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https://www.readbyqxmd.com/read/28528536/efficacy-of-ultrasound-guided-transversus-abdominis-plane-block-and-rectus-sheath-block-with-ropivacaine-and-dexmedetomidine-in-elderly-high-risk-patients-undergoing-emergency-abdominal-surgery
#1
Lili Xu, Zhiyong Hu, Jianjun Shen, Patrick M McQuillan
BACKGROUND: This study was designed to evaluate the effectiveness and safety of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks with ropivacaine and dexmedetomidine in elderly, high-risk patients undergoing emergency abdominal surgery. METHODS: Sixty elderly patients undergoing emergency abdominal surgery receiving both bilateral ultrasound-guided TAP and RS blocks were randomly divided into two groups: R+D (10 ml of 0.25% ropivacaine+0...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28528478/the-diagnosis-and-management-of-a-vertebral-artery-loop-causing-cervical-radiculopathy
#2
L Wood, M Czyz, S Forster, Bronek M Boszczyk
BACKGROUND: Cervical radiculopathies are rarely caused by vertebral artery loop formation, which is estimated to be present in less than 3% of patients. It is uncertain what causes the loop formation: some propose an association with spondylotic changes or trauma, whilst others suggest hypertension and atherosclerosis may be responsible. CASE REPORT 1: A 35-year-old male patient presented with signs and symptoms of cervical radiculopathy that was not improved with anterior cervical discectomy and fusion surgery performed 2 years beforehand...
May 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28528191/subcutaneous-implant-breast-reconstruction-time-to-reconsider
#3
REVIEW
M-K Tasoulis, F M Iqbal, S Cawthorn, F MacNeill, R Vidya
Improvements in breast surgery techniques such as skin and nipple preserving mastectomy and innovative prosthetics (implants, acellular dermal matrices and meshes) is renewing interest in subcutaneous (pre-pectoral) implant reconstruction. The aim of this paper is to review the current literature in an attempt to provide a rationale that may support a return to subcutaneous implant placement, so minimising the pain and functional problems resulting from submuscular breast reconstruction.
May 4, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28527552/postoperative-instructions-preoperatively-evaluating-the-effectiveness-of-a-teaching-model-on-patient-satisfaction-regarding-instructions-for-home-care
#4
Jennifer Hovsepian, Cheryl McGah, Claire O'Brien
Patients in the ambulatory setting often receive home care instructions, primarily in the postoperative phase. Patient's retention and understanding of these instructions is one determinant of postoperative outcomes. This article highlights how we designed and implemented a teaching strategy to better prepare patients for discharge from an ambulatory surgical setting. Our methods included developing a day of surgery plan for teaching patients their discharge instructions upon arrival, creating on-line teaching videos, and revising post discharge pain medication instructions...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28527544/a-prospective-study-of-nausea-and-vomiting-after-breast-cancer-surgery
#5
Susan W Wesmiller, Catherine M Bender, Yvette P Conley, Dana H Bovbjerg, Gretchen Ahrendt, Marguerite Bonaventura, Susan M Sereika
PURPOSE: Postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting (PDNV) continue to be common and disturbing complications experienced after surgery, particularly in women and especially in women undergoing breast cancer surgery. The purpose of this study was to assess the incidence and risk factors associated with PONV and PDNV from preoperative to 48 hours postoperatively in 97 women scheduled for breast cancer surgery. DESIGN: Prospective, comparative design...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28527519/-adult-intramedullary-gliomas
#6
C Campello, F Parker, S Slimani, A Le Floch, A Herbrecht, N Aghakhani, C Lacroix, H Loiseau, J P Lejeune, G Perrin, J Honnorat, H Dufour, O Chinot, D Figarella, L Bauchet, H Duffau, M Lonjon, P Labauge, M Messerer, J P Daures, P Fabbro, B Ducot
OBJECTIVES: Intramedullary gliomas are rare tumors accounting for less than 4% of all primary central nervous system tumors. The aims of this retrospective multicenter study were to assess their natural outcome as well as management. METHODS AND MATERIALS: We studied 332 patients from 1984 to 2011. Histopathological examination revealed 72% ependymomas (94% were low grade tumors), 24% astrocytomas (29% were high grade tumors), 2.4% mixed gliomas and 1.7% oligodendrogliomas...
May 17, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28527248/-clinical-and-demographic-profile-and-risk-factors-for-clostridium-difficile-infection
#7
Carlos Carvajal, Carlos Pacheco, Fabián Jaimes
INTRODUCTION: Clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. The increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease. OBJECTIVE: To determine the clinical characteristics of hospitalized patients with C. difficile infection. MATERIALS AND METHODS: We made a nested case-cohort study. We reviewed medical records of the patients with nosocomial diarrhea for whom an assay for toxin A-B of C...
January 24, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28526917/do-we-know-the-outcome-predictors-for-cauda-equine-syndrome-ces-a-retrospective-single-center-analysis-of-60-patients-with-ces-with-a-suggestion-for-a-new-score-to-measure-severity-of-symptoms
#8
Alexander König, Lisa Amelung, Marco Danne, Ullrich Meier, Johannes Lemcke
OBJECTIVE: Despite the awareness and familiarity of almost every medical professional with the cauda equine compression syndrome (CES), risk factors for a poor prognosis of the disease remain elusive. Even the relationship between subsequent outcome and the time elapsed from the time of appearance of symptoms to surgery taking place remain obscure. The aim of our study, therefore, was to analyze a relatively large population of our own patients studied consecutively, to identify outcome predictors for CES and to propose a clinical score for CES symptoms (Berlin CES score)...
May 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28526569/total-joint-replacement-for-neglected-posterior-knee-dislocation-following-septic-arthritis-after-arthroscopy
#9
Yusuf Öztürkmen, Yunus Emre Akman, Ethem Ayhan Ünkar, Erhan Şükür
This report presents the first case of a knee dislocation following septic arthritis after arthroscopy. A 65-year-old woman had an arthroscopy with irrigation and debridement (I&D) of the joint and microfracture for the chondral lesions. She had complaints of postarthroscopic infection but non-steroidal anti-inflammatory medication and local ice compression was recommended. She revisited her physician twice and at the last visit she had a large purulent effusion in her knee. The gram stain of the joint fluid aspirate demonstrated gram-positive cocci and the cultures grew methicilline-sensitive Staphylococcus aureus...
May 16, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28526518/clinical-presentation-of-endometriosis-identified-at-interval-laparoscopic-tubal-sterilization-prospective-series-of-465-cases
#10
Marion Tissot, Lise Lecointre, Emilie Faller, Karolina Afors, Chérif Akladios, Alain Audebert
OBJECTIVES: Women seeking sterilization are usually parous and have no major complains, such as pelvic pain. This could be a good model to indirectly assess the prevalence of endometriosis in the general population. Prevalence of endometriosis in women undergoing tubal sterilization by laparoscopy has been assessed in 17 published reports. Results indicate a surprising wide variation of prevalence of endometriosis, ranging from 1.4% to 43.3 %. This clinical study describes the prevalence and clinical presentations of endometriosis identified at interval laparoscopic tubal sterilization, as a close representation of endometriosis in general population...
May 16, 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28526423/pseudoparalysis-a-systematic-review-of-term-definitions-treatment-approaches-and-outcomes-of-management-techniques
#11
REVIEW
John M Tokish, Thomas C Alexander, Michael J Kissenberth, Richard J Hawkins
BACKGROUND: Pseudoparalysis remains one of the most challenging conditions in shoulder surgery. Long thought of as an unsolvable problem, recent advances in surgical techniques offer potential return of overhead motion in the setting of massive irreparable rotator cuff tears. This article summarizes the available literature including existing definitions and the results of different treatment approaches regarding range of motion, outcome scores, and reversal. METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the MEDLINE database, Cochrane database, Physiotherapy Evidence Database, and Google Scholar database was performed for studies that defined a preoperative shoulder group as having pseudoparalysis...
June 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28526156/essential-elements-of-multimodal-analgesia-in-enhanced-recovery-after-surgery-eras-guidelines
#12
REVIEW
Anair Beverly, Alan D Kaye, Olle Ljungqvist, Richard D Urman
Perioperative multimodal analgesia uses combinations of analgesic medications that act on different sites and pathways in an additive or synergistic manner to achieve pain relief with minimal or no opiate consumption. Although all medications have side effects, opiates have particularly concerning, multisystemic, long-term, and short-term side effects, which increase morbidity and prolong admissions. Enhanced recovery is a systematic process addressing each aspect affecting recovery. This article outlines the evidence base forming the current multimodal analgesia recommendations made by the Enhanced Recovery After Surgery Society (ERAS)...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526040/catching-a-floating-thrombus-a-case-report-on-the-treatment-of-a-large-thrombus-in-the-ascending-aorta
#13
Gijs Eduard de Maat, Giorgio Vigano, Massimo Alessandro Mariani, Ehsan Natour
BACKGROUND: The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. CASE PRESENTATION: A healthy 48-year-old man was hospital admitted with acute abdominal pain...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28525981/combination-of-gabapentin-and-ramosetron-for-the-prevention-of-postoperative-nausea-and-vomiting-after-gynecologic-laparoscopic-surgery-a-prospective-randomized-comparative-study
#14
Kyung Mi Kim, Jin Huh, Soo Kyung Lee, Eun Young Park, Jung Min Lee, Hyo Ju Kim
BACKGROUND: As a drug originally introduced for its anticonvulsant effects, gabapentin has been recently shown to be effective in the treatment of nausea and vomiting in various clinical settings. This study compared the antiemetic efficacy of oral gabapentin, intravenous ramosetron and gabapentin plus ramosetron in patients receiving fentanyl-based patient-controlled analgesia after laparoscopic gynecologic surgery. METHODS: One hundred and thirty two patients undergoing laparoscopic gynecologic surgery under general anesthesia were allocated randomly into three groups: group G received 300 mg oral gabapentin 1 h before anesthesia, group R received 0...
May 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28525512/parecoxib-supplementation-to-morphine-analgesia-decreases-incidence-of-delirium-in-elderly-patients-after-hip-or-knee-replacement-surgery-a-randomized-controlled-trial
#15
Dong-Liang Mu, Da-Zhi Zhang, Dong-Xin Wang, Geng Wang, Chun-Jing Li, Zhao-Ting Meng, Ya-Wei Li, Chao Liu, Xue-Ying Li
BACKGROUND: Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery. METHODS: In a randomized, double-blind, 2-center trial, patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline)...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525497/enhanced-recovery-after-surgery-for-suspected-ovarian-malignancy-a-survey-of-perioperative-practice-among-gynecologic-oncologists-in-australia-and-new-zealand-to-inform-a-clinical-trial
#16
Kristina Lindemann, Peey-Sei Kok, Martin Stockler, Peter Sykes, Alison Brand
OBJECTIVES: The objective of this survey was to review the current standard of perioperative care of patients with suspected advanced ovarian cancer in Australia and New Zealand in order to determine the level of equipoise for specific interventions. METHODS: In May 2016, a web-based questionnaire (SurveyMonkey Inc, Palo Alto, CA) was sent to all gynecologic oncologists in Australia and New Zealand (n = 56). Descriptive statistics were used. RESULTS: Response rate was 75%...
June 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28525490/surgeon-procedure-volume-and-complication-rates-in-anterior-cervical-discectomy-and-fusions-analysis-of-a-national-longitudinal-database
#17
Tyler Cole, Anand Veeravagu, Michael Zhang, John K Ratliff
STUDY DESIGN: Retrospective study using the MarketScan longitudinal database (2006-2010). OBJECTIVE: Compare complication rates between groups of patients undergoing anterior cervical discectomy and fusion (ACDF) procedures performed by surgeons with high versus low mean annual ACDF volume. SUMMARY OF BACKGROUND DATA: Over the past decade the volume of ACDFs performed has increased, concurrent with greater appreciation of potential for associated complications...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525488/artificial-disk-replacement-combined-with-fusion-versus-2-level-fusion-in-cervical-2-level-disk-disease-with-a-5-year-follow-up
#18
Gyu Yeul Ji, Chang Hyun Oh, Dong Ah Shin, Yoon Ha, Seong Yi, Keung Nyun Kim, Hyun Cheol Shin, Do Heum Yoon
STUDY DESIGN: Prospective study. OBJECTIVE: The purpose of this study was to compare the long-term clinical and radiologic outcomes of hybrid surgery (HS) and 2-level anterior cervical discectomy and fusion (2-ACDF) in patients with 2-level cervical disk disease. SUMMARY OF BACKGROUND DATA: In a previous study with a 2-year follow-up, HS was shown to be superior to 2-ACDF, with a better Neck Disability Index (NDI) score, less postoperative neck pain, faster C2-C7 range of motion (ROM) recovery, and less adjacent ROM increase...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525482/artificial-cervical-disk-replacement-for-the-treatment-of-adjacent-segment-disease-after-anterior-cervical-decompression-and-fusion
#19
Sheng Bin, Huang Xiangwang, Xiao Sheng, Xiang Tiecheng, Liu Xiangyang, Zhang Yi, Liu Bin
STUDY DESIGN: Retrospective study. OBJECTIVE: To evaluate the outcome of artificial cervical disk replacement (ACDR) for the treatment of adjacent segment disease (ASD) after anterior cervical decompression and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is the useful procedure for degenerative cervical diseases. However, studies have reported accelerated degeneration of functional spinal units adjacent to the fusion site after ACDF. MATERIALS AND METHODS: Between January 2004 and January 2011, 32 inpatients (18 male, 14 female; age, 38-61 y; mean, 48 y) underwent ACDR for the treatment of ASD after previous ACDF (single-level: n=12; 2-level: n=15; 3-level: n=5)...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525479/outcome-of-bilateral-c1-laminar-hooks-combined-with-c2-pedicle-screw-fixation-for-the-treatment-of-c1-c2-instability-a-report-of-18-cases-from-a-single-chinese-center
#20
Lifeng Lao, Guibin Zhong, Qianyi Li, Xinfeng Li, Bin Chen, Lie Qian, Zude Liu
STUDY DESIGN: A retrospective technical report. OBJECTIVE: To assess the effect of bilateral C1 laminar hooks combined with C2 pedicle screw fixation for the treatment of C1-C2 instability. SUMMARY OF BACKGROUND DATA: Various posterior atlantoaxial fixations for C1-C2 instability have been developed. However, due to anatomic anomalies of the vertebral artery, the smallness of the pedicle, trajectories of broken screws, or a lack of surgical experience, a simple atlantoaxial fixation technique with good safety and effectiveness is urgently needed...
June 2017: Clinical Spine Surgery
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