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https://www.readbyqxmd.com/read/28535919/precision-iort-image-guided-intraoperative-radiation-therapy-igiort-using-online-treatment-planning-including-tissue-heterogeneity-correction
#1
Frank Schneider, Frederic Bludau, Sven Clausen, Jens Fleckenstein, Udo Obertacke, Frederik Wenz
BACKGROUND: To the present date, IORT has been eye and hand guided without treatment planning and tissue heterogeneity correction. This limits the precision of the application and the precise documentation of the location and the deposited dose in the tissue. Here we present a set-up where we use image guidance by intraoperative cone beam computed tomography (CBCT) for precise online Monte Carlo treatment planning including tissue heterogeneity correction. MATERIALS AND METHODS: An IORT was performed during balloon kyphoplasty using a dedicated Needle Applicator...
May 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28533829/clinical-analysis-of-aqueductal-stenosis-in-patients-with-hydrocephalus-in-a-kenyan-setting
#2
Loyal Poonamjeet Kaur, Nderitu Joseph Munyiri, Wekesa Vincent Dismus
INTRODUCTION: Aqueductal stenosis is the commonest cause of congenital hydrocephalus. The scope of this paper is to highlight the disease burden of hydrocephalus attributed to aqueductal stenosis which still remains unknown in our setting. METHODS: In a descriptive cross-sectional study, 258 records of patients diagnosed with hydrocephalus were analyzed after ethical approval from Kenyatta National Hospital- University of Nairobi (KNH-UON) ethics and research committee from January 2010 to May 2016...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28532856/implementation-of-a-referral-to-discharge-glycemic-control-initiative-for-reduction-of-surgical-site-infections-in-gynecologic-oncology-patients
#3
Laura Hopkins, Jennifer Brown-Broderick, James Hearn, Janine Malcolm, James Chan, Wendy Hicks-Boucher, Filomena De Sousa, Mark C Walker, Sylvain Gagné
OBJECTIVE(S): To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. STUDY METHODS: As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II')...
May 20, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28523393/flavored-anesthetic-masks-for-inhalational-induction-in-children
#4
Aakriti Gupta, Preethy Joseph Mathew, Neerja Bhardwaj
OBJECTIVES: To evaluate the clinical efficacy of masking the odor of inhalational agents using fruit flavors on the anxiety behavior and compliance of children for inhalational induction. METHODS: A prospective randomized double blind, placebo controlled study was conducted on 60 unpremedicated children in the age group of 4-12 y. Thirty children received anesthetic masks smeared with a flavor of child's choice while the other 30 children were induced using masks without flavor...
May 19, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28523165/plasma-levels-of-matrix-metalloproteinase-9-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting
#5
Haiqing Li, Zhize Yuan, Sen Li, Quan Qi, Jun Liu, Mi Zhou, Junfeng Cai, Anqing Chen, Zhe Wang, Xiaofeng Ye, Qiang Zhao
BACKGROUND: Matrix metalloproteinase 9 (MMP9) has recently emerged as a risk predictor in patients with cardiovascular diseases. However, little is known about the significance of increased plasma MMP9 in patients with perioperative myocardial injury. We aimed to investigate the role of MMP9 in the occurrence of myocardial injury during off-pump coronary artery bypass grafting (OPCAB). METHODS: A total of 34 consecutive patients with coronary artery diseases (CAD) were recruited in this prospective, observational study...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28507661/bone-marrow-aspirate-concentrate-in-combination-with-intravenous-iloprost-increases-bone-healing-in-patients-with-avascular-necrosis-of-the-femoral-head-a-matched-pair-analysis
#6
Hakan Pilge, Bernd Bittersohl, Johannes Schneppendahl, Tobias Hesper, Christoph Zilkens, Martin Ruppert, Rüdiger Krauspe, Marcus Jäger
With disease progression, avascular necrosis (AVN) of the femoral head may lead to a collapse of the articular surface. The exact pathophysiology of AVN remains unclear, although several conditions are known that can result in spontaneous cell death, leading to a reduction of trabecular bone and the development of AVN. Hip AVN treatment is stage-dependent in which two main stages of the disease can be distinguished: pre-collapse (ARCO 0-II) and post-collapse stage (ARCO III-IV, crescent sign). In the pre-collapse phase, core decompression (CD), with or without the addition of bone marrow (e...
November 17, 2016: Orthopedic Reviews
https://www.readbyqxmd.com/read/28489659/relationship-between-the-quantity-of-nerve-exposure-during-bilateral-sagittal-split-osteotomy-surgery-and-sensitive-recovery
#7
Paolo Gennaro, Maria Elisa Giovannoni, Niccolò Pini, Ikenna Valentine Aboh, Guido Gabriele, Giorgio Iannetti, Flavia Cascino
AIM AND OBJECTIVES: The purpose of this study was to evaluate how different exposures of the V3 nerves during orthognathic surgery impact neurosensory disturbances. METHODS: The study included 127 patients who underwent either bilateral sagittal split osteotomy (BSSO) or BSSO with maxillary le Fort 1. They were divided into 6 groups, identified by the quantity of V3 nerve exposure. All patients were examined in a pre-op period and again after 1, 3, 6 months post-op...
May 9, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28457536/pre-versus-postoperative-chemoradiotherapy-for-locally-advanced-esophageal-squamous-cell-carcinoma
#8
Po-Kuei Hsu, Hui-Shan Chen, Chia-Chuan Liu, Chien-Sheng Huang, Chih-Cheng Hsieh, Han-Shui Hsu, Shiao-Chi Wu
OBJECTIVES: Although preoperative chemoradiation followed by surgery has been recognized as an efficient strategy for esophageal cancer treatments, several studies demonstrate survival benefits of postoperative chemoradiation for those undergoing upfront resection. The optimal sequence of surgery and chemoradiation remains unclear. METHODS: Data of 1647 patients with clinical stage II/III esophageal squamous cell carcinoma (ESCC), including 1245 receiving preoperative chemoradiation followed by esophagectomy (pre-OP CRT group) and 402 receiving primary esophagectomy followed postoperative chemoradiation (post-OP CRT group), were obtained from a nationwide database...
March 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28442206/change-the-habit-to-change-the-practice-do-audits-really-ever-change-anything
#9
D Bodansky, Y Oskrochi, G Judah, M Lewis, B Fischer, B Narayan
INTRODUCTION: Methicillin resistant staphylococcus aureus (MRSA) eradication by nurses and pre-op induction antibiotics are mandated for emergency surgery, where true status is unknown. We assessed adherence to local MRSA guidelines for patients undergoing emergency hip fracture surgery and employed point of decision prompts to influence clinicians' behaviour. METHODS: We undertook a retrospective record review for all patients undergoing emergency hip fracture surgery at a UK major trauma centre over 3-months...
April 17, 2017: Injury
https://www.readbyqxmd.com/read/28436362/comparative-analysis-of-anticipated-pain-versus-experienced-pain-in-patients-undergoing-office-vasectomy
#10
James Furr, Ryan Baker, Quy Pham, Puneet Sindhwani
INTRODUCTION: Advances in vasectomy technique have minimized patient discomfort; however fear of pain remains a primary concern. The objective is to determine how the anticipation of pain associated with vasectomy compares with patient's actual intraoperative experienced pain levels. MATERIALS AND METHODS: A cohort of patients undergoing clinic vasectomy was analyzed. Using visual analog pain scale patients were asked to rate their anticipated pain score (APS) pre-procedure and then an experienced pain score (EPS) post-procedure...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28434475/music-listening-alleviates-anxiety-and-physiological-responses-in-patients-receiving-spinal-anesthesia
#11
Wen-Ping Lee, Pao-Yuan Wu, Meng-Ying Lee, Lun-Hui Ho, Whei-Mei Shih
OBJECTIVE: The aim of this study was to explore the effects of listening to music on the anxiety levels and physiological responses of surgical patients receiving spinal anesthesia. METHODS: An experimental design was used in the study with an experimental group (n=50) and a control group (n=50). The experimental group received 30min of musical intervention and routine nursing care in the Post-Anesthesia Care Unit (PACU) while the control group received only routine nursing care...
April 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28425068/analysis-of-cervical-sagittal-alignment-change-following-correction-of-thoracic-and-thoracolumbar-scheuermann-s-kyphosis
#12
Luigi Aurelio Nasto, Saggah Tarek Shalabi, Ana Belen Perez-Romera, Samiul Muquit, Amir Reza Ghasemi, Hossein Mehdian
PURPOSE: To analyse pre-operative and post-operative changes of cervical sagittal alignment (CSA) in Scheuermann's kyphosis (SK) patients. METHODS: 64 SK and 33 control patients were retrospectively reviewed. Whole spine X-rays obtained at pre-op, 3 months post-op and at latest follow-up were reviewed and ten separate CSA radiological parameters were measured. Patients were divided in three groups: thoracic SK (TK group, apex T6-T9, n = 40), thoracolumbar SK (TLK group, apex T10-T12, n = 24), and controls...
April 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28390918/dynamic-geometric-analysis-of-the-renal-arteries-and-aorta-following-complex-endovascular-aneurysm-repair
#13
Brant W Ullery, Ga-Young Suh, John J Kim, Jason T Lee, Ronald L Dalman, Christopher P Cheng
INTRODUCTION: Aneurysm regression and target vessel patency during early and mid-term follow-up may be related to the effect of stent graft configuration on the anatomy. We quantified geometry and remodeling of the renal arteries and aneurysm following fenestrated (F-) or snorkel/chimney (Sn-) endovascular aneurysm repair (EVAR). METHODS: 29 patients (mean age, 76.8±7.8 years) treated with F- or Sn-EVAR underwent computed tomography angiography at pre-op, post-op, and follow-up...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28379086/boosting-clinical-performance-the-impact-of-enhanced-final-year-placements
#14
D V H Williams, A M Reid, M Homer
BACKGROUND: This study follows on from a study that investigated how to develop effective final year medical student assistantship placements, using multidisciplinary clinical teams in planning and delivery. AIMS: This study assessed the effects on objective structured clinical examination (OSCE) performance of the in-course enhanced "super-assistantship" placement introduced to a randomly selected sample of 2013-14 final year medical students at Leeds medical school...
April 2017: Medical Teacher
https://www.readbyqxmd.com/read/28374128/cage-deviation-in-the-subaxial-cervical-spine-in-relation-to-implant-position-in-the-sagittal-plane
#15
Klaus Christian Mende, Sven Oliver Eicker, Friedrich Weber
Subsidence of interbody cages is a frequently observed and relevant complication in anterior cervical discectomy and fusion (ACDF). Only a handful of studies concentrated on the modality of subsidence and its clinical impact. We performed a retrospective analysis of ACDF patients from 2004 to 2010. Numeric analog scale (NAS) score pre-op and post-op, Oswestry Disability Index (ODI) on x-rays, endplate (EP) and cage dimensions, implant position, lordotic/kyphotic subsidence patterns (>5°), and cervical alignment were recorded...
April 4, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28369239/coronary-artery-doppler-patterns-are-associated-with-clinical-outcomes-post-arterial-switch-operation-for-transposition-of-the-great-arteries
#16
Lynne E Nield, Andreea Dragulescu, Christine MacColl, Cedric Manlhiot, Henrik Brun, Brian W McCrindle, Bart Kuipers, Christopher A Caldarone, Steven E S Miner, Luc Mertens
Aims: Transposition of the great arteries (TGA) is generally repaired using the arterial switch operation (ASO) involving coronary transfer. The objective of this prospective study was to determine whether specific coronary Doppler patterns intra-operatively predicted adverse early myocardial events. Methods and results: Patients < 3 months old with TGA undergoing the ASO were eligible. All patients (when feasible) underwent an intra-operative transoesophageal echo (TEE) plus an epicardial echo and had pre-op, early post-op, pre-discharge and follow-up functional echocardiograms...
March 28, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28368983/patient-reported-outcomes-and-revision-rates-at-a-mean-follow-up-of-ten-years-after-lumbar-total-disc-replacement
#17
Line A Laugesen, Rune T Paulsen, Leah Carreon, Carsten Ernst, Mikkel Ø Andersen
STUDY DESIGN: Prospective observational cohort study. OBJECTIVE: To determine the long-term clinical results and prosthesis survival in patients treated with lumbar total disc replacement (TDR). SUMMARY OF BACKGROUND DATA: Fusion has become the current standard surgical treatment for lumbar degenerative disease. TDR is an alternative treatment that seeks to avoid fusion-related adverse events, specifically adjacent segment disease. METHODS: Sixty-eight consecutive patients treated with TDR from 2003-2008 were invited to follow-up and complete a Visual Analog Scale (VAS) for back and leg pain, the Dallas Pain Questionnaire (DPQ) and the Short Form-36...
March 31, 2017: Spine
https://www.readbyqxmd.com/read/28356560/brain-activity-in-the-right-frontal-pole-and-lateral-occipital-cortex-predicts-successful-post-operatory-outcome-after-surgery-for-anterior-glenoumeral-instability
#18
Davide Zanchi, Gregory Cunningham, Alexandre Lädermann, Mehmet Ozturk, Pierre Hoffmeyer, Sven Haller
Shoulder apprehension is more complex than a pure mechanical problem of the shoulder, creating a scar at the brain level that prevents the performance of specific movements. Surgery corrects for shoulder instability at the physical level, but a re-dislocation within the first year is rather common. Predicting which patient will be likely to have re-dislocation is therefore crucial. We hypothesized that the assessment of neural activity at baseline and follow-up is the key factor to predict the post-operatory outcome...
March 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28348884/xen-glaucoma-implant-with-mitomycin-c-1-year-follow-up-result-and-complications
#19
Ahmed Galal, Alper Bilgic, Rasha Eltanamly, Amr Osman
Purpose. To evaluate gel microstent (XEN, Aquesys, Inc) for treatment of primary open angle glaucoma (POAG). Methods. In this prospective interventional study, 13 eyes with POAG underwent XEN implantation with subconjunctival mitomycin-C. Of those eyes, 3 were pseudophakic and 10 underwent simultaneous phacoemulsification and XEN. Patients had uncontrolled IOP, had intolerance to therapy, or had maximal therapy but undergoing cataract extraction. Follow-up visits included IOP, number of medications, vision, and complications and lasted for 1 year...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28344829/systemic-angiopoietin-1-2-dysregulation-following-cardiopulmonary-bypass-in-adults
#20
Emmanuel Charbonney, Elizabeth Wilcox, Yuexin Shan, Pablo Perez d'Empaire, Abhijit Duggal, Gordon D Rubenfeld, Conrad Liles, Claudia Dos Santos
AIM: Vascular leakage following cardiopulmonary bypass contributes to morbidity. Angiopoietin-1 and -2 are biomarkers of endothelial dysfunction. Our aim was to characterize Ang-1 and -2 association with clinical characteristics and outcomes. METHODS: Observational cohort study measuring Ang-1/-2 with a panel of cytokines in adults undergoing cardiopulmonary bypass. RESULTS: Ang-2 levels increased immediately postop whereas Ang-1 levels decreased over time...
March 2017: Future Science OA
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