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Standards for General Surgery

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https://www.readbyqxmd.com/read/28728205/-predictability-of-postoperative-pain-and-satisfaction-how-precise-are-we-and-what-is-the-role-of-professional-experience
#1
Ulf Krister Hofmann, Cosima Dobler, Marco Gesicki, Torsten Kluba, Sebastian Scheidt
Background The indication for surgery is justified by an expected improvement for the patient. To evaluate the probability and extent of individual postoperative patient benefit, the surgeon needs to elaborate numerous parameters of potential relevance for the outcome beyond his key competence, that is the technical dimension of the operation. Despite the highest medical standards, individual postoperative satisfaction with surgery is highly variable, even in cases with a technically good result. The aim of the present study was to investigate the individual predictability of postoperative pain and satisfaction in patients with elective musculoskeletal surgery...
July 20, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28727896/proseal-versus-classic-laryngeal-mask-airway-lma-for-positive-pressure-ventilation-in-adults-undergoing-elective-surgery
#2
REVIEW
Muhammad Qamarul Hoda, Khalid Samad, Hameed Ullah
BACKGROUND: The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to facilitate positive pressure ventilation: the ProSeal laryngeal mask airway (pLMA) and the Classic laryngeal mask airway (cLMA). It is not clear whether these devices have important clinical differences in terms of efficacy or complications. OBJECTIVES: To compare the effectiveness of the ProSeal laryngeal mask airway (pLMA) and the Classic LMA (cLMA) for positive pressure ventilation in adults undergoing elective surgery...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28720423/undergraduate-clinical-teaching-in-orthopedic-surgery-a-randomized-control-trial-comparing-the-effect-of-case-based-teaching-and-bedside-teaching-on-musculoskeletal-osce-performance
#3
Martin Kelly, Iain Feeley, Fiona Boland, John M O'Byrne
INTRODUCTION: Musculoskeletal (MSK) complaints are the second most common reason for a hospital outpatient appointment in the US, and account for 19.5% of general practice consultations. Previous studies have shown that passive teaching in medical school does not imbue students with an adequate degree of confidence in MSK evaluation. The aim of this study was to conduct a randomized control trial to compare the effect of the gold standard small group tutorial of bedside teaching against case-based teaching (CBT) in relation to orthopedic surgery in medical students...
July 15, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28720359/functional-outcomes-following-radical-cystectomy-in-women-with-bladder-cancer-a-systematic-review
#4
REVIEW
Angela B Smith, Karen Crowell, Michael E Woods, Eric M Wallen, Raj S Pruthi, Matthew E Nielsen, Cheryl T Lee
CONTEXT: Gender-specific functional and health-related quality of life (HRQOL) outcomes following radical cystectomy (RC) for bladder cancer (BCa) remain unclear, with many studies excluding women from the study population. OBJECTIVE: To better characterize female-specific functional outcomes following RC and urinary diversion for BCa. EVIDENCE ACQUISITION: We performed a critical review of PubMed/Medline and Embase in August 2015 according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement...
February 2017: European Urology Focus
https://www.readbyqxmd.com/read/28719527/pupillometry-guided-intraoperative-remifentanil-administration-versus-standard-practice-influences-opioid-use-a-randomized-study
#5
Nada Sabourdin, Jérôme Barrois, Nicolas Louvet, Agnès Rigouzzo, Marie-Laurence Guye, Christophe Dadure, Isabelle Constant
BACKGROUND: Pupillometry has shown promising results for assessing nociception in anesthetized patients. However, its benefits in clinical practice are not demonstrated. The aim of this prospective randomized study was to evaluate the impact of intraoperative pupillometry monitoring on perioperative opioid consumption in major gynecologic surgery. METHODS: After receiving ethics committee approval and written consent of patients, American Society of Anesthesiologists status I to II women undergoing gynecologic surgery were included in this single-blinded, prospective, parallel-arm randomized study...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28719454/the-difference-in-clinical-outcomes-after-anterior-cervical-fusion-disk-replacement-and-foraminotomy-in-professional-athletes
#6
Harry T Mai, Danielle S Chun, Andrew D Schneider, Andrew C Hecht, Joseph C Maroon, Wellington K Hsu
STUDY DESIGN: Retrospective case series. OBJECT: To compare postoperative outcomes of professional athletes treated for cervical disk herniation after anterior cervical discectomy and fusion (ACDF) and posterior foraminotomy (PF), or total disk replacement (TDR). SUMMARY OF BACKGROUND DATA: ACDF, PF, and TDR have all led to excellent outcomes in the general population but the unique demands in the professional athlete necessitate specific study...
July 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28713677/radio-immunotherapy-and-chemo-immunotherapy-as-a-novel-treatment-paradigm-in-malignant-pleural-mesothelioma
#7
REVIEW
Licun Wu, Marc de Perrot
Malignant pleural mesothelioma (MPM) is an aggressive neoplasm with poor outcome. Novel radical radiation techniques using intensity modulated radiation therapy (IMRT) have become an important component of therapy in mesothelioma. Immunotherapy also provides new therapeutic options. However, how best to integrate immunotherapy with standard therapy such as radiation, chemotherapy and surgery remains unknown. A change of paradigm from adjuvant normofractionation to induction accelerated hypofractionated hemithoracic radiation could provide a platform to combine immunotherapy due to the potential benefit of short course high dose radiation on the immune system...
June 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28711570/anesthetic-management-of-reversible-cerebral-vasoconstriction-syndrome-a-case-report
#8
Hiroshi Hoshijima, Naoki Itoh, Yoshinori Iwase, Hiroshi Nagasaka
Reversible cerebral vasoconstriction syndrome (RCVS) is a group of disorders characterized by prolonged reversible cerebral vasoconstriction, associated with acute-onset, severe, episodic "thunderclap" headaches with or without other neurologic clinical features. We describe the first reported case, to our knowledge, of a patient with RCVS who was managed under general anesthesia in the field of oral and maxillofacial surgery. A 67-year-old woman with a diagnosis of RCVS made 2 months earlier was scheduled to undergo surgical extraction of the mandibular right third molar...
June 14, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28708807/a-systematic-review-of-internet-decision-making-resources-for-patients-considering-surgery-for-ulcerative-colitis
#9
Daniel M Baker, Jack H Marshall, Matthew J Lee, Georgina L Jones, Steven R Brown, Alan J Lobo
BACKGROUND: Guidance from the Royal College of Surgeons advocates patient use of on-line resources to assist in decision making. Our aim was to assess the quality of on-line resources to facilitate decision making for patients considering surgery for ulcerative colitis (UC). METHODS: We undertook a systematic review based on PRISMA guidelines. This was registered on the PROSPERO database (CRD42016047177). We searched Google and repositories using several lay search terms for patient information discussing surgery for UC, published in English...
August 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28706584/assessment-of-aortic-valve-disease-a-clinician-oriented-review
#10
REVIEW
Andrei D Mǎrgulescu
Aortic valve disease [aortic stenosis (AS) and aortic regurgitation (AR)] represents an important global health problem; when severe, aortic valve disease carries poor prognosis. For AS, aortic valve replacement, either surgical or interventional, may provide definite treatment in carefully selected patients. For AR, valve surgery (either replacement or - in selected cases - aortic valve repair) remains the gold standard of care. To properly identify those patients who are candidates for surgery, the clinician has to carefully assess the severity of valve disease with an understanding of the potential pitfalls involved in these assessments...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28703112/the-usefulness-of-d-dimer-in-diagnosis-and-prediction-of-venous-thromboembolism-in-patients-with-abdominal-malignancy
#11
Marcin Kwietniak, Tariq Al-Amawi, Tomasz Błaszkowski, Violetta Sulżyc-Bielicka, Józef Kładny
THE AIM: of the study was to evaluate the usefulness of D-dimer evaluation in the diagnosis and prediction of venous thromboembolism (VTE) of lower extremities in patients operated on for abdominal tumors depending on the chosen cut-off point for this parameter. MATERIAL AND METHODS: We included 150 patients operated on for abdominal cancer in our department between October 2014 and June 2016. In these patients, concentration of D-dimer was determined, medical histories were taken, and physical examinations were performed...
June 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28697713/an-update-of-the-italian-stroke-organization-stroke-prevention-awareness-diffusion-group-guidelines-on-carotid-endarterectomy-and-stenting-a-personalized-medicine-approach
#12
Gaetano Lanza, Carlo Setacci, Stefano Ricci, Patrizio Castelli, Alberto Cremonesi, Jessica Lanza, Claudio Novali, Carlo Pratesi, Paola Santalucia, Francesco Speziale, Augusto Zaninelli, Gian Franco Gensini
Although proof-based medicine has generated much valid evidence for the drawing up of guidelines and recommendations for best clinical practice in symptomatic and asymptomatic carotid stenosis, whether and when it is better to employ endarterectomy or stenting as the intervention of choice still remain matters of debate. Moreover, guidelines have been targeted up to now to the 'representative' patient, as resulting from the statistical analyses of the studies conducted on the safety and efficacy of both interventions as well as on medical therapy alone...
July 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28695972/the-incidence-of-postoperative-pneumonia-in-various-surgical-subspecialties-a-dual-database-analysis
#13
Morad Chughtai, Chukwuweike U Gwam, Anton Khlopas, Jared M Newman, Gannon L Curtis, Pedro A Torres, Rafay Khan, Michael A Mont
INTRODUCTION: Pneumonia is the third most common postoperative complication. However, its epidemiology varies widely and is often difficult to assess. For a better understanding, we utilized two national databases to determine the incidence of postoperative pneumonia after various surgical procedures. Specifically, we used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and the Nationwide Inpatient Sample (NIS) to determine the incidence and yearly trends of postoperative pneumonia following orthopaedic, urologic, otorhinolaryngologic, cardiothoracic, neurosurgery, and general surgeries...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28695560/minimally-invasive-extracorporeal-circulation-excellent-outcome-and-life-expectancy-after-coronary-artery-bypass-grafting-surgery
#14
Bernhard Winkler, Paul Philipp Heinisch, Grzegorz Zuk, Katarzyna Zuk, Brigitta Gahl, Hans-Jörg Jenni, Alexander Kadner, Christoph Huber, Thierry Carrel
OBJECTIVE: Coronary artery bypass grafting (CABG) remains the gold standard for complex revascularisation in multivessel disease. The concept of the minimally invasive extracorporeal circulation circuit (MiECC) was introduced to minimise pathophysiological side effects of conventional extracorporeal circulation. This study presents early and long-term outcomes after CABG with use of MiECC in a single-centre consecutive patient cohort. METHODS: From 1 January 2005 to 31 December 2010, 2130 patients underwent isolated CABG with MiECC at our centre...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28693792/cholangiocarcinoma
#15
REVIEW
Michela Squadroni, Luca Tondulli, Gemma Gatta, Stefania Mosconi, Giordano Beretta, Roberto Labianca
Biliary tract cancer accounts for <1% of all cancers and affects chiefly an elderly population, with predominance in men. We distinguish cholangiocarcinoma (intrahepatic, hilar and distal) and gallbladder cancer, with different pathogenesis and prognosis. The treatment is based on surgery (whenever possible), radiotherapy in selected cases, and chemotherapy. The standard cytotoxic treatment for advanced/metastatic disease is represented by the combination of gemcitabine and cisplatin, whereas fluoropyrimidines are generally administered in second line setting...
August 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28693476/intended-cost-reduction-in-laparoscopic-appendectomy-by-introducing-the-endoloop-a-single-center-experience
#16
Matthias Mehdorn, Olaf Schürmann, H Maximilian Mehdorn, Ines Gockel
BACKGROUND: Cost reduction measures in medicine are gaining greater importance nowadays, especially in high-volume procedures such as laparoscopic appendectomy (LAE). Currently there are two common methods of dissecting the appendix from the caecal pole: linear stapler and endoloops. The endoloop is the cheaper device but can only be used in uncomplicated cases of appendicitis. Therefore both methods are used in LAE depending on intraoperative findings. The goal of this study was to retrospectively evaluate possible cost reduction due to increased use of endoloop in LAE in our general surgery department of a tertiary referral university hospital...
July 11, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28693178/presurgical-neoadjuvant-targeted-molecular-therapy-for-kidney-cancer-with-concomitant-vena-cava-tumor-embolus-a-clinical-study
#17
Gang Guo, Wei Cai, Hongzhao Li, Jiangping Gao, Xin Ma, Jun Dong, Weijun Fu, Xu Zhang
The present study aimed to investigate presurgical neoadjuvant targeted therapy for patients with kidney cancer and vena cava tumor embolus, in order to examine its indications, therapeutic effects and optimal timing of surgery. Between June 2009 and June 2014, 12 patients from The People's Liberation Army General Hospital (Beijing, China) were diagnosed with kidney cancer with superior vena cava tumor embolus, and received presurgical neoadjuvant targeted therapy (sorafenib 400 mg twice a day or sunitinib 50 mg/day) for a median of 13...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28692347/prevalence-of-difficult-intubation-and-failed-intubation-in-a-diverse-obstetric-community-based-population
#18
Richard Pollard, Matthew Wagner, Katherine Grichnik, Brittany C Clyne, Ashraf S Habib
Objective To describe the incidence of difficult and failed intubations in obstetric patients during a 6-year period monitored by a quality assurance program together with American Society of Anesthesiologists Physical Status (ASA PS) scores, and obesity (Body mass index > 30 kg/m(2)). Methods Following Institutional Review Board approval, data about obstetric patients who experienced unanticipated difficult or failed intubations from 2010-2015 were obtained from the quality assurance database of a large, community-based anesthesiology group practice...
July 10, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28688650/pilot-evaluation-of-the-computer-based-assessment-for-sampling-personal-characteristics-test
#19
Edward S Shipper, Laura M Mazer, Sylvia Bereknyei Merrell, Dana T Lin, James N Lau, Marc L Melcher
BACKGROUND: High attrition rates hint at deficiencies in the resident selection process. The evaluation of personal characteristics representative of success is difficult. Here, we evaluate a novel tool for assessing personal characteristics. MATERIALS AND METHODS: To evaluate feasibility, we used an anonymous voluntary survey questionnaire offered to study participants before and after contact with the CASPer test. To evaluate the CASPer test as a predictor of success, we compared CASPer test assessments of personal characteristics versus traditional faculty assessment of personal characteristics with applicant rank list position...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28687917/the-application-of-surgical-procedure-manager-spm-first-experience-with-fess
#20
Katharina Feige, Iris Gollnick, Pia Schmitz, Gero Strauss
In our hypothesis, the newly developed program SPM (surgical procedure manager) will ensure successful standardization and efficiency of the FESS (functional endoscopic sinus surgery) and therefore make a decisive contribution in terms of economization and improvement of intraoperative quality. Between 27th March 2015 and 8th October 2015, data from 259 FESS procedures were collected using the SPM. The study took place at the surgical desk, an operating room in the ACQUA clinic in Leipzig, Germany. 233 FESS (90%) of the total FESS (n = 259, 100%) were conducted entirely with SPM...
July 7, 2017: European Archives of Oto-rhino-laryngology
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