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https://www.readbyqxmd.com/read/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#1
L McLean House, Nathan H Calloway, Warren S Sandberg, Jesse M Ehrenfeld
BACKGROUND AND AIMS: Emergence time, or the duration between incision closure and extubation, is costly nonoperative time. Efforts to improve operating room efficiency and identify trainee progress make such time intervals of interest. We sought to calculate the incidence of prolonged emergence (i.e., >15 min) for patients under the care of clinical anesthesia (CA) residents. We also sought to identify factors from resident training, medical history, anesthetic use, and anesthesia staffing, which affect emergence...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28094660/postoperative-bleeding-and-associated-utilization-following-tonsillectomy-in-children
#2
David O Francis, Christopher Fonnesbeck, Nila Sathe, Melissa McPheeters, Shanthi Krishnaswami, Sivakumar Chinnadurai
Objective To assess posttonsillectomy hemorrhage (PTH), associated nonoperative readmissions/revisits, and reoperations in children. Data Sources MEDLINE, EMBASE, and the Cochrane Library. Review Methods Two investigators independently screened studies against predetermined criteria and extracted key data. Investigators independently assessed study risk of bias and the strength of the evidence of the body of literature. We calculated unadjusted pooled estimates of PTH frequency and conducted a Bayesian meta-analysis to estimate frequency of primary and secondary PTH and PTH-associated reoperation and revisits/readmissions by partial and total tonsillectomy and surgical approach...
January 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28089257/the-natural-course-of-nonoperatively-treated-rotator-cuff-tears-an-8-8-year-follow-up-of-tear-anatomy-and-clinical-outcome-in-49-patients
#3
Stefan Moosmayer, Anne V Gärtner, Rana Tariq
BACKGROUND: The natural course of nonoperatively treated rotator cuff tears is not fully understood. We explored the long-term development of tear anatomy and assessed functional outcomes. METHODS: Eighty-nine small to medium-sized full-thickness tears of the rotator cuff, all primarily treated by physiotherapy, were identified retrospectively. Twenty-three tears needed surgical treatment later on, and 17 patients were unable to meet for follow-up. The remaining 49 still unrepaired tears were re-examined after 8...
January 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28087066/use-of-water-soluble-contrast-medium-gastrografin-does-not-decrease-the-need-for-operative-intervention-nor-the-duration-of-hospital-stay-in-uncomplicated-acute-adhesive-small-bowel-obstruction-a-multicenter-randomized-clinical-trial-adhesive-small-bowel-obstruction
#4
Michel Scotté, Francois Mauvais, Michael Bubenheim, Cyril Cossé, Leslie Suaud, Celine Savoye-Collet, Isabelle Plenier, Aurelien Péquignot, Thierry Yzet, Jean Marc Regimbeau
BACKGROUND: This study evaluated the association between oral gastrografin administration and the need for operative intervention in patients with presumed adhesive small bowel obstruction. METHODS: Between October 2006 and August 2009, 242 patients with uncomplicated acute adhesive small bowel obstruction were included in a randomized, controlled trial (the Adhesive Small Bowel Obstruction Study, NCT00389116) and allocated to a gastrografin arm or a saline solution arm...
January 10, 2017: Surgery
https://www.readbyqxmd.com/read/28079807/a-case-report-distal-humeral-diaphyseal-fracture-in-a-child
#5
Yuji Tomori, Takuya Sawaizumi, Mitsuhiko Nanno, Shinro Takai
RATIONALE: Distal humeral diaphyseal fractures are much less common than supracondylar humeral fractures. The triangular shape and thinner periosteum in the diaphyseal region than in the supracondylar region of the distal diaphysis makes the treatment of diaphyseal fractures difficult. Nonoperative treatment for this fracture is challenging and troublesome; thus, open reduction and internal fixation (OR/IF) is generally recommended. PATIENT CONCERNS: We herein report a distal humeral diaphyseal fracture in a child...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28063718/second-date-appendectomy-operating-for-failure-of-nonoperative-treatment-in-perforated-appendicitis
#6
Marco Lotti
BACKGROUND: Nonoperative treatment of acute appendicitis is embraced by many surgical teams, driven by low to moderate quality randomized studies that support noninferiority of antibiotics versus appendectomy for treatment of acute uncomplicated appendicitis. Several flaws of these studies have emerged, especially in the recruitment strategy and in the diagnostic criteria that were used. The growing confidence given to antibiotics, together with the lack of reliable criteria to distinguish between uncomplicated and perforated appendicitis, exposes patients with perforated appendicitis to the likelihood to be treated with antibiotics instead of surgery...
January 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28063681/is-fundoplication-required-after-the-foker-procedure-for-long-gap-esophageal-atresia
#7
Dylan Wanaguru, Catherine Langusch, Usha Krishnan, Vincent Varjavandi, Ashish Jiwane, Susan Adams, Guy Henry
BACKGROUND: Fundoplication has been performed almost universally in children treated with the Foker procedure (FP) for long gap esophageal atresia (LGEA). We report our experience with pharmacological management and endoscopic surveillance rather than early routine fundoplication in infants treated with the FP. METHODS: A retrospective chart review was performed of all children treated with the Foker procedure at our institution. RESULTS: Nine children have undergone the FP since 2007...
December 28, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28062098/midshaft-clavicle-fractures-with-associated-ipsilateral-acromioclavicular-joint-dislocations-incidence-and-risk-factors
#8
Christina Ottomeyer, Benjamin C Taylor, Mark Isaacson, Lara Martinez, Pierce Ebaugh, Bruce G French
INTRODUCTION: Simultaneous ipsilateral clavicle and acromioclavicular (AC) joint injury have been infrequently reported in the literature at this time. The purpose of this study was to assess incidence as well as assess risk factors for this dual injury pattern. METHODS: We performed a retrospective review of a prospectively collected database (Level III evidence), evaluating 383 adult patients without previous shoulder girdle injury or trauma with a minimum 1-year follow-up who sustained a displaced diaphyseal clavicle fracture...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28051044/childhood-intussusception-impact-of-delay-in-presentation-in-a-developing-country
#9
Olakayode Olaolu Ogundoyin, Dare Isaac Olulana, Taiwo Akeem Lawal
BACKGROUND: The classical cases of intussusception are readily diagnosed clinically, and despite recent improvements in radiological techniques, the diagnosis of intussusception and success in its nonoperative reduction has been suboptimal, thus making operative management a veritable backup. This study examined the impact of delays in presentation on the rate of bowel resection, length of hospital stay, and appraised the outcome of operative treatment. PATIENTS AND METHODS: This was a retrospective study of consecutive children admitted and treated surgically for intussusception between January 2002 and December 2011 at the University College Hospital, Ibadan, Nigeria...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28050916/division-tenorrhaphy
#10
Jesse Doty, Yoshihiro Katsuura, Nicholas Richardson
: Here we describe a modified open technique for the repair of a ruptured Achilles tendon using multiple looped sutures with the creation of interdigitating tendon stumps maximizing surface area for suture application as well as allowing for significant tissue overlay. This technique produces a high strength repair that is useful in cases of extensive degeneration or poor-quality tissue. Degenerative tissue may be encountered with chronic ruptures or failed nonoperative treatment, as well as those ruptures that occur at the proximal myotendinous junction...
January 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28050542/epidemiological-profile-of-patients-diagnosed-with-athletic-pubalgia
#11
Anderson Luiz de Oliveira, Carlos Vicente Andreoli, Benno Ejnisman, Roberto Dantas Queiroz, Osvaldo Guilherme Nunes Pires, Guilherme Guadagnini Falótico
OBJECTIVE: To evaluate the clinical and epidemiological characteristics of pubalgia in patients from a Sports Medicine Center. METHODS: Data analysis from medical records of patients with athletic pubalgia attended to from January 2007 to January 2015. The diagnosis was made by an experienced hip surgeon, complemented with pelvic X-ray, abdominal wall ultrasound, and magnetic resonance imaging of the pelvis. RESULTS: Among 43 patients, 42 were men, with mean age of 33 years...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28043928/outcome-of-children-with-blunt-liver-or-spleen-injuries-experience-from-a-single-institution-in-korea
#12
Ki Hoon Kim, Jin Soo Kim, Woon-Won Kim
INTRODUCTION: The aim of this study is to evaluate the demographics, injury pattern, and treatment outcomes among children hospitalized for the management of blunt liver and spleen injury at a single institution in Korea, and to document trends in treatment strategies of children with blunt torso trauma. METHODS: Children (<20 years) with blunt liver and spleen injuries, hospitalized at our center between May 2010 and February 2016, were included in the present study...
December 30, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/28042726/hybrid-cervical-disc-arthroplasty
#13
Tsung-Hsi Tu, Jau-Ching Wu, Henrich Cheng, Praveen V Mummaneni
For patients with multilevel cervical stenosis at nonadjacent segments, one of the traditional approaches has included a multilevel fusion of the abnormal segments as well as the intervening normal segment. In this video we demonstrate an alternative treatment plan with tailored use of a combination of anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) with an intervening skipped level. The authors present the case of a 72-year-old woman with myeloradiculopathy and a large disc herniation with facet joint degeneration at C3-4 and bulging disc at C5-6...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28038475/readability-of-online-sources-regarding-meniscal-tears
#14
Jonathan D Hodax, Grayson L Baird, Trevor McBride, Brett D Owens
Meniscal injuries are extremely common, with an incidence of 8.3 per 1,000 person/years in young, active individuals. Patients often turn to the internet to glean information about their injuries, and even to guide decision making about treatment. Much research has been done demonstrating that a reading level of eighth grade or lower is appropriate for accurately communicating written information to patients, yet medical practitioners often fail to meet this requirement. To better examine the information patients receive about meniscal injuries, we set out to evaluate the reading level and content of three commonly used search terms on the three search engines with the largest market share...
December 30, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28032031/fifth-metatarsal-fractures-and-current-treatment
#15
REVIEW
Julia Bowes, Richard Buckley
Metatarsal fractures are one of the most common injuries of the foot. There has been conflicting literature on management of fifth metatarsal fractures due to inconsistency with respect to classification of these fractures. This article provides a thorough review of fifth metatarsal fractures with examination of relevant literature to describe the management of fifth metatarsal fractures especially the proximal fracture. A description of nonoperative and operative management for fifth metatarsal fractures according to anatomical region is provided...
December 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28031517/review-article-operative-versus-nonoperative-treatment-for-displaced-intraarticular-calcaneal-fracture-a-meta-analysis-of-randomised-controlled-trials
#16
Sanjay Meena, Shreesh Kumar Gangary, Pankaj Sharma
We reviewed 8 randomised controlled trials that compared operative and non-operative treatment for displaced intra-articular calcaneal fractures. Patients with operative treatment were more likely to resume pre-injury work (relative risk [RR]=0.60, p=0.04), had fewer problems when wearing shoes (RR=0.42, p=0.0004), and had a higher physical component summary score of SF-36 (difference in means=6.75, p<0.0001) but a higher complication rate (RR=1.74, p=0.0005).
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28030965/is-histopathological-analysis-of-interdigital-morton-s-neuroma-necessary
#17
Ravi Kanth Mallina, Khalid Al-Dadah, Kirtan Patel, Pal Ramesh
BACKGROUND: Interdigital neuroma (IN), otherwise known as Morton's neuroma, is a common cause of metatarsalgia presenting to the elective foot and ankle clinic. Surgical excision of the IN in patients who fail to respond to nonoperative measures is considered to be the gold standard of care in many centers. The Royal College of Pathologists UK recommend that all excised interdigital Morton's neuromas are sent for formal histopathological analysis. We present a study correlating clinical and radiological diagnosis with histopathologic appearances of IN following surgical excision, and question if routine histopathological analysis is warranted...
December 1, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28028444/commentary-on-the-management-of-type-ii-odontoid-process-fractures-in-octogenarians-article-by-graffeo-et-al-and-editorial-by-falavigna-j-neurosurgery-spine-august-19-2016
#18
Nancy E Epstein
BACKGROUND: Establishing a clear treatment paradigm for octogenarians with type II odontoid fractures in hampered by a literature replete with level III articles. METHODS: In the study by Graffeo et al., the authors evaluated 111 patients over the age of 79 (average age: 87) with type II odontoid fractures undergoing nonoperative (94 patients) vs. operative intervention (17 total; 15 posterior and 2 anterior). They studied multiple variables and utilized several scales [abbreviated injury scale (AIS), injury severity score (ISS), and the Glasgow coma scale (GCS)] to determine the outcomes of nonoperative vs...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/28027261/evidence-based-medicine-the-evaluation-and-treatment-of-pressure-injuries
#19
Joseph A Ricci, Lauren R Bayer, Dennis P Orgill
LEARNING OBJECTIVE: After studying this article, the participant should be able to: 1. Discuss the approach to and rationale for pressure injury management, including specific techniques for prevention and preoperative evaluation. 2. Develop a management algorithm for these wounds that includes operative and nonoperative modalities. 3. Understand how to identify and manage the complications of surgical intervention for pressure injuries, including recurrence. SUMMARY: Pressure injuries are a common problem associated with great morbidity and cost, often presenting as complex challenges for plastic surgeons...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28027259/evidence-based-medicine-thumb-basal-joint-arthritis
#20
Richard H J Baker, Jaber Al-Shukri, Tim R C Davis
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Assess the patient's history, clinical examination, and radiographic findings to diagnose and stage basilar joint arthritis. 2. Recall the cause and epidemiology of the condition. 3. Formulate a management plan including nonoperative management, and evaluate the candidacy for surgical treatment. 4. Understand the rationale for the various surgical options available (including rehabilitation), their potential complications, and the evidence related to outcomes...
January 2017: Plastic and Reconstructive Surgery
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