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Effect of specialization on surgery safety

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https://www.readbyqxmd.com/read/28827901/applied-research-on-laparoscopic-simulator-in-the-resident-surgical-laparoscopic-operation-technical-training
#1
Shangxi Fu, Xiao Liu, Li Zhou, Meisheng Zhou, Liming Wang
The purpose of this study was to estimate the effects of surgical laparoscopic operation course on laparoscopic operation skills after the simulated training for medical students with relatively objective results via data gained before and after the practice course of laparoscopic simulator of the resident standardized trainees. Experiment 1: 20 resident standardized trainees with no experience in laparoscopic surgery were included in the inexperienced group and finished simulated cholecystectomy according to simulator videos...
August 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28718878/deep-brain-and-cortical-stimulation-for-epilepsy
#2
REVIEW
Mathieu Sprengers, Kristl Vonck, Evelien Carrette, Anthony G Marson, Paul Boon
BACKGROUND: Despite optimal medical treatment, including epilepsy surgery, many epilepsy patients have uncontrolled seizures. Since the 1970s interest has grown in invasive intracranial neurostimulation as a treatment for these patients. Intracranial stimulation includes both deep brain stimulation (DBS) (stimulation through depth electrodes) and cortical stimulation (subdural electrodes). This is an updated version of a previous Cochrane review published in 2014. OBJECTIVES: To assess the efficacy, safety and tolerability of DBS and cortical stimulation for refractory epilepsy based on randomized controlled trials (RCTs)...
July 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28700011/how-does-practice-improve-the-skills-of-medical-students-during-consecutive-training-courses
#3
Erzsebet Vanyolos, Istvan Furka, Iren Miko, Aida Viszlai, Norbert Nemeth, Katalin Peto
Purpose: To follow-up the development of medical students in taking a stitch using two different bench models, and to assess their performance with regards to gender, handedness, prior recreational activities and interest in surgery. Methods: The study was performed during the compulsory basic (n=152) and the consecutive elective course (n=27). Students took simple interrupted stitches into synthetic and biopreprate models in the classroom and in the operating room...
June 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28666699/perioperative-pain-management-an-update-for-obstetrician-gynecologists
#4
REVIEW
Georgine Lamvu, Jessica Feranec, Emily Blanton
The opioid epidemic in the United States is unprecedented and continues to worsen. Many opioid abusers obtain their pills through legitimate prescriptions, directly or indirectly, from a medical provider. While practitioners have a responsibility to treat pain, it is now becoming clear that aggressive opioid prescription practices contribute to an epidemic of abuse. The medical community has to balance the unintended consequences of opioid misuse and abuse with the need to provide adequate pain control. Additionally, providers are being held accountable by the legal system and professional organizations for their prescribing practices...
June 27, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28655529/telementoring-and-telesurgery-for-minimally-invasive-surgery
#5
REVIEW
Andrew J Hung, Jian Chen, Ankeet Shah, Inderbir S Gill
PURPOSE: Tremendous interest and need lie in the intersection of telemedicine and minimally invasive surgery. Robotics provides an ideal environment for surgical telementoring and telesurgery, given its endoscopic optics and mechanized instrument movement. We review the current status, challenges and future promise of telemedicine in endoscopic and minimally invasive surgery, with particular focus on urologic applications. MATERIALS AND METHODS: Two paired investigators screened Pubmed(®), Scopus(®) and Web of Science(®) databases for all full-text English language articles published between 1995 and 2016, using the keywords: telemedicine, minimally invasive surgical procedure, robotic surgical procedure, education, distance...
June 24, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28525415/effects-of-collagenase-digestion-and-stromal-vascular-fraction-supplementation-on-volume-retention-of-fat-grafts
#6
Jonathan B Olenczak, Scott A Seaman, Kant Y Lin, Angela Pineros-Fernandez, Catherine E Davis, Lisa S Salopek, Shayn M Peirce, Patrick S Cottler
OBJECTIVE: The use of autologous fat as a soft tissue filler has increased over the past decade in both reconstructive and aesthetic surgeries. Enhancement of autologous fat grafts with the addition of the stromal vascular fraction (SVF) has been reported to improve long-term volume retention. Stromal vascular fraction is most commonly isolated using enzymatic digestion, but it is unknown what effect the digestion process has on the adipocytes and SVF cells that comprise the graft. Some clinicians have reported use of enzymatically digested fat grafts to alter the physical properties of the tissue in specialized applications...
June 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28456730/usefulness-of-pbpk-modeling-in-incorporation-of-clinical-conditions-in-personalized-medicine
#7
REVIEW
Niloufar Marsousi, Jules A Desmeules, Serge Rudaz, Youssef Daali
Personalized medicine aims to determine the most adequate treatment and dose regimen to obtain the maximum efficacy and minimum side effect by taking into account patients' characteristics. For numerous reasons, one being ethical and methodological hurdles in including specific populations in clinical trials, innovative methods for optimization of drugs safety and efficacy in such patients have received increasing interest recently. Physiological-based pharmacokinetic (PBPK) modeling has emerged as a promising approach in designing adequate clinical trials and quantifying anticipated changes in unknown clinical situations...
April 26, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28452912/effects-of-a-brief-team-training-program-on-surgical-teams-nontechnical-skills-an-interrupted-time-series-study
#8
Brigid M Gillespie, Emma Harbeck, Evelyn Kang, Catherine Steel, Nicole Fairweather, Kriengsak Panuwatwanich, Wendy Chaboyer
BACKGROUND: Up to 60% of adverse events in surgery are the result of poor communication and teamwork. Nontechnical skills in surgery (NOTSS) are critical to the success of surgery and patient safety. The study aim was to evaluate the effect of a brief team training intervention on teams' observed NOTSS. METHODS: Pretest-posttest interrupted time-series design with statistical process control analysis was used to detect longitudinal changes in teams' NOTSS. We evaluated NOTSS using the revised NOTECHS weekly for 20 to 25 weeks before and after implementation of a team training program...
April 27, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28360973/endoluminal-solutions-to-bariatric-surgery-complications-a-review-with-a-focus-on-technical-aspects-and-results
#9
REVIEW
Raquel Souto-Rodríguez, María-Victoria Alvarez-Sánchez
Obesity is a growing problem in developed countries, and surgery is the most effective treatment in terms of weight loss and improving medical comorbidity in a high proportion of obese patients. Despite the advances in surgical techniques, some patients still develop acute and late postoperative complications, and an endoscopic evaluation is often required for diagnosis. Moreover, the high morbidity related to surgical reintervention, the important enhancement of endoscopic procedures and technological innovations introduced in endoscopic equipment have made the endoscopic approach a minimally-invasive alternative to surgery, and, in many cases, a suitable first-line treatment of bariatric surgery complications...
March 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28272086/effectiveness-and-safety-of-surgical-excision-in-the-treatment-of-digital-mucoid-cysts
#10
Galina Balakirski, Christoph Loeser, Jens M Baron, Edgar Dippel, Laurenz Schmitt
BACKGROUND: Digital mucoid cysts have a tendency for recurrence after operative intervention. Several procedures are in use. OBJECTIVE: Retrospective evaluation for effectiveness, safety and patient satisfaction by using a questionnaire after treatment for digital mucoid cysts with targeted surgical excision and closure by flap-design. MATERIALS AND METHODS: All patients treated with surgical excision for digital mucoid cysts at the Dermatology Department of the Ludwigshafen City Hospital between 2007 and 2011 were evaluated using a specially designed questionnaire...
July 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28072800/modified-percutaneous-lumbar-foraminoplasty-and-percutaneous-endoscopic-lumbar-discectomy-instrument-design-technique-notes-and-5-years-follow-up
#11
Zhen-Zhou Li, Shu-Xun Hou, Wei-Lin Shang, Ke-Ran Song, Hong-Liang Zhao
BACKGROUND: Conventional percutaneous endoscopic lumbar discectomy (PELD) with an "inside-outside" technique has 4.3% - 10.3% surgical failure rate, especially in central herniated discs (HDs), migrated HDs, and axillary type HDs. PELD with foraminoplasty has been used for complex HDs. Percutaneous lumbar foraminoplasty (PLF), which is performed with a trephine or bone reamer introduced over a guidewire without a protective working cannula in the original Tessys technique, can quickly cut the hypertrophied bony structure under fluoroscopic guidance, and risk injury to the exiting and traversing nerve roots...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/27924508/ultrasonography-guided-percutaneous-nephrolithotomy-with-chinese-one-shot-tract-dilation-technique-based-on-stimulated-diuresis-a-report-of-67-cases
#12
Ying Shi, Hua-Geng Liang, Xiong Yang, Bo Hai, Liang Wang, Yi-Fei Xing, Wen Ju, Fu-Qing Zeng, Xiao-Ping Zhang, Wen-Cheng Li
The safety and effectiveness of a novel Chinese one-shot dilation technique based on stimulated diuresis for percutaneous nephrolithotomy (PCNL) were investigated. After the feasibility of the Chinese one-shot dilation based on stimulated diuresis was verified by an animal study, this technique was applied in the clinical practice. A total of 67 patients in our department underwent the modified PCNL from July 2014 to June 2015. After the renal infundibulum was distended by stimulated diuresis, the kidney was punctured under the ultrasonographic guidance via the fornix of the target calyx...
December 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/27921198/-metabolic-surgery-or-conservative-measures-as-therapy-of-obese-type%C3%A2-2%C3%A2-diabetics
#13
REVIEW
Udo Jahn, Thomas Schubert, Sibylle Schlepp, Heinz Jürgen Deuber
After bariatric surgery there are some favourable effects on comorbidities of obesity as glucose and lipid metabolism besides weight loss. Therefore surgical measures targeting at improvement of such metabolic disorders especially diabetes type 2 has been called "metabolic surgery". The complexity of its underlying metabolic mechanisms is not yet clear, but restriction of energy and weight loss (maintenance) seem to be the cornerstones.Risks of these procedures which are drawn of the established methods of bariatric surgery are reported to be relatively low in qualified centers...
June 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27731885/transfusion-thresholds-and-other-strategies-for-guiding-allogeneic-red-blood-cell-transfusion
#14
REVIEW
Jeffrey L Carson, Simon J Stanworth, Nareg Roubinian, Dean A Fergusson, Darrell Triulzi, Carolyn Doree, Paul C Hebert
BACKGROUND: There is considerable uncertainty regarding the optimal haemoglobin threshold for the use of red blood cell (RBC) transfusions in anaemic patients. Blood is a scarce resource, and in some countries, transfusions are less safe than others because of a lack of testing for viral pathogens. Therefore, reducing the number and volume of transfusions would benefit patients. OBJECTIVES: The aim of this review was to compare 30-day mortality and other clinical outcomes in participants randomized to restrictive versus liberal red blood cell (RBC) transfusion thresholds (triggers) for all conditions...
October 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27695249/the-use-of-intraoperative-computed-tomography-navigation-in-pituitary-surgery-promises-a-better-intraoperative-orientation-in-special-cases
#15
Stefan Linsler, Sebastian Antes, Sebastian Senger, Joachim Oertel
OBJECTIVE: The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. MATERIALS AND METHODS: We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated...
October 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/27677879/preoperative-planning-with-three-dimensional-reconstruction-of-patient-s-anatomy-rapid-prototyping-and-simulation-for-endoscopic-mitral-valve-repair
#16
Peyman Sardari Nia, Samuel Heuts, Jean Daemen, Peter Luyten, Jindrich Vainer, Jan Hoorntje, Emile Cheriex, Jos Maessen
Objectives: Mitral valve repair performed by an experienced surgeon is superior to mitral valve replacement for degenerative mitral valve disease; however, many surgeons are still deterred from adapting this procedure because of a steep learning curve. Simulation-based training and planning could improve the surgical performance and reduce the learning curve. The aim of this study was to develop a patient-specific simulation for mitral valve repair and provide a proof of concept of personalized medicine in a patient prospectively planned for mitral valve surgery...
February 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27555214/effect-of-prolonged-released-oxycodone-naloxone-in-postoperative-pain-management-after-total-knee-replacement-a-nonrandomized-prospective-trial
#17
Johannes Oppermann, Jan Bredow, Christian K Spies, Julia Lemken, Frank Unglaub, Christoph K Boese, Jens Dargel, Peer Eysel, Jan Zöllner
PURPOSE: The purpose of this study was to examine the effect of postoperative prolonged release oxycodone/naloxone (OXN) in comparison to other opioids (control group) on the early postoperative rehabilitation outcome after total knee replacement. METHODS: In a prospective, noninterventional, nonrandomized clinical trial, 80 patients were assigned to either the OXN group or a control group. Postoperative outcome and pain level at days 3, 6, 21, 35, and 6months were evaluated using the Bowel Function Index, Brief Pain Inventory Short Form questionnaire, the Hospital for Special Surgery score, modified Larson score, and the ability to attend physiotherapy...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27388136/hemilaminectomy-for-spinal-meningioma-a-case-series-of-20-patients-with-a-focus-on-ventral-and-ventrolateral-lesions
#18
S Tola, M De Angelis, S Bistazzoni, C Chiaramonte, V Esposito, S Paolini
OBJECTIVE: To demonstrate the effectiveness and safety of hemilaminectomy in spinal-meningioma surgery, with special attention to ventral lesions. We also describe technical tips to enhance surgical-corridor width. PATIENTS AND METHODS: A total of 20 patients (14 female and 6 male) underwent hemilaminectomy for resection of a spinal meningioma between January 2005 and December 2015. Preoperative magnetic resonance imaging defined the tumor location (16 thoracic, 3 cervical, 1 lumbar) and the dural-attachment site (4 ventral, 11 ventrolateral, 3 lateral, 2 posterior)...
September 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27275050/the-efficacy-and-safety-of-epidural-dexmedetomidine-and-clonidine-with-bupivacaine-in-patients-undergoing-lower-limb-orthopedic-surgeries
#19
Safiya I Shaikh, Sarala B Mahesh
BACKGROUND AND AIMS: Alpha (α-2) adrenergic agonists have both analgesic and sedative properties when used as an adjuvant in regional anesthesia. A prospective randomized double-blind study was carried out to evaluate the efficacy of epidural route and to compare the efficacy and clinical profile of dexmedetomidine and clonidine as an adjuvant to bupivacaine with special emphasis on their quality of analgesia, sedation and the ability to provide the smooth intra-operative and postoperative course...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27258495/impact-of-type-of-surgery-on-survival-outcome-in-patients-with-early-gallbladder-cancer-in-the-era-of-minimally-invasive-surgery-oncologic-safety-of-laparoscopic-surgery
#20
MULTICENTER STUDY
Jin-Young Jang, Jin Seok Heo, Youngmin Han, Jihoon Chang, Jae Ri Kim, Hongbeom Kim, Wooil Kwon, Sun-Whe Kim, Seong Ho Choi, Dong Wook Choi, Kyoungbun Lee, Kee-Taek Jang, Sung-Sik Han, Sang-Jae Park
Laparoscopic surgery has been widely accepted as a feasible and safe treatment modality in many cancers of the gastrointestinal tract. However, most guidelines on gallbladder cancer (GBC) regard laparoscopic surgery as a contraindication, even for early GBC. This study aims to evaluate and compare recent surgical outcomes of laparoscopic and open surgery for T1(a,b) GBC and to determine the optimal surgical strategy for T1 GBC.The study enrolled 197 patients with histopathologically proven T1 GBC and no history of other cancers who underwent surgery from 2000 to 2014 at 3 major tertiary referral hospitals with specialized biliary-pancreas pathologists and optimal pathologic handling protocols...
May 2016: Medicine (Baltimore)
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