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Global surgery

Andrew J Beamish, Torsten Olbers, Aaron S Kelly, Thomas H Inge
Obesity is a major global health problem, and its multisystem effects are inextricably linked with elevated cardiovascular risk and adverse outcomes. The cardiovascular benefits of reversing obesity in adults are well-established. Compared with other weight-loss strategies, programmes that incorporate bariatric surgery for weight loss are beneficial for sustained BMI reduction. A marked improvement in cardiovascular risk factors, including hypertension, dyslipidaemia, inflammation, and type 2 diabetes mellitus, has been observed after bariatric surgery...
October 20, 2016: Nature Reviews. Cardiology
Nadia Haj Mohammad, Sophia De Rooij, Maarten Hulshof, Jelle Ruurda, Bas Wijnhoven, Frans Erdkamp, Meindert Sosef, Suzanne Gisbertz, Mark van Berge Henegouwen, Mirjam Sprangers, Hanneke van Laarhoven
BACKGROUND AND OBJECTIVES: Neoadjuvant chemoradiation (nCRT) followed by esophagectomy is a treatment with curative intent for resectable esophageal cancer. The aim of this study was to measure activities of daily living (ADL) and quality of life (QoL), and to examine correlates of changes in ADL and QoL. METHODS: A prospective study was performed with three time points (baseline, 1 week after the end of nCRT, 3-months post-surgery) together with a cross-sectional post-treatment study...
October 20, 2016: Journal of Surgical Oncology
Elisabeth Sterrer, Franz Windisch, Kurt Frey, Klaus Rettensteiner, Benjamin Loader
BACKGROUND: Middle ear adenoma with neuroendocrine differentiation (MEA-ND), also known as carcinoid tumor of the middle ear, is an extremely rare neoplasm, especially when located within the tympanic cavity. To the best of our knowledge, this represents the first pediatric case of a MEA-ND described in Europe. Excluding the present case, only three other pediatric cases of this disease have been published globally. CASE REPORT: We report on a 15-year-old female patient who presented with conductive hearing loss of the right ear...
October 19, 2016: Wiener Klinische Wochenschrift
Rosita Zakeri, Gilles Moulay, Qiang Chai, Ozgur Ogut, Saad Hussain, Hiroyuki Takahama, Tong Lu, Xiao-Li Wang, Wolfgang A Linke, Hon-Chi Lee, Margaret M Redfield
BACKGROUND: Left atrial (LA) compliance and contractility influence left ventricular stroke volume. We hypothesized that diminished LA compliance and contractile function occur early during the development of heart failure with preserved ejection fraction (HFpEF) and impair overall cardiac performance. METHODS AND RESULTS: Cardiac magnetic resonance imaging, echocardiography, left ventricular and LA pressure-volume studies, and tissue analyses were performed in a model of early HFpEF (elderly dogs, renal wrap-induced hypertension, exogenous aldosterone; n=9) and young control dogs (sham surgery; n=13)...
October 2016: Circulation. Heart Failure
A Pinsent, I M Blake, M G Basáñez, M Gambhir
The World Health Organization has targeted the elimination of blinding trachoma by the year 2020. To this end, the Global Elimination of Blinding Trachoma (GET, 2020) alliance relies on a four-pronged approach, known as the SAFE strategy (S for trichiasis surgery; A for antibiotic treatment; F for facial cleanliness and E for environmental improvement). Well-constructed and parameterized mathematical models provide useful tools that can be used in policy making and forecasting in order to help to control trachoma and understand the feasibility of this large-scale elimination effort...
2016: Advances in Parasitology
Louis M Day, Subaraman Ramchandran, Cyrus M Jalai, Bassel G Diebo, Barthelemy Liabaud, Renaud Lafage, Themistocles Protopsaltis, Peter G Passias, Frank J Schwab, Shay Bess, Thomas J Errico, Virginie Lafage, Aaron J Buckland
STUDY DESIGN: Retrospective clinical and radiographic single-center study OBJECTIVE.: Assess simultaneous cervical spine and lower extremity compensatory changes with changes in thoracolumbar spinal alignment. SUMMARY OF BACKGROUND DATA: Full-body stereoradiographic imaging allows better understanding of reciprocal changes in cervical and lower extremity alignment in the setting of thoracolumbar malalignment. Few studies describe the simultaneous effect of alignment correction on these mechanisms...
October 17, 2016: Spine
Peter Szasz, Esther M Bonrath, Marisa Louridas, Andras B Fecso, Brett Howe, Adam Fehr, Michael Ott, Lloyd A Mack, Kenneth A Harris, Teodor P Grantcharov
OBJECTIVES: The objectives of this study were to (1) create a technical and nontechnical performance standard for the laparoscopic cholecystectomy, (2) assess the classification accuracy and (3) credibility of these standards, (4) determine a trainees' ability to meet both standards concurrently, and (5) delineate factors that predict standard acquisition. BACKGROUND: Scores on performance assessments are difficult to interpret in the absence of established standards...
July 28, 2016: Annals of Surgery
Hjalte C R Sass, Rehannah Borup, Mikkel Alanin, Finn Cilius Nielsen, Per Cayé-Thomasen
The objective of this study was to determine global gene expression in relation to Vestibular schwannomas (VS) growth rate and to identify signal transduction pathways and functional molecular networks associated with growth. Repeated magnetic resonance imaging (MRI) prior to surgery determined tumor growth rate. Following tissue sampling during surgery, mRNA was extracted from 16 sporadic VS. Double stranded cDNA was synthesized from the mRNA and used as template for in vitro transcription reaction to synthesize biotin-labeled antisense cRNA, which was hybridized to Affymetrix HG-U133A arrays and analyzed by dChip software...
October 17, 2016: Journal of Neuro-oncology
Jennifer Muir, Melyssa Aronson, Mary-Jane Esplen, Aaron Pollett, Carol J Swallow
BACKGROUND: Hereditary diffuse gastric cancer (HDGC) syndrome is caused by germline mutations in the CDH1 gene and carries a lifetime gastric cancer risk of approximately 70 % in men and 56 % in women. Current consensus guidelines recommend that people of age ≥20 who harbor a CDH1 mutation undergo prophylactic total gastrectomy (PTG). However, the decision to proceed with a major visceral resection for prophylactic reasons may be difficult, especially since long-term outcomes are not well defined...
October 17, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Marian Wiegersma, Chantal M C R Panman, Marjolein Y Berger, Henrica C W De Vet, Boudewijn J Kollen, Janny H Dekker
BACKGROUND: The Pelvic Floor Distress Inventory-20 is used to evaluate symptoms and treatment effects in women with pelvic floor disorders. To interpret changes in the scores of this inventory, information is needed on what patients and clinicians perceive as the minimal important (meaningful) change. Although this change in the inventory score has previously been investigated in women undergoing pelvic floor surgery, the results could not be generalized to women with milder symptoms (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Julien Bonenfant, Sophie Drapier, Jean François Houvenaghel, Florian Naudet, Claire Haegelen, Paul Sauleau, Marc Vérin
INTRODUCTION: Over a 3-year period, we monitored the efficacy and safety of deep-brain stimulation of the globus pallidus pars interna in patients with advanced Parkinson's disease whose cognitive, psychiatric impairment and/or dopa-resistant axial motor signs made them ineligible for surgery targeting the subthalamic nucleus. METHODS: A total of 25 patients were assessed before surgery, 1 year and 3 years after surgery, on the UPDRS and a neuropsychological battery...
October 11, 2016: Parkinsonism & related Disorders
Şule Özbilgin, Volkan Hanc, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
Joshua Xu, Jessica G Y Luc, Kevin Phan
Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in modern clinical practice, with an estimated prevalence of 1.5-2%. The prevalence of AF is expected to double in the next decades, progressing with age and increasingly becoming a global medical challenge. The first-line treatment for AF is often medical treatment with either rate control or anti-arrhythmic agents for rhythm control, in addition to anti-coagulants such as warfarin for stroke prevention in patient at risk. Catheter ablation has emerged as an alternative for AF treatment, which involves myocardial tissue lesions to disrupt the underlying triggers and substrates for AF...
September 2016: Journal of Thoracic Disease
Zaheer Nabi, D Nageshwar Reddy
Gastroesophageal reflux disease (GERD) is defined by the presence of troublesome symptoms resulting from the reflux of gastric contents. The prevalence of GERD is increasing globally. An incompetent lower esophageal sphincter underlies the pathogenesis of GERD. Proton pump inhibitors (PPIs) form the core of GERD management. However, a substantial number of patients do not respond well to PPIs. The next option is anti-reflux surgery, which is efficacious, but it has its own limitations, such as gas bloating, inability to belch or vomit, and dysphagia...
September 2016: Clinical Endoscopy
J Keszte, H Danker, A Dietz, E Meister, F Pabst, O Guntinas-Lichius, J Oeken, S Singer, A Meyer
In a German multi-center prospective cohort study, we wanted to assess the course of psychiatric comorbidity, utilization of mental health care and psychosocial care needs in laryngeal cancer patients during the first year after partial laryngectomy (PRL). Structured interviews with patients were conducted before surgery, 1 week (1 w), 3 months (3 m) and 1 year (12 m) after PRL. Psychiatric comorbidity was assessed using the Structured Clinical Interview for DSM-IV (SCID). Psychosocial care needs and utilization of mental health care were evaluated with standardized face-to-face interviews...
October 15, 2016: European Archives of Oto-rhino-laryngology
Yong-Chan Kim, Lawrence G Lenke, Seon-Jong Lee, Jeffrey L Gum, Sirichai Wilartratsami, Kathy M Blanke
PURPOSE: Our study aimed to confirm the correlation between the Cranial Sagittal Vertical Axis (CrSVA) and patient-reported outcomes and to compare clinical correlation between CrSVA and C7 SVA in adult spinal deformity (ASD) patients. METHODS: 108 consecutive ASD patients were evaluated using the EOS(®) 2D/3D radio-imaging device. A vertical plumb line from the cranial center was utilized to measure the distance to the posterior corner of S1 (CrSVA-S), and to the centers of the hip (CrSVA-H), the knee (CrSVA-K), and ankle (CrSVA-A), as well as measuring the standard C7 SVA...
October 14, 2016: European Spine Journal
Ehab Atef, Khaled Refaat Zalata, Hoda Atef, Ahmed A M Abdel-Hamid
BACKGROUND AND AIM: The use of BioEnterics intragastric balloon (BIB) is progressively increasing, owing to the fact that morbid obesity becomes a global epidemic together with risks of bariatric surgery. Yet, the possible local BIB effect on gastric mucosa is not clearly elucidated. The aim of the current study was to assess the histological changes occurring in the gastric mucosa post-BIB insertion. METHODS: Gastric mucosa biopsy was obtained from 87 cases of morbid obesity both pre-BIB and 6 months post-BIB insertion to compare the local changes by histological and immunohistochemical analysis...
October 14, 2016: Digestive Diseases and Sciences
Breanne Mordorski, Adam J Friedman, Leon H Kircik
Dermatologists frequently create cutaneous defects that heal by second intention, yet there is no universal protocol for wound care in this setting. Several ointments commonly used for wound healing are not cost effective as they contain known contact allergens, contribute to antimicrobial resistance, and do not enhance the healing process. Recent studies indicate that Bensal HP, a commercially available ointment used for a variety of dermatologic conditions, may be useful for wound healing; although clinical data is currently limited...
October 1, 2016: Journal of Drugs in Dermatology: JDD
Jacques Vermeulen
PURPOSE: To investigate the difference in accuracy between freehand and guided single-implant placement in situations with one or more missing teeth as performed by experienced surgeons. MATERIALS AND METHODS: A total of 80 implants were placed by 10 experienced clinicians in the anterior site of maxillary models, made of polyamide by selective laser sintering and mounted in a dummy head. Each clinician performed the same four single-implant cases via freehand surgery and then with a three-dimensional fabricated SIMPLANT Guide...
October 14, 2016: International Journal of Oral & Maxillofacial Implants
Benilde Cosmi
Idiopathic or unprovoked venous thromboembolism is an event occurring in the absence of any apparent provoking or triggering environmental risk factors, such as surgery, trauma, and immobilization. Areas covered: Unprovoked VTE can be associated with occult cancer, but only limited, and not extensive cancer screening, may be warranted, as the rate of occult cancer is low in such patients. Routine thrombophilia testing is not currently recommended as it does not influence the management of the disease. The duration of anticoagulation for unprovoked VTE after the first three months is still debated as the disease tends to recur regardless of treatment duration...
October 14, 2016: Expert Review of Cardiovascular Therapy
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