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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27913975/clinical-impact-of-an-antibiotic-stewardship-program-at-a-children-s-hospital
#2
Brian R Lee, Jennifer L Goldman, Diana Yu, Angela L Myers, Leslie M Stach, Erin Hedican, Mary Anne Jackson, Jason G Newland
INTRODUCTION: Antibiotic stewardship programs (ASP) improve appropriate antibiotic use. Data are limited on the clinical benefit of ASPs in children's hospitals. This study's objective was to determine the impact of an ASP on length of stay (LOS) and readmission rate among patients admitted to children's hospitals. METHODS: Data from a prospective-audit-with-feedback ASP were used to examine the ASP review characteristics, including antibiotic(s) prescribed, clinical indication, recommendations made by the ASP, and agreement with recommendations...
December 2, 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27913755/applications-of-three-dimensional-printing-in-surgery
#3
REVIEW
Chi Li, Tsz Fung Cheung, Vei Chen Fan, Kin Man Sin, Chrisity Wai Yan Wong, Gilberto Ka Kit Leung
Three-dimensional (3D) printing is a rapidly advancing technology in the field of surgery. This article reviews its contemporary applications in 3 aspects of surgery, namely, surgical planning, implants and prostheses, and education and training. Three-dimensional printing technology can contribute to surgical planning by depicting precise personalized anatomy and thus a potential improvement in surgical outcome. For implants and prosthesis, the technology might overcome the limitations of conventional methods such as visual discrepancy from the recipient's body and unmatching anatomy...
December 2, 2016: Surgical Innovation
https://www.readbyqxmd.com/read/27913720/presentation-and-management-of-giant-fibrovascular-polyps-of-the-hypopharynx-and-esophagus
#4
Julina Ongkasuwan, C Lane Anzalone, Esperanza Salazar, Donald T Donovan
OBJECTIVE: Fibrovascular polyps of the hypopharynx and esophagus are rare, with few case reports in the literature. In this article, we present our institutional experience with a focus on airway and surgical management. STUDY DESIGN: Case series. SETTING: Tertiary academic institution. METHODS: A retrospective review was conducted of 4 patients that presented to a tertiary medical center with fibrovascular polyps between 1990 and 2012...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27913266/cost-utility-of-video-electroencephalography-monitoring-followed-by-surgery-in-adults-with-drug-resistant-focal-epilepsy-in-thailand
#5
Pimprapa Kitwitee, Kanjana Unnwongse, Teeradej Srikijvilaikul, Tinonkorn Yadee, Chulaporn Limwattananon
OBJECTIVES: This study assessed, whether video-electroencephalography (VEEG) monitoring followed by surgery was cost-effective in adult patients with drug-resistant focal epilepsy under Thai healthcare context, as compared to continued medical treatment without VEEG. METHODS: Total cost (in Thai Baht, THB) and effectiveness (in quality-adjusted life years, QALYs) were estimated over a lifetime horizon, using a decision tree and a Markov model. Data on short-term surgical outcomes, direct health care costs, and utilities, were collected from Thai patients in a specialized hospital...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913069/otolaryngology-sleep-medicine-curriculum-objectives-as-determined-by-sleep-experts
#6
Nathan Cass, Alan Kominsky, Cristina Cabrera-Muffly
PURPOSE: (1) Ascertain the most important concepts and topics for otolaryngology resident education in sleep medicine and surgery, as determined by faculty who teach sleep medicine to otolaryngology residents. (2) Create learning objectives within the area of otolaryngologic sleep medicine in order to design a sleep medicine curriculum for otolaryngology residents. MATERIALS AND METHODS: Two web-based surveys were sent to 163 academic otolaryngologists who teach sleep medicine...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27912930/prognostic-significance-of-venous-invasion-and-maximum-standardized-uptake-value-of-18-f-fdg-pet-ct-in-surgically-resected-t1n0-esophageal-squamous-cell-carcinoma
#7
J H Jeon, J M Lee, D H Moon, H C Yang, M S Kim, G-K Lee, J I Zo
BACKGROUND: The purpose of this study was to analyze the risk factors of recurrence in patients with early stage esophageal squamous cell carcinoma (ESCC). METHODS: We retrospectively analyzed the medical records of 190 patients with confirmed T1N0M0 ESCC after curative esophagectomy. The following potential prognostic factors for recurrence were investigated: age, sex, pathologic T category, tumor location, differentiation grade, tumor size, venous invasion, angiolymphatic invasion, perineural invasion and the maximum standardized uptake value (SUVmax) of the primary tumor...
November 22, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27912036/failure-to-redose-antibiotic-prophylaxis-in-long-surgery-increases-risk-of-surgical-site-infection
#8
Nongyao Kasatpibal, Joanne D Whitney, E Patchen Dellinger, Bala G Nair, Kenneth C Pike
BACKGROUND: Antibiotic prophylaxis is a key component of the prevention of surgical site infection (SSI). Failure to manage antibiotic prophylaxis effectively may increase the risk of SSI. This study aimed to examine the effects of antibiotic prophylaxis on SSI risk. METHODS: A retrospective cohort study was conducted among patients having general surgery between May 2012 and June 2015 at the University of Washington Medical Center. Peri-operative data extracted from hospital databases included patient and operation characteristics, intra-operative medication and fluid administration, and survival outcome...
December 2, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27911433/-medical-terminology-blepharorhaphy
#9
E V Boiko, V F Chernysh
: Ophthalmic literature currently lacks definiteness in classifying surgeries aimed at eyelid closure. In Western countries the term tarsorrhaphy is most commonly used, while in Russia another term - blepharorhaphy - is widely accepted. The latter seems more appropriate as the sutures are passed through all palpebral layers, not just the cartilage. It has also been suggested that temporary blepharorhaphy, which implies that we use only sutures to bring the eyelids together, and therefore, the procedure cannot be permanent, should be called simple blepharorhaphy...
2016: Vestnik Oftalmologii
https://www.readbyqxmd.com/read/27911364/an-intramedullary-locking-nail-for-standardized-fixation-of-femur-osteotomies-to-analyze-normal-and-defective-bone-healing-in-mice
#10
Tina Histing, Michael D Menger, Tim Pohlemann, Romano Matthys, Tobias Fritz, Patric Garcia, Moritz Klein
Bone healing models are essential to the development of new therapeutic strategies for clinical fracture treatment. Furthermore, mouse models are becoming more commonly used in trauma research. They offer a large number of mutant strains and antibodies for the analysis of the molecular mechanisms behind the highly differentiated process of bone healing. To control the biomechanical environment, standardized and well-characterized osteosynthesis techniques are mandatory in mice. Here, we report on the design and use of an intramedullary nail to stabilize open femur osteotomies in mice...
November 13, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27911065/-gastric-tube-esophagoplasty-using-the-retroesternal-route-in-children
#11
L García Martínez, J A Molino Gahete, S Redecillas Ferreiro, E Bordón Cabrera, J Bueno Recio, G Guillén Burrieza, C Giné Prades, A Lara Valtueña, J Lloret Roca
INTRODUCTION: Esophageal replacement is a surgical alternative once native esophagus can't be preserved. Different organs and routes for the replacement have been described, being the retroesternal route the least used. The aim is to present our results using gastric tube esophagoplasty with a retroesternal approach. PATIENTS AND METHODS: We performed a retrospective and descriptive study of 11 patients operated from 2000 to 2015. Median age at surgery was 2.2 years (5 months-9 years) and median weight was 11...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27910205/neurosurgical-robotic-arm-drilling-navigation-system
#12
Chung-Chih Lin, Hsin-Cheng Lin, Wen-Yo Lee, Shih-Tseng Lee, Chieh-Tsai Wu
BACKGROUND: The aim of this work was to develop a neurosurgical robotic arm drilling navigation system that provides assistance throughout the complete bone drilling process. METHODS: The system comprised neurosurgical robotic arm navigation combining robotic and surgical navigation, 3D medical imaging based surgical planning that could identify lesion location and plan the surgical path on 3D images, and automatic bone drilling control that would stop drilling when the bone was to be drilled-through...
December 2, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/27909658/minimally-invasive-surgery-for-lumbar-synovial-cysts-with-coexisting-degenerative-spondylolisthesis
#13
Daniel R Denis, Daniel Hirt, Saumya Shah, Daniel C Lu, Langston T Holly
BACKGROUND: About one third of lumbar synovial cysts are associated with degenerative spondylolisthesis. Segmental instability is thought to contribute to the pathogenesis and recurrence of synovial cysts and lumbar fusion has been advocated as a treatment of choice in the presence of spondylolisthesis. In patients with spondylolisthesis, minimally invasive resection of lumbar synovial cysts, without fusion, could minimize surgically induced segmental instability while providing good pain relief...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27909568/implementation-of-minimal-invasive-gynaecological-surgery-certification-will-challenge-gynaecologists-with-new-legal-and-ethical-issues
#14
V Tanos, R Socolov, P Demetriou, M Kyprianou, A Watrelot, Y Van Belle, R Campo
The introduction of a certification / diploma program in Minimal Invasive Surgery (MIS) is expected to improve surgical performance, patient's safety and outcome. The Gynaecological Endoscopic Surgical Education and Assessment programme (GESEA) and the ESHRE Certification for Reproductive Endoscopic Surgery (ECRES) provides a structured learning path, recognising different pillars of competence. In order to achieve a high level of competence a two steps validation is necessary: (a) the individual should be certified of having the appropriate theoretical knowledge and (b) the endoscopic psychomotor skills before entering in the diploma programme reflecting the surgical competence...
June 27, 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/27909512/concomitant-left-atrial-appendage-clipping-during-minimally-invasive-mitral-valve-surgery-technically-feasible-and-safe
#15
Ashraf Alqaqa Md, Shabiah Martin Md, Aiman Hamdan Md Facc, Fayez Shamoon Md Facc, Kourosh T Asgarian DO
BACKGROUND: It is believed that most of thrombi form in the left atrial appendage (LAA)before they emboli. Different surgical and percutaneouse approaches were suggested to manage the LAA. In this study we are evaluating the safety of clipping the LAA via minithoractotomy approach. METHOD: All consecutive patients who had minimally invasive mitral valve surgery with concomitant LAA clipping between December 2012 and February 2014 were included in the study. LAA exclusion was performed using AtriClip® LAA Exclusion System (Cincinnati, Ohio, AtriCure®)...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909067/concept-and-evaluation-of-the-german-war-surgery-course-einsatzchirurgie-kurs-der-bundeswehr
#16
David A Back, K Waldmann, T Hauer, N Huschitt, M W Bowyer, U Wesemann, A Lieber, C Willy
INTRODUCTION: Military surgeons must be prepared to care for severe and complex life-threatening injuries rarely seen in the civilian setting. Typical civilian training and practice do not provide adequate exposure to the broad set of surgical skills required. The German Bundeswehr Medical Service has developed and refined the War Surgery Course (WSC) to meet this training gap. This article describes the recent experience with this readiness curriculum. METHODS: Run annually since 1998, WSC consists nowadays of 5 days with 20 theoretical modules...
December 1, 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27908955/measuring-family-satisfaction-with-care-delivered-in-the-intensive-care-unit
#17
Kathleen Clark, Kerry A Milner, Marlene Beck, Virginia Mason
BACKGROUND: In our competitive health care environment, measuring the experience of family members of patients in the intensive care unit to ensure that health care providers are meeting families' needs is critical. Surveys from Press Ganey and the Centers for Medicare and Medicaid Services are unable to capture families' satisfaction with care in this setting. OBJECTIVE: To implement a sustainable measure for family satisfaction in a 12-bed medical and surgical intensive care unit...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908945/norwood-procedure-for-palliation-of-hypoplastic-left-heart-syndrome-right-ventricle-to-pulmonary-artery-conduit-vs-modified-blalock-taussig-shunt
#18
Dorothy M Beke
Patients with hypoplastic left heart syndrome undergo a series of operations to separate the pulmonary and systemic circulations. The first of at least 3 operations occurs in the newborn period, with a stage I palliation. The goal of stage I palliation is to provide pulmonary blood flow and create an unobstructed systemic outflow tract. Advances in surgical techniques and intraoperative and postoperative care have helped decrease morbidity and mortality for patients with hypoplastic left heart syndrome who have the stage I Norwood operation, but the patients continue to be at increased risk for hemodynamic collapse and adverse outcomes...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908805/understanding-patient-acceptance-of-risk-with-treatment-options-for-intermittent-claudication
#19
Abigail Hm Morbi, Sophie Coles, Mostafa Albayati, Ian M Nordon, Cliff Shearman
OBJECTIVES: Intermittent claudication has a major impact on the quality of life and functional ability of the patient. However, when treating these patients, management is largely influenced by vascular surgeons' perceptions of risk. There is little information available regarding the level of risk that patients perceive to be acceptable, when considering complications of treatment. This study investigates patients' acceptance of risk associated with current management options for intermittent claudication and explores factors associated with greater risk acceptance...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908638/using-the-acmge-milestones-as-a-handover-tool-from-medical-school-to-surgery-residency
#20
Lauren M Wancata, Helen Morgan, Gurjit Sandhu, Sally Santen, David T Hughes
OBJECTIVE: To map current medical school assessments for graduating students to the Accreditation Council for Graduate Medical Education (ACGME) milestones in general surgery, and to pass forward individual performance metrics on level 1 milestones to receiving residency programs. DESIGN: The study included 20 senior medical students who were accepted into surgery internship positions. Data from medical school performance assessments from the third-year surgery clerkship, fourth-year surgery rotations, fourth-year surgery boot camp, Clinical Competency Assessment Examination, and United States Medical Licensing Examination (USMLE) Step 1 and 2 examinations were used to map each student's competency assessments to the General Surgery Milestones based on a scoring system created and validated by independent assessors...
November 28, 2016: Journal of Surgical Education
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