglottic devices with an esophageal suction port. In the present prospective, randomized study, the effectiveness of airway seal, hemodynamic variables, ability to pass orogastric tube, and postoperative complications with the two devices were evaluated. Material and Methods: This was a prospective, randomized, single-blind study conducted in a hospital-based setting...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
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