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https://www.readbyqxmd.com/read/28340493/conservative-treatment-with-octreotide-to-provide-early-recovery-of-children-with-esophageal-perforation
#1
Ramazan Karabulut, Zafer Turkyilmaz, Kaan Sonmez, Abdullah Can Basaklar
Background The effectiveness of nonoperative treatment of esophageal perforation (EP) in children with octreotide is highlighted. Methods Records of nine patients (seven boys and two girls with an average age of 5.83 ± 5.35 years) with EP were reviewed. Results EP developed in six patients during dilation of esophageal stenosis (five of six caused by caustic burns). In the other three patients, EP developed after nasogastric placement, after endotracheal intubation, and during endoscopy for foreign body...
March 24, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28338596/operation-versus-antibiotics-the-appendicitis-conundrum-continues-a-meta-analysis
#2
Joseph V Sakran, Konstantinos S Mylonas, Alexandros Gryparis, Stanislaw P Stawicki, Christopher J Burns, Maher M Matar, Konstantinos P Economopoulos
BACKGROUND: Acute appendicitis continues to constitute a diagnostic and therapeutic challenge. The aim of this study was to synthesize evidence from randomized controlled trials (RCTs) comparing nonoperative versus surgical management of uncomplicated acute appendicitis in adult patients. METHODS: A systematic literature search of the PubMed, Cochrane and Scopus databases was performed with respect to the PRISMA statement (end-of-search date: January 29, 2017). Data on the study design, interventions, participants, and outcomes were extracted by two independent reviewers...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333840/primary-versus-preoperative-radiation-for-locally-advanced-vulvar-cancer
#3
Divya Natesan, Julian C Hong, Jonathan Foote, Julie A Sosa, Laura Havrilesky, Junzo Chino
OBJECTIVES: The objective of this study was to evaluate patterns of care and the survival impact of primary radiation and preoperative radiation therapy with surgery in women with locally advanced vulvar cancer using a large national cohort. METHODS AND MATERIALS: Women with vulvar cancer, diagnosed from 2004 to 2012, who received primary or preoperative radiation therapy were identified in the National Cancer Database. Patient characteristics, such as age, race, American Joint Committee on Cancer stage, and comorbidity score, were compared between those that received primary radiation only and those that received preoperative radiation with surgery using the χ, Fisher exact, and Mann-Whitney tests as appropriate...
March 23, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28331365/mastectomy-skin-flap-necrosis-challenges-and-solutions
#4
REVIEW
Stuart A Robertson, Johann A Jeevaratnam, Avi Agrawal, Ramsey I Cutress
INTRODUCTION: Mastectomy skin flap necrosis (MSFN) has a reported incidence of 5%-30% in the literature. It is often a significant and underappreciated problem. The aim of this article was to review the associated challenges and possible solutions. METHODS: A MEDLINE search was performed using the search term "mastectomy skin flap necrosis". Titles and abstracts from peer-reviewed publications were screened for relevance. RESULTS: MSFN is a common complication and may present as partial- or full-thickness necrosis...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28328638/complications-after-reduction-mammaplasty-a-comparison-of-wise-pattern-inferior-pedicle-and-vertical-scar-superomedial-pedicle
#5
Adeyemi A Ogunleye, Ofelia Leroux, Norman Morrison, Aviva B Preminger
Reduction mammaplasty is a commonly-performed procedure among plastic surgeons. Although several methods exist, the Wise pattern/inferior pedicle (IP) technique is the most widely used. The vertical scar/superomedial pedicle (SP) technique has gained acceptance for its shorter scar and more durable projection results, but some hesitation remains with its use in larger volume reductions.The incidence of complications in 124 consecutively performed breast reductions (246 breasts) at a single institution using either the Wise pattern/IP technique or vertical scar/SP technique, as well as risk factors associated with them, was determined...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28327997/lumbar-fusion-for-degenerative-disease-a-systematic-review-and-meta-analysis
#6
Daniel Yavin, Steven Casha, Samuel Wiebe, Thomas E Feasby, Callie Clark, Albert Isaacs, Jayna Holroyd-Leduc, R John Hurlbert, Hude Quan, Andrew Nataraj, Garnette R Sutherland, Nathalie Jette
BACKGROUND: Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. OBJECTIVE: To summarize the current evidence on the comparative safety and efficacy of lumbar fusion, decompression-alone, or nonoperative care for degenerative indications. METHODS: A systematic review was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to June 30, 2016)...
March 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326411/medial-tibial-spackling-to-lessen-chronic-medial-tibial-soft-tissue-irritation
#7
J Ryan Martin, Tyler Steven Watters, Daniel L Levy, Jason M Jennings, James P Boyle, Douglas A Dennis
We describe a unique, utilitarian reconstructive treatment option known as tibial "spackling" for chronic, localized medial joint line pain corresponding with progressive radiographic peripheral medial tibial bone loss beneath a well-fixed revision total knee arthroplasty tibial baseplate. It is believed that this localized pain is due to chronic irritation of the medial capsule and collateral ligament from the prominent medial edge of the tibial component. In the setting of failed nonoperative treatment, our experience with utilizing bone cement to reconstruct the medial tibial bone defect and create a smooth medial tibial surface has been successful in eliminating chronic medial soft tissue irritation...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28325459/natural-history-of-acute-subdural-hematoma
#8
REVIEW
Rafael A Vega, Alex B Valadka
Because published guidelines for surgical decision-making in patients with acute subdural hematomas (ASDHs) are based largely on case series and other weak evidence, management often must be individualized. Nonoperative management is a viable option in many cases. The literature is divided about the effects of anticoagulant and antiplatelet medications on rapid growth of ASDHs and on their likelihood of progression to large chronic subdural hematomas. Close clinical and radiologic follow-up is needed, both acutely to detect rapid expansion of an ASDH, and subacutely to detect formation of a large subacute or chronic subdural hematoma...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325455/chronic-subdural-medical-management
#9
REVIEW
David Roh, Michael Reznik, Jan Claassen
Chronic subdural hematomas (cSDHs) that are asymptomatic or have minimal symptoms have become more prevalent, with an increased rate of detection with neuroimaging in the setting of an aging population and increasing use of anticoagulants. These cSDHs have been known to spontaneously resolve, and subsequent efforts have been made to study the role of nonoperative initial medical management strategies in these patients. Current and potential strategies for the medical management of cSDH are discussed.
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28324284/nonoperative-management-or-watch-and-wait-for-rectal-cancer-with-complete-clinical-response-after-neoadjuvant-chemoradiotherapy-a-critical-appraisal
#10
Tarik Sammour, Brandee A Price, Kate J Krause, George J Chang
BACKGROUND: There is increasing interest in nonoperative management (NOM) for rectal cancer with complete clinical response (cCR) after neoadjuvant chemoradiation (nCRT). OBJECTIVE: The aim of this systematic review was to summarize the available data on NOM, with the intention of formulating standardized protocols on which to base future investigations. METHODS: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted...
March 21, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28321428/high-grade-partial-and-retracted-2-cm-proximal-hamstring-ruptures-nonsurgical-treatment-revisited
#11
Jonathan R Piposar, Amrit V Vinod, Joshua R Olsen, Edward Lacerte, Suzanne L Miller
BACKGROUND: High-grade partial proximal hamstring tears and complete tears with retraction less than 2 cm are a subset of proximal hamstring injuries where, historically, treatment has been nonoperative. It is unknown how nonoperative treatment compares with operative treatment. HYPOTHESIS: The clinical and functional outcomes of nonoperative and operative treatment of partial/complete proximal hamstring tears were compared. We hypothesize that operative treatment of these tears leads to better clinical and functional results...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28316316/colonic-diverticulosis-and-diverticulitis-in-renal-transplant-recipients-management-and-long-term-outcomes
#12
Ahmet Rencuzogullari, Gokhan Ozuner, Sinan Binboga, Erman Aytac, Venkatesh Krishnamurthi, Emre Gorgun
Data regarding management of colonic diverticulitis in renal transplant recipients (RTRs) are limited. This study aims to identify prevalence, risk factors, and outcomes in RTRs with colonic diverticulosis and diverticulitis. Between January 2004 and December 2013, all patients who underwent kidney transplantation were analyzed. Among all RTSs, patients who had a pretransplant colonoscopic diagnosis of diverticulosis and patients with a proven attack of diverticulitis were included in our analysis. There were 1578 RTRs with a mean age of 50 ± 14 years at the time of transplantation...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28306630/nonoperative-management-of-appendicitis-in-children
#13
Joseph J López, Katherine J Deans, Peter C Minneci
PURPOSE OF REVIEW: The aim of this review is to summarize the recent literature investigating nonoperative management of uncomplicated and complicated appendicitis and highlight recent data establishing its safety and efficacy. RECENT FINDINGS: Recent studies and clinical trials have demonstrated the efficacy of nonoperative treatment of both uncomplicated and complicated appendicitis, defined as perforated appendicitis with or without formed abscess or phlegmon...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28306628/pediatric-spinal-cord-injury-without-radiographic-abnormality-in-the-era-of-advanced-imaging
#14
Caitlin A Farrell, Megan Hannon, Lois K Lee
PURPOSE OF REVIEW: The current review describes the current evidence on pediatric spinal cord injury without radiographic abnormality (SCIWORA) with attention to the definition, epidemiology, and clinical presentation of the condition, as well as common MRI findings, management strategies, and outcomes. RECENT FINDINGS: Recent literature demonstrates that with more widespread MRI use, our understanding of SCIWORA has improved. The new literature, although still limited, provides a more granular conceptualization of patterns of injury as well as potential prognostic stratification of patients based on MRI findings...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28304232/a-systematic-evaluation-of-intraoperative-white-matter-tract-shift-in-pediatric-epilepsy-surgery-using-high-field-mri-and-probabilistic-high-angular-resolution-diffusion-imaging-tractography
#15
Joseph Yuan-Mou Yang, Richard Beare, Marc L Seal, A Simon Harvey, Vicki A Anderson, Wirginia J Maixner
OBJECTIVE Characterization of intraoperative white matter tract (WMT) shift has the potential to compensate for neuronavigation inaccuracies using preoperative brain imaging. This study aimed to quantify and characterize intraoperative WMT shift from the global hemispheric to the regional tract-based scale and to investigate the impact of intraoperative factors (IOFs). METHODS High angular resolution diffusion imaging (HARDI) diffusion-weighted data were acquired over 5 consecutive perioperative time points (MR1 to MR5) in 16 epilepsy patients (8 male; mean age 9...
March 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28301361/modified-fleur-de-lis-abdominoplasty-for-massive-weight-loss-patients
#16
Ulrich Eugen Ziegler, Selina Nora Ziegler, Philip Helge Zeplin
INTRODUCTION: Fleur-de-lis abdominoplasty is an effective procedure for correcting abdominal contour abnormalities in both the vertical and horizontal orientation. Tension on the approximated tissue edges and reduced microvascular perfusion is mainly responsible for wound dehiscence and delayed wound healing in the T-point area and seroma formation. To reduce these complications, we developed a modification of the fleur-de-lis abdominoplasty technique forming upper abdominal skin flaps with deepithelialized mediocaudal edges...
March 16, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28296515/risk-preferences-and-attitudes-to-surgery-in-decision-making
#17
Andreas Meunier, Kinga Posadzy, Gustav Tinghög, Per Aspenberg
Background and purpose - There is increasing evidence that several commonly performed surgical procedures provide little advantage over nonoperative treatment, suggesting that doctors may sometimes be inappropriately optimistic about surgical benefit when suggesting treatment for individual patients. We investigated whether attitudes to risk influenced the choice of operative treatment and nonoperative treatment. Methods - 946 Swedish orthopedic surgeons were invited to participate in an online survey. A radiograph of a 4-fragment proximal humeral fracture was presented together with 5 different patient characteristics, and the surgeons could choose between 3 different operative treatments and 1 nonoperative treatment...
March 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28288080/management-of-pediatric-type-i-open-fractures-in-the-emergency-department-or-operating-room-a-multicenter-perspective
#18
Jenna Godfrey, Paul D Choi, Lior Shabtai, Sarah B Nossov, Amy Williams, Antoinette W Lindberg, Selina Silva, Michelle S Caird, Mathew D Schur, Alexandre Arkader
BACKGROUND: The management of pediatric type I open fractures remains controversial. The aim of this study is to compare outcomes in type I open fractures managed with superficial wound debridement and antibiotics in the emergency department (ED) (nonoperative management) to patients managed with operative debridement and antibiotics (operative management). METHODS: A multicenter retrospective review was performed of all pediatric type I open forearm, wrist, and tibia fractures treated at 4 high volume pediatric centers between 2000 and 2015...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28285900/low-incidence-of-postoperative-complications-with-navigated-total-knee-arthroplasty
#19
Matthew J Brown, John R Matthews, Mary T Bayers-Thering, Matthew J Phillips, Kenneth A Krackow
BACKGROUND: A number of postoperative complications of navigated total knee arthroplasty (TKA) have been discussed in the literature, including tracker pin site infection and fracture. In this article, we discuss the low postoperative complication rate in a series of 3100 navigated TKAs and the overall complication rate in a systematic analysis of the literature. METHODS: Three thousand one hundred consecutive patients with navigated TKAs from 2001-2016 were retrospectively evaluated for complications specific to navigation...
February 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28282004/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#20
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
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