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Standards for General Surgery

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https://www.readbyqxmd.com/read/28823025/nanomedicine-associated-with-photodynamic-therapy-for-glioblastoma-treatment
#1
REVIEW
Leonardo B de Paula, Fernando L Primo, Antonio C Tedesco
Glioblastoma, also known as glioblastoma multiforme (GBM), is the most recurrent and malignant astrocytic glioma found in adults. Biologically, GBMs are highly aggressive tumors that often show diffuse infiltration of the brain parenchyma, making complete surgical resection difficult. GBM is not curable with surgery alone because tumor cells typically invade the surrounding brain, rendering complete resection unsafe. Consequently, present-day therapy for malignant glioma remains a great challenge. The location of the invasive tumor cells presents several barriers to therapeutic delivery...
August 19, 2017: Biophysical Reviews
https://www.readbyqxmd.com/read/28819802/significance-of-human-chorionic-gonadotropin-as-a-predictor-of-resistance-to-standard-chemo-radiotherapy-for-pure-germinoma
#2
Akihiro Inoue, Takanori Ohnishi, Shohei Kohno, Shiro Ohue, Shinji Iwata, Shirabe Matsumoto, Masahiro Nishikawa, Saya Ozaki, Yawara Nakamura, Yosuke Mizuno, Riko Kitazawa, Takeharu Kunieda
Intracranial pure germinomas in children generally respond well to standard chemo-radiotherapy. However, some patients are refractory to standard therapy and require additional treatment. To investigate the characteristics of this subgroup, we retrospectively analyzed the clinical features and treatment outcomes of a cohort of 21 patients with intracranial pure germinomas who were diagnosed between April 2002 and December 2016 at Ehime University Hospital in Japan. Pure germinoma diagnosis was verified by histological examination of the tumor after surgery, and all patients received standard chemo-radiotherapy...
August 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28819358/surgical-treatment-for-chronic-pancreatitis-past-present-and-future
#3
REVIEW
Stephanie Plagemann, Maria Welte, Jakob R Izbicki, Kai Bachmann
The pancreas was one of the last explored organs in the human body. The first surgical experiences were made before fully understanding the function of the gland. Surgical procedures remained less successful until the discovery of insulin, blood groups, and finally the possibility of blood donation. Throughout the centuries, the surgical approach went from radical resections to minimal resections or only drainage of the gland in comparison to an adequate resection combined with drainage procedures. Today, the well-known and standardized procedures are considered as safe due to the high experience of operating surgeons, the centering of pancreatic surgery in specialized centers, and optimized perioperative treatment...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28815132/precision-diagnosis-of-melanoma-and-other-skin-lesions-from-digital-images
#4
Abhishek Bhattacharya, Albert Young, Andrew Wong, Simone Stalling, Maria Wei, Dexter Hadley
Melanoma will affect an estimated 73,000 new cases this year and result in 9,000 deaths, yet precise diagnosis remains a serious problem. Without early detection and preventative care, melanoma can quickly spread to become fatal (Stage IV 5-year survival rate is 20-10%) from a once localized skin lesion (Stage IA 5- year survival rate is 97%). There is no biomarker for melanoma in clinical use, and the current diagnostic criteria for skin lesions remains subjective and imprecise. Accurate diagnosis of melanoma relies on a histopathologic gold standard; thus, aggressive excision of melanocytic skin lesions has been the mainstay of treatment...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28812156/accredited-residents-perform-colonoscopy-to-the-same-high-standards-as-consultants
#5
Dedrick Kok Hong Chan, Reuben Kong Min Wong, Khay Guan Yeoh, Ker-Kan Tan
BACKGROUND: Endoscopy remains a critical component of General Surgery and Gastroenterology training. Whilst residents need to gain experience, the quality of endoscopy which patients receive cannot be compromised. We conducted this study to compare quality indicators between consultants and residents with regards to colonoscopy. METHODS: A review of colonoscopies from a prospectively collected database was performed from September 2011 to February 2016. Quality indicators such as caecum intubation rate, adenoma detection rate, adherence to a 6-min withdrawal rule, mean number of polyps detected per colonoscope, and complications were collected and compared between the two groups...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28806822/-multiple-myeloma-current-status-in-diagnostic-testing-and-therapy
#6
Michael Kehrer, Sebastian Koob, Andreas Strauss, Dieter Christian Wirtz, Jan Schmolders
Background Multiple myeloma is a haematological blood cancer of the bone marrow and is classified by the World Health Organisation (WHO) as a plasma cell neoplasm. In multiple myeloma, normal plasma cells transform into malignant myeloma cells and produce large quantities of an abnormal immunoglobulin called monoclonal protein or M protein. This ultimately causes multiple myeloma symptoms such as bone damage or kidney problems. The annual worldwide incidence of multiple myeloma is estimated to be 6 - 7/100,000 and accounts for 1% of all cancer...
August 14, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28806283/expanding-the-scope-of-quality-measurement-in-surgery-to-include-non-operative-care-results-from-the-acs-nsqip-emergency-general-surgery-pilot
#7
Michael W Wandling, Clifford Y Ko, Paul E Bankey, Chris Cribari, H Gill Cryer, Jose J Diaz, Therese M Duane, S Morad Hameed, Matthew M Hutter, Michael H Metzler, Justin L Regner, Patrick M Reilly, H David Reines, Jason L Sperry, Kristan L Staudenmayer, Garth H Utter, Marie L Crandall, Karl Y Bilimoria, Avery B Nathens
BACKGROUND: Patients managed non-operatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where non-operative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed non-operatively to evaluate variability in non-operative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered...
August 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28804864/prescription-and-indication-for-oral-nutritional-supplements-in-a-swiss-university-hospital-a-prospective-survey
#8
Julie Mareschal, Jean Altwegg, Dimitri Berthet, Marinette Chikhi, Pierre Chopard, Séverine Graf, Christian Sierro, Claude Pichard, Laurence Genton
AIMS OF THE STUDY: Patients with an acute or chronically negative nutritional balance are at nutritional risk. Oral nutritional supplements (ONS) are simple and effective medical treatments of nutritional risk. In the ambulatory setting, in Switzerland, ONS are reimbursed by public insurance under conditions defined by Swiss Society for Clinical Nutrition. The reimbursement requires a medical prescription for ONS and their delivery at the patient's home by a homecare service. The indication for the ONS, defined as a Nutritional Risk Screening-2002 (NRS-2002) score ≥3, must also be present...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28801924/foramen-epiploicum-mesh-closure-femc-through-a-ventral-midline-laparotomy
#9
T van Bergen, A Rötting, P Wiemer, S Schauvliege, K Vanderperren, F Ugahary, A Martens
BACKGROUND: Preventive laparoscopic closure of the epiploic foramen (EF) has previously been described, but methods for EF closure during laparotomy for treatment of colic are lacking. OBJECTIVES: To describe the Foramen Epiploicum Mesh Closure (FEMC) technique through a ventral midline laparotomy in horses under general anaesthesia and its outcome. STUDY DESIGN: Terminal surgical experiment and in vivo study. METHODS: In a pilot study a standard ventral midline laparotomy was performed under general anaesthesia in 10 experimental horses and a three-dimensional expandable diabolo-shaped mesh construct was manually introduced through the EF into the omental vestibule...
August 12, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28800778/effects-of-intraoperative-peep-optimization-on-postoperative-pulmonary-complications-and-the-inflammatory-response-study-protocol-for-a-randomized-controlled-trial
#10
Zoltán Ruszkai, Erika Kiss, Ildikó László, Fanni Gyura, Erika Surány, Péter Töhötöm Bartha, Gergely Péter Bokrétás, Edit Rácz, István Buzogány, Zoltán Bajory, Erzsébet Hajdú, Zsolt Molnár
BACKGROUND: Patients undergoing general anesthesia and mechanical ventilation during major abdominal surgery commonly develop pulmonary atelectasis and/or hyperdistention of the lungs. Recent studies show benefits of lung-protective mechanical ventilation with the use of low tidal volumes, a moderate level of positive end-expiratory pressure (PEEP) and regular alveolar recruitment maneuvers during general anesthesia, even in patients with healthy lungs. The purpose of this clinical trial is to evaluate the effects of intraoperative lung-protective mechanical ventilation, using individualized PEEP values, on postoperative pulmonary complications and the inflammatory response...
August 11, 2017: Trials
https://www.readbyqxmd.com/read/28800725/a-novel-thermal-compression-device-for-perioperative-warming-a-randomized-trial-for-feasibility-and-efficacy
#11
Peter Luke Santa Maria, Chloe Santa Maria, Andreas Eisenried, Nathalia Velasquez, Brian Thomas Kannard, Abhinav Ramani, David Mark Kahn, Amanda Jane Wheeler, John Gerhard Brock-Utne
BACKGROUND: Inadvertent perioperative hypothermia (IPH) leads to surgical complications and increases length of stay. IPH rates are high with the current standard of care, forced air warming (FAW). Our hypothesis is that a prototype thermal compression device that heats the popliteal fossa and soles of the feet, with lower leg compression, increases perioperative temperatures and reduces IPH compared to the current standard of care. METHODS: Thirty six female breast surgery patients, at a tertiary academic hospital, were randomized to the device or intraoperative FAW (stage I) with a further 18 patients randomized to the device with a single heating area only (stage II, popliteal fossa or sole of the feet)...
August 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28799867/endoscope-assisted-repair-of-csf-otorrhea-and-temporal-lobe-encephaloceles-via-keyhole-craniotomy
#12
Pamela C Roehm, Derrick Tint, Norman Chan, Ryan Brewster, Vishad Sukul, Kadir Erkmen
OBJECTIVE Temporal lobe encephaloceles and cerebrospinal fluid otorrhea from temporal bone defects that involve the tegmen tympani and mastoideum are generally repaired using middle fossa craniotomy, mastoidectomy, or combined approaches. Standard middle fossa craniotomy exposes patients to dural retraction, which can lead to postoperative neurological complications. Endoscopic and minimally invasive techniques have been used in other surgeries to minimize brain retraction, and so these methods were applied to repair the lateral skull base...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28799727/cryosurgical-posterior-nasal-tissue-ablation-for-the-treatment-of-rhinitis
#13
Peter H Hwang, Bryant Lin, Raymond Weiss, James Atkins, Jacob Johnson
BACKGROUND: Endoscopic posterior nasal nerve (PNN) resection has been described as an efficacious surgical treatment of allergic and nonallergic rhinitis, but the requirement for surgery under general anesthesia has limited its acceptance. We report the first series of patients treated for chronic rhinitis using a novel device designed for office-based cryosurgical ablation of the PNN. METHODS: Twenty-seven patients with chronic rhinorrhea and/or nasal congestion for >3 months were recruited (allergic or nonallergic rhinitis), with minimum rhinorrhea and/or congestion subscores of 2 as part of the Total Nasal Symptom Score [TNSS])...
August 11, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28799151/contrast-enhanced-ultrasound-features-of-hepatocellular-carcinoma-not-detected-during-the-screening-procedure
#14
Yi Dong, Wen-Ping Wang, Feng Mao, Christoph Dietrich
Aim The aim of this retrospective study is to report on the characteristics of contrast-enhanced ultrasound (CEUS) of primarily not detected hepatocellular carcinoma (HCC) during the screening procedure of patients at risk. Methods Sixty-four patients with a finally solitary and histologically proven HCC not detected HCC during the screening procedure were retrospectively analyzed. Most of HCC lesions (90.6 %, 58/64) measured < 20 mm in diameter. All HCC lesions were not detected during the initial screening procedure but suspected using contrast-enhanced magnetic resonance imaging...
August 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28796754/perioperative-patient-beliefs-regarding-potential-effectiveness-of-marijuana-cannabinoids-for-treatment-of-pain-a-prospective-population-survey
#15
Yury Khelemsky, Andrew T Goldberg, Yasmin L Hurd, Gary Winkel, Allen Ninh, Lucia Qian, Anna Oprescu, Jeffrey Ciccone, Daniel J Katz
BACKGROUND AND OBJECTIVES: Cannabinoids have an expanding presence in medicine. Perioperative patients' perceptions of the effectiveness of these compounds, and acceptance if prescribed for pain, have not been previously described. Our primary objective was to describe patients' beliefs regarding the potential effectiveness of cannabinoids for the treatment of acute and chronic pain, as well as gauge patient acceptance of these compounds if prescribed by a physician. In addition, demographic and pain history data were collected to elucidate the predictors of the aforementioned patient attitudes...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28795911/the-development-of-eras-across-surgical-specialties
#16
James C Senturk, Gentian Kristo, Jason Gold, Ronald Bleday, Edward Whang
BACKGROUND: Enhanced recovery after surgery (ERAS(®)) principles have gained traction in variety of surgical disciplines. The promise of a reduced length of stay without compromising patient safety or increasing readmission rates has produced a body of literature examining the implementation of ERAS in the care of general, thoracic, urologic, and gynecologic surgery patients. METHODS: We performed a review of the literature pertaining to studies of ERAS implementation across colorectal surgery, general surgery, thoracic surgery, urology, and gynecology...
August 10, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28795136/renal-autotransplantation-and-extracorporeal-nephron-sparing-surgery-for-de-novo-renal-cell-carcinoma-in-a-kidney-allograft
#17
Shinichiro Ono, Takashi Kenmochi, Taihei Ito, Naohiro Aida, Kazunori Otsuki, Naotake Akutsu, Michihiro Maruyama, Mamoru Kusaka, Ryoichi Shiroki, Kiyotaka Hoshinaga
De novo renal cell carcinoma (RCC) rarely occurs in kidney allografts; however, the risk of RCC in these patients is 100-fold that of the general healthy population. Although total nephrectomy has been the standard treatment for kidney allograft RCC, several authors have reported that early-stage RCC in kidney allografts was successfully treated with nephron-sparing surgery. We herein describe a new procedure involving renal autotransplantation and extracorporeal nephron-sparing surgery, which was performed to treat de novo RCC near the hilum of a transplanted kidney...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28793278/mixed-adenoneuroendocrine-carcinoma-derived-from-the-cystic-duct-a-case-report
#18
Yu-Ki Takemoto, Tomoyuki Abe, Hironobu Amano, Keiji Hanada, Akihito Okazaki, Tomoyuki Minami, Tsuyoshi Kobayashi, Masahiro Nakahara, Shuji Yonehara, Hideki Ohdan, Toshio Noriyuki
INTRODUCTION: Mixed adenoneuroendocrine carcinomas (MANECs) derived from cystic duct are extremely rare. PRESENTATION OF CASE: An 80-year-old woman was admitted to the department of surgery, Onomichi general hospital with abnormal liver function and jaundice. Enhanced abdominal computed tomography (CT) detected a well-enhanced papillary tumor in the cystic duct, which protruded into the common bile duct. The intrahepatic bile duct was dilated due to tumor obstruction...
July 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28791424/-to-stent-or-not-to-stent-immediate-emergency-surgery-with-laparoscopic-radical-colectomy-with-cme-and-primary-anastomosis-is-feasible-for-obstructing-left-colon-carcinoma
#19
Salomone Di Saverio, Arianna Birindelli, Edoardo Segalini, Matteo Novello, Anna Larocca, Francesco Ferrara, Gian Andrea Binda, Marco Bassi
Great debate exists in the initial acute management of large bowel obstruction from obstructing left colon carcinoma. While endoscopic stenting is well established as the first approach in the setting of palliative care of patients with advanced metastatic disease as well as a bridge to elective surgery in elderly patients who have an increased risk of postoperative mortality (age >70 years and/or ASA status ≥3), controversies exist regarding oncological safety and long-term outcomes of endoscopic colonic stenting in younger patients and ESGE Guidelines do not recommend SEMS placement in patients <70 and fit for curative surgery...
August 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28780843/-initial-study-of-transthoracic-echocardiography-guided-three-dimensional-printing-on-the-application-of-assessment-of-structural-heart-disease
#20
Y B Zhu, J S Liu, L Q Wang, X Guan, Y J Luo, J Geng, Q G Geng, Y J Lin, L X Zhang, X X Li, Y P Lu
Objective: To investigate the feasibility and diagnostic value of preoperative transthoracic echocardiography guided three dimensional printing model (TTE Guided 3DPM) on the assessment of structural heart disease (SHD). Methods: From February 2016 to October 2016, 44 patients underwent cardiac surgery in Tianjin Chest Hospital, forty-four patients were assessed preoperatively using TTE Guided 3DPM, including 25 males and 19 females, aged 3-75 years, with an average of (44±22) years. compared to conventional three dimensional transthoracic echocardiography (3D-TTE), and took direct intraoperative findings as "Golden Standard" simultaneously...
August 1, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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