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Medical surgical

Igor Niechajev
BACKGROUND: The Middle East (ME) proper, a vast area between the East coast of the Mediterranean Sea and Afghanistan, is populated by many nations and tribes. Several nose phenotypes are prevalent throughout the region, but there is no published study encompassing and exploring nose phenotypes encountered in the various countries and subregions of the ME. METHODS: The current study was based on the analysis of compiled data from 1207 patients of ME origin (53% of my total rhinoplasty patient cohort) operated by the author during the years 1985 to 2015...
October 2016: Journal of Craniofacial Surgery
Daniel S Chan, Paul M Balthrop, Brian White, David Glassman, Roy W Sanders
OBJECTIVE: To determine whether multiple approaches pose an increased risk to fracture healing when compared to a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN: Retrospective review of a prospective database. SETTING: Level I academic trauma center and level II community trauma center. METHODS: From January 1, 2005 to December 31, 2011, all records of patients treated for OTA 43C fractures of the distal tibia were reviewed...
October 1, 2016: Journal of Orthopaedic Trauma
Anand Pandey, Vipin Gupta, Shailendra P Singh, Vijendra Kumar, Rajesh Verma
A trophic ulcer is a pressure ulcer caused by external trauma to a part of the body that is compromised due to disease, vascular insufficiency, or loss of afferent nerve fibers. Spinal dysraphism (ie, neural tube defects [NTD]) such as meningomyelocele is a risk factor for developing these ulcers in adults and pediatric patients. Information regarding the occurrence of trophic ulcers in pediatric patients with NTD is lacking. A review of the English-language literature on skin/neuropathic ulcers in patients with NTDs, irrespective of study design, published between 1975 and 2014, was undertaken using the PubMed database...
December 2015: Ostomy/wound Management
Z W Teo Wendy, P C Schalock
The use of metals in the medical field has become increasingly prevalent over the past few decades. Patients find themselves being exposed to metals in a variety of ways, ranging from external exposure to instruments such as the stainless steel in surgical blades to internal exposure via medical devices being implanted in their bodies. There has been growing interest in the possibility of developing hypersensitivity reactions to constituent metals in medical implant devices, both in cutaneous and systemic forms...
October 2016: Journal of Investigational Allergology & Clinical Immunology
Nicholas Arlas, Harry Jergesen
Factors endemic in safety-net hospitals may breed poor outcomes in hip and knee arthroplasty. This review highlights these challenges and discusses strategies to reduce operative risk and promote better surgical outcomes. Sub-optimally managed medical co-morbidities, poverty, and substance abuse are examples of challenges common in safety-net hospital populations and are associated with poor surgical outcomes. Patient management strategies that positively affect surgical outcomes may be nonexistent, underfunded, or underused...
2016: Journal of Health Care for the Poor and Underserved
Jennie Engstrand, Grzegorz Toporek, Piotr Harbut, Eduard Jonas, Henrik Nilsson, Jacob Freedman
OBJECTIVE: The purpose of the present study is to evaluate the accuracy and safety of antenna placement performed with the use of a CT-guided stereotactic navigation system for percutaneous ablation of liver tumors and to assess the safety of high-frequency jet ventilation for target motion control. MATERIALS AND METHODS: Twenty consecutive patients with malignant liver lesions for which surgical resection was contraindicated or that were not readily visible on ultrasound or not accessible by ultrasound guidance were included in the study...
October 20, 2016: AJR. American Journal of Roentgenology
David P Seamans, Boshra F Louka, F David Fortuin, Bhavesh M Patel, John P Sweeney, Louis A Lanza, Patrick A DeValeria, Kim M Ezrre, Harish Ramakrishna
BACKGROUND: The surgical and procedural specialties are continually evolving their methods to include more complex and technically difficult cases. These cases can be longer and incorporate multiple teams in a different model of operating room synergy. Patients are frequently older, with comorbidities adding to the complexity of these cases. Recording of this environment has become more feasible recently with advancement in video and audio capture systems often used in the simulation realm...
October 2016: Annals of Cardiac Anaesthesia
Colleen Tewksbury, Noel N Williams, Kristoffel R Dumon, David B Sarwer
Bariatric surgery is the most robust treatment for extreme obesity. The impact of preoperative medical weight management sessions designed, in theory, with the primary goal of promoting preoperative weight loss, is unclear. This paper reviews studies that have investigated the relationship between preoperative weight loss and bariatric surgical outcomes, both with respect to postoperative weight loss and complications. We conclude that the most robust of preoperative interventions has not been implemented or evaluated in a manner which would conclusively assess the value of this element of care...
October 20, 2016: Obesity Surgery
Nicole A Lamparello, Vijay Jaswani, Keith DeSousa, Maksim Shapiro, Sandor Kovacs
We present a case of a 41-year-old man with symptomatic pulmonary cement embolism following percutaneous vertebral augmentation, which was successfully retrieved via a percutaneous endovascular approach, a novel technique with only two prior cases reported. Cement leakage, including venous embolization of cement into the cardiopulmonary circulation, is a known potential complication following percutaneous kyphoplasty and vertebroplasty. While many patients with pulmonary cement embolism are asymptomatic and likely go undiagnosed, others experience respiratory distress and hemodynamic compromise requiring surgical and medical intervention...
July 2016: Journal of Radiology Case Reports
Kyle T Aune, Joseph M Powers
BACKGROUND: Extreme conditioning programs (ECPs) are fitness training regimens relying on aerobic, plyometric, and resistance training exercises, often with high levels of intensity for a short duration of time. These programs have grown rapidly in popularity in recent years, but science describing the safety profile of these programs is lacking. HYPOTHESIS: The rate of injury in the extreme conditioning program is greater than the injury rate of weightlifting and the majority of injuries occur to the shoulder and back...
October 19, 2016: Sports Health
J N Wang, L X Wang, W Lian, B Xing, Y Yao, M Feng, R Z Wang
Objective: To investigate the clinical characteristics and treatment of pituitary adenomas of childhood and adolescence. Methods: Thisarticle was a retrospective study of 140 pituitary adenomas of childhood and adolescence that was admitted into Peking Union Medical College Hospital from December 1987 to December 2014, whose clinical manifestations, hormone secretions, images, pathological types, surgical complications and follow-ups were studied. Results: A total of 58 (41.4%) males and 82 females (58.6%) were included, whose mean age was 12...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Yanjiao Zhang, Yushun Gao
BACKGROUND: Lung cancer is a malignancy with high morbidity and mortality rates worldwide. Surgery is the preferred treatment for non-small cell lung cancer. This study aims to investigate the effects of video-assisted thoracoscopic surgery (VATS) lobectomy, VATS segmentectomy, and open thoracotomy on pulmonary function in the early postoperative stage and compare the difference among three groups. METHODS: Pulmonary function data of patients were collected from September 2015 to February 2016 in Department of Thoracic Surgical Oncology, Cancer Hospital Chinese Academy of Medical Sciences...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Anne M Drewry, Enyo A Ablordeppey, Ellen T Murray, Evan R Beiter, Andrew H Walton, Mark W Hall, Richard S Hotchkiss
BACKGROUND: Identifying patients in the immunosuppressive phase of sepsis is essential for development of immunomodulatory therapies. Little data exists comparing the ability of the two most well-studied markers of sepsis-induced immunosuppression, human leukocyte antigen (HLA)-DR expression and lipopolysaccharide (LPS)-induced tumor necrosis factor alpha (TNF-ɑ) production, to predict mortality and morbidity. The purpose of this study was to compare HLA-DR expression and LPS-induced TNF-ɑ production as predictors of 28-day mortality and acquisition of secondary infections in adult septic patients...
October 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
Harshal Ingale, Samiul Muquit, Othman Al-Helli, Barrie White, Surajit Basu
BACKGROUND: Consultant Outcomes Publication (COP) is an NHS England initiative for promoting improvements in quality of care. However, at present outcomes are commonly expressed as mortality rates which do not necessarily reflect the performance of surgeons. We developed the Nottingham Expectation and Complication score following Surgery (NECS) to determine the success of surgical treatment from both the clinical perspective and the practical expectations agreed between surgeons and patients during the consent process...
October 20, 2016: British Journal of Neurosurgery
Nicola Benedetto, Carlo Gambacciani, Nicola Montemurro, Riccardo Morganti, Paolo Perrini
OBJECTIVE: To evaluate the clinical outcome of patients over 70 years old who have received surgical treatment for traumatic acute subdural haematoma (aSDH) in our Neurosurgical Department. We also disclose related surgical and medical costs. METHODS: A retrospective analysis was performed by analyzing the medical records of patients older than 70 who had undergone surgery for evacuation of traumatic aSDH between June 2011 and December 2014. Through univariate and multivariate analyses, we correlated clinical and radiological pre-operatory features with outcome at one and six months after surgery...
October 19, 2016: British Journal of Neurosurgery
Emily B Devine, Rafael Alfonso-Cristancho, N David Yanez, Todd C Edwards, Donald L Patrick, Cheryl A L Armstrong, Allison Devlin, Rebecca G Symons, Mark H Meissner, Ellen L T Derrick, Danielle C Lavallee, Larry G Kessler, David R Flum
Importance: Intermittent claudication (IC) is the most common presentation of infrainguinal peripheral artery disease. Both medical and revascularization interventions for IC aim to increase walking comfort and distance, but there is inconclusive evidence of the comparative benefit of revascularization given the possible risk of limb loss. Objective: To compare the effectiveness of a medical (walking program, smoking cessation counseling, and medications) vs revascularization (endovascular or surgical) intervention for IC in the community, focusing on outcomes of greatest importance to patients...
October 19, 2016: JAMA Surgery
Jonathan M Scott, Stephen E Robinson, Tom Holroyd, Richard Coppola, Susumu Sato, Sara K Inati
PURPOSE: To describe and optimize an automated beamforming technique followed by identification of locations with excess kurtosis (g2) for efficient detection and localization of interictal spikes in patients with medically refractory epilepsy. METHODS: Synthetic aperture magnetometry with g2 averaged over a sliding time window (SAMepi) was performed in seven patients with focal epilepsy and five healthy volunteers. The effect of varied window lengths on detection of spiking activity was evaluated...
October 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Athanasios Tselebonis, Evangelia Nena, Christos Nikolaidis, Theocharis Konstantinidis, Christos Kontogiorgis, Maria Panopoulou, Theodore C Constantinidis
OBJECTIVE: To monitor microbes, focusing on drug resistance, on the hands of the personnel of four departments of a tertiary hospital (ICU, neonatal unit, internal medicine ward and surgical ward) and explore differences between departments, professions and genders. MATERIALS AND METHODS: Hand sampling from 125 healthcare employees was conducted followed by isolation, identification and antibiotic resistance profiling of different microbial species. RESULTS: Staphylococcus spp was the most prevalent microbe (76/125, 60...
September 1, 2016: Folia Medica
Deng-Wei Chou, Shu-Ling Wu, Kuo-Mou Chung, Shu-Chen Han, Bruno Man-Hon Cheung
OBJECTIVES: Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care. METHODS: The electronic medical records of 20 patients with septic pulmonary embolism who required intensive care unit admission between January 2005 and December 2013 were reviewed...
October 1, 2016: Clinics
Carlos Walter Sobrado, Lucas Faraco Sobrado
Introduction: Acute severe colitis is a potentially lethal medical emergency and, even today, its treatment remains a challenge for clinicians and surgeons. Intravenous corticoid therapy, which was introduced into the therapeutic arsenal in the 1950s, continues to be the first-line treatment and, for patients who are refractory to this, the rescue therapy may consist of clinical measures or emergency colectomy. Objective: To evaluate the indications for and results from drug rescue therapy (cyclosporine, infliximab and tacrolimus), and to suggest a practical guide for clinical approaches...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
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