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https://www.readbyqxmd.com/read/29156795/prognostic-evaluation-of-platelet-to-lymphocyte-ratio-in-patients-with-colorectal-cancer
#1
Chong Lu, Peng Gao, Yuchong Yang, Xiaowan Chen, Longyi Wang, Dehao Yu, Yongxi Song, Qingzhou Xu, Zhenning Wang
Growing evidence indicates that inflammation plays an important role in cancer progression and prognosis; however, the prognostic role of platelet to lymphocyte ratio (PLR) in colorectal cancer (CRC) is unknown. A cohort of 1845 CRC patients from the Department of Surgical Oncology at The First Hospital of China Medical University (CMU-SO) was retrospectively analyzed. Harrell's concordance index (c-index) was used to determine the optimal cut-off value of PLR and evaluate its predictive ability. Our results from CMU-SO indicated that the overall survival (OS) rate was significantly lower in the high-PLR group compared with the low-PLR group (P = 0...
October 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29156483/-interventions-for-assisting-geriatric-patients-with-frailty-before-surgery
#2
Jörn Kiselev
Frailty is a complex syndrome leading to a higher vulnerability in elderly patients, especially during and after surgery. It is characterized by the simultaneous presence of at least three of five phenotypical symptoms: unintentional weight loss, exhaustion, muscle weakness, slow walking speed, and low activity levels. The presence of two of these symptoms is often labelled as pre-frailty.By identifying these symptoms of frailty, medical teams can plan and perform suitable interventions prior to a planned surgery in order to lower these risk factors and to avoid complications, such as delir, hospital re-admission, loss of independence, and increased mortality...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29156450/current-indications-and-outcome-of-pulmonary-resections-of-tuberculosis-complications-in-ibadan-nigeria
#3
Mudasiru A Salami, Arinola A Sanusi, Victor O Adegboye
OBJECTIVES: To review the current indications and outcome of pulmonary resections for tuberculosis (TB) at the Cardiothoracic Surgery unit of the University College Hospital, Ibadan, Nigeria. SUBJECTS AND METHODS: A retrospective case series of patients who had lung resections from January 2014 to January 2017 was performed. Data obtained from medical records included demographics, presenting symptoms, indication for surgery, preoperative evaluation and preparation, operative procedure, post-operative complications and follow up...
November 16, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29156189/obesity-in-pregnancy-optimizing-outcomes-for-mom-and-baby
#4
REVIEW
Heidi Dutton, Sarah Jean Borengasser, Laura Marie Gaudet, Linda A Barbour, Erin Joanne Keely
Obesity is common in women of childbearing age, and management of this population around the time of pregnancy involves specific challenges. Weight and medical comorbidities should be optimized both before and during pregnancy. During pregnancy, gestational weight gain should be limited, comorbidities should be appropriately screened for and managed, and fetal health should be monitored. Consideration should be given to the optimal timing of delivery and to reducing surgical and anesthetic complications. In the postpartum period, breastfeeding and weight loss should be promoted...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156186/treatment-of-obesity-in-primary-care
#5
REVIEW
Adam G Tsai, Jocelyn E Remmert, Meghan L Butryn, Thomas A Wadden
This article outlines some of the behavioral, pharmacologic, and surgical interventions available to primary care physicians (PCPs) to help their patients with weight management. Studies on lifestyle modification, commercial weight loss programs, and medical and surgical options are reviewed. Several clinical suggestions on obesity management that PCPs can take back and use immediately in office practice are offered.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156162/the-evolution-of-limb-deformity-what-has-changed-over-the-past-ten-years
#6
REVIEW
Jessica L Wilczek, Guido A LaPorta
Limb deformity correction has been widely discussed in orthopedic literature with an increasing interest in technologically based surgical strategies. However, principles described by Ilizarov and Paley still form the basis of these newly developing surgical systems. The recent advances and increased use of computers and mobile devices in the medical arena, along with the application of dynamic hexapod external fixation, have allowed for easier and more convenient strategies, leading to a greater outreach and more confidence in the newer surgeon when faced with addressing a patient with a limb deformity...
January 2018: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/29156160/treating-charcot-arthropathy-is-a-challenge-explaining-why-my-treatment-algorithm-has-changed
#7
REVIEW
Lawrence DiDomenico, Zachary Flynn, Michael Reed
Charcot deformity is a challenge that foot and ankle surgeons struggle to manage successfully. Despite the advances in knowledge, technology, and treatment modalities, limb loss is still greater than 10%. This article discusses the efficacy of conservative measures and traditional surgical approaches. It proposes a multidisciplinary team approach, medical optimization, and lifestyle modification to put the patient in the best position to heal. Also discussed is the authors' staged surgical treatment protocol to enhance outcomes and decrease the rate of limb loss...
January 2018: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/29156147/electromagnetic-navigational-bronchoscopy-versus-ct-guided-percutaneous-sampling-of-peripheral-indeterminate-pulmonary-nodules-a-cohort-study
#8
Kavita M Bhatt, Yasmeen K Tandon, Ruffin Graham, Charles T Lau, Jason K Lempel, Joseph T Azok, Peter J Mazzone, Erika Schneider, Nancy A Obuchowski, Michael A Bolen
Purpose To compare the diagnostic yield and complication rates of electromagnetic navigational bronchoscopic (ENB)-guided and computed tomography (CT)-guided percutaneous tissue sampling of lung nodules. Materials and Methods Retrospectively identified were 149 patients sampled percutaneously with CT guidance and 146 patients who underwent ENB with transbronchial biopsy of a lung lesion between 2013 and 2015. Clinical data, incidence of complications, and nodule pathologic analyses were assessed through electronic medical record review...
November 20, 2017: Radiology
https://www.readbyqxmd.com/read/29156146/effectiveness-of-a-staged-us-and-unenhanced-mr-imaging-algorithm-in-the-diagnosis-of-pediatric-appendicitis
#9
Elizabeth H Dibble, David W Swenson, Claudia Cartagena, Grayson L Baird, Thaddeus W Herliczek
Purpose To establish, in a large cohort, the diagnostic performance of a staged algorithm involving ultrasonography (US) followed by conditional unenhanced magnetic resonance (MR) imaging for the imaging work-up of pediatric appendicitis. Materials and Methods A staged imaging algorithm in which US and unenhanced MR imaging were performed in pediatric patients suspected of having appendicitis was implemented at the authors' institution on January 1, 2011, with US as the initial modality followed by unenhanced MR imaging when US findings were equivocal...
November 20, 2017: Radiology
https://www.readbyqxmd.com/read/29156011/pulmonary-resection-for-patients-with-multidrug-resistant-tuberculosis-based-on-survival-outcomes-a-systematic-review-and-meta-analysis
#10
Hyunsuk Frank Roh, Jihoon Kim, Seung Hyuk Nam, Jung Mogg Kim
We investigated the survival benefit of pulmonary resection for patients with multidrug-resistant tuberculosis. To weigh the survival benefit of pulmonary resection for patients with multidrug-resistant tuberculosis who have undergone surgical treatment combined with medical chemotherapy compared with medical chemotherapy alone, we did a meta-analysis of available studies containing a hazard ratio for pulmonary resection. Among 1726 articles, 6 clinical reports, with a mean sample size of 47 patients per report, met the inclusion criteria...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29155985/a-systematic-review-the-management-and-outcomes-of-ileal-pouch-strictures
#11
Jonathan P Segal, Guy Worley, Samuel O Adegbola, Kapil Sahnan, Philip Tozer, Phillip F C Lung, Omar D Faiz, Susan K Clark, Ailsa L Hart
Background: Restorative proctocolectomy with ileal pouch-anal anastomosis removes the diseased tissue in ulcerative colitis but also allows gastrointestinal continuity and stoma-free living. Pouch strictures are a complication with a reported incidence of 5-38%. The three areas where pouch strictures occur are in the pouch inlet, mid-pouch and pouch-anal anastomosis. Aim: To undertake a systematic review of the literature and to identify management strategies available for pouch-anal, mid-pouch and pre-pouch ileal strictures and their outcomes...
November 16, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29155533/conservative-prosthetic-rehabilitation-of-medication-related-osteonecrosis-of-the-jaw-mronj
#12
Alexandra Johanna Leven, Antony J Preston
Osteonecrosis of the jaw associated with bisphosphonates and other medications is a growing problem facing dentists. It can have a significant and debilitating impact upon patients. Various treatment options ranging from surgical intervention to management with antibiotics and analgesics have been proposed. This article presents one method of conservative treatment and prosthetic rehabilitation in a patient with ongoing BRONJ of the maxilla unsuitable for surgical management. Clinical relevance: Dentists need to be able to identify patients who are at risk of developing BRONJ and have an awareness of the appropriate management as well as potential oral rehabilitation options for these patients...
December 2016: Dental Update
https://www.readbyqxmd.com/read/29155340/ambulatory-anterior-cervical-discectomy-and-fusion-is-associated-with-a-higher-risk-of-revision-surgery-and-perioperative-complications-an-analysis-of-a-large-nationwide-database
#13
Armin Arshi, Christopher Wang, Howard Y Park, Gideon W Blumstein, Zorica Buser, Jeffrey C Wang, Arya N Shamie, Don Y Park
BACKGROUND CONTEXT: With the changing landscape of healthcare, outpatient spine surgery is being more commonly performed to reduce cost and improve efficiency. Anterior cervical discectomy and fusion (ACDF) is one of the most common spine surgeries performed and demand is expected to increase with an aging population. PURPOSE: To determine the nationwide trends and relative complication rates associated with outpatient ACDF. STUDY DESIGN/SETTING: Large-scale retrospective case control study PATIENT SAMPLE: Humana-insured patients who underwent 1-2 level ACDF as either outpatients or inpatients from 2011-2016 OUTCOME MEASURES: Incidence and adjusted odds ratio (OR) of postoperative medical and surgical complications within one year of the index surgery METHODS: A retrospective review was performed of the PearlDiver® Humana insurance records database to identify patients undergoing 1-2 level ACDF (CPT-22551 AND ICD-9-816...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155253/the-association-of-inflammatory-bowel-disease-and-immediate-postoperative-outcomes-following-lumbar-fusion
#14
Joseph E Tanenbaum, Stephanie T Kha, Edward C Benzel, Michael P Steinmetz, Thomas E Mroz
BACKGROUND CONTEXT: The United States Centers for Disease Control estimates the prevalence of inflammatory bowel disease (IBD) at over 3.1 million people. As diagnostic techniques and treatment options for IBD improve, the prevalence of IBD is expected to increase. For spine surgeons, patients with IBD have a unique complication profile because IBD patients may present with poor nutritional status and because the medications used to manage IBD have been associated with poor vertebral bone mineralization and immunosuppression...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155251/the-rothman-index-as-a-predictor-of-post-discharge-adverse-events-after-elective-spine-surgery
#15
Ryan P McLynn, Nathaniel T Ondeck, Jonathan J Cui, David R Swanson, Blake N Shultz, Patawut Bovonratwet, Jonathan N Grauer
BACKGROUND CONTEXT: The Rothman Index (RI) is a comprehensive rating of overall patient condition in the hospital setting. It is used at many medical centers and calculated based on vital signs, lab values, and nursing assessments in the electronic medical record. Past research has demonstrated an association with adverse events, readmission, and mortality in other fields, but it has not been investigated in spine surgery. PURPOSE: To determine the potential utility of the RI as a predictor of adverse events after discharge following elective spine surgery...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155035/utility-of-anesthetic-block-for-endometrial-ablation-pain-a-randomized-controlled-trial
#16
Jordan S Klebanoff, Nima R Patel, Nancy L Sloan
BACKGROUND: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment in premenopausal women, who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists and practice varies depending on physician or patient preference and hospital policy and setting. OBJECTIVE: To evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29154980/treatment-of-carpal-tunnel-syndrome-from-ultrasonography-to-ultrasound-surgery
#17
David Petrover, Pascal Richette
Carpal tunnel syndrome is the most common nerve entrapment syndrome. The majority of cases are due to compression or irritation of the median nerve in the carpal canal. It is diagnosed clinically, often being confirmed by an electromyogram, while ultrasonography criteria have become increasingly useful for the diagnosis. Ultrasonography is better tolerated, less expensive, yet just as effective as other diagnostic methods. It provides a good indication of the severity of the condition and it allows anatomical variants to be discerned...
November 15, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/29154246/do-we-need-changes-in-the-organization-of-training-in-the-hernia-treatment-in-poland-a-survey-on-the-acknowledgment-of-the-recommendations-of-international-hernia-societies-by-surgeons
#18
Kryspin Mitura, Stanisław Dąbrowiecki, Maciej Śmietański, Andrzej Matyja
In the therapy of an inguinal hernia, there is a huge variety in the way of treating and the choice of surgical technique. Practice shows that the intraoperative improvisation and surgeons' own modifications of the original techniques have become part of routine procedure. No mandatory hernia registration system causes the actual detailed herniology status in our country remains unknown. The aim of the study was to summarize the results of a survey on knowledge of a hernia according to the standards developed by international hernia societies compared with everyday clinical practice...
October 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29154229/iliac-fascia-compartment-block-and-analgesic-consumption-in-patients-operated-on-for-hip-fracture
#19
Mateusz Klukowski, Rafał Kowalczyk, Grzegorz Górniewski, Paweł Łęgosz, Marek Janiak, Janusz Trzebicki
BACKGROUND: Fractures of the proximal femur in elderly patients are a challenge for orthopedics, anesthe-sio-logy and geriatrics. Early mobilization reduces postoperative mortality among these patients. Effective anal-gesia is necessary to achieve this goal. MATERIAL AND METHODS: A retrospective analysis of perioperative medical records of 78. patients undergoing surgical treatment of proximal femur fractures was performed. Group 1 (n=35)consisted of patients who were treated with pharmacologic analgesia only (systemic analgesics) and Group 2 (n=43) involved patients who re-ceived a preoperative fascia iliaca compartment block (FICB) and pharmacologic analgesia...
October 31, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/29154106/diagnostic-criteria-for-idiopathic-pulmonary-fibrosis-a-fleischner-society-white-paper
#20
REVIEW
David A Lynch, Nicola Sverzellati, William D Travis, Kevin K Brown, Thomas V Colby, Jeffrey R Galvin, Jonathan G Goldin, David M Hansell, Yoshikazu Inoue, Takeshi Johkoh, Andrew G Nicholson, Shandra L Knight, Suhail Raoof, Luca Richeldi, Christopher J Ryerson, Jay H Ryu, Athol U Wells
This Review provides an updated approach to the diagnosis of idiopathic pulmonary fibrosis (IPF), based on a systematic search of the medical literature and the expert opinion of members of the Fleischner Society. A checklist is provided for the clinical evaluation of patients with suspected usual interstitial pneumonia (UIP). The role of CT is expanded to permit diagnosis of IPF without surgical lung biopsy in select cases when CT shows a probable UIP pattern. Additional investigations, including surgical lung biopsy, should be considered in patients with either clinical or CT findings that are indeterminate for IPF...
November 15, 2017: Lancet Respiratory Medicine
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