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https://www.readbyqxmd.com/read/28724275/a-case-report-of-paraneoplastic-pemphigus-associated-with-retroperitoneal-inflammatory-myofibroblastic-tumor
#1
Kamran Balighi, Arghavan Azizpour, Ali Sadeghinia, Vahide Saeidi
Paraneoplastic pemphigus (PNP) is an autoimmune bullous disease associated with underlying neoplasms, both malignant and benign. The most constant clinical presentation of PNP is the presence of intractable stomatitis. Herein we present a 25-year-old male with a 3-month history of refractory stomatitis especially involving the lips and widespread vesiculobullous eruption on his trunk and extremities. The diagnosis of PNP was confirmed based on histological and serological results. Investigation for the underlying neoplasm revealed a retroperitoneal tumorous mass which was biopsied and diagnosed as the inflammatory myofibroblastic tumor (IMT)...
May 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28724143/potentially-avoidable-surgical-intensive-care-unit-admissions-and-disposition-delays
#2
Navpreet K Dhillon, Ara Ko, Eric J T Smith, Mayumi Kharabi, Joseph Castongia, Michael Nurok, Bruce L Gewertz, Eric J Ley
Importance: High health care costs encourage initiatives that avoid overuse of resources and identify opportunities to promote appropriate care. Objective: To investigate the causes of potentially avoidable surgical intensive care unit (SICU) admissions and disposition delays to determine whether targeted interventions could decrease these stays. Design, Setting, and Participants: This prospective, observational study focused on potentially avoidable SICU days, as determined by observers with input from the rounding intensivists at a 24-bed open SICU at an urban, academic hospital...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28724133/a-nationwide-analysis-of-cost-variation-for-autologous-free-flap-breast-reconstruction
#3
Jessica I Billig, Yiwen Lu, Adeyiza O Momoh, Kevin C Chung
Importance: Cost variation among hospitals has been demonstrated for surgical procedures. Uncovering these differences has helped guide measures taken to reduce health care spending. To date, the fiscal consequence of hospital variation for autologous free flap breast reconstruction is unknown. Objective: To investigate factors that influence cost variation for autologous free flap breast reconstruction. Design, Setting, and Participants: A secondary cross-sectional analysis was performed using the Healthcare Cost and Utilization Project National Inpatient Sample database from 2008 to 2010...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28724125/comparison-of-wound-complications-after-immediate-delayed-and-secondary-breast-reconstruction-procedures
#4
Margaret A Olsen, Katelin B Nickel, Ida K Fox, Julie A Margenthaler, Anna E Wallace, Victoria J Fraser
Importance: Few data are available concerning surgical site infection (SSI) and noninfectious wound complications (NIWCs) after delayed (DR) and secondary reconstruction (SR) compared with immediate reconstruction (IR) procedures in the breast. Objective: To compare the incidence of SSI and NIWCs after implant and autologous IR, DR, and SR breast procedures after mastectomy. Design, Setting, and Participants: This retrospective cohort study included women aged 18 to 64 years undergoing mastectomy from January 1, 2004, through December 31, 2011...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28724122/association-between-patient-age-and-lymph-node-positivity-in-thin-melanoma
#5
Andrew J Sinnamon, Madalyn G Neuwirth, Pratyusha Yalamanchi, Phyllis Gimotty, David E Elder, Xiaowei Xu, Rachel R Kelz, Robert E Roses, Emily Y Chu, Michael E Ming, Douglas L Fraker, Giorgos C Karakousis
Importance: More than half of all new melanoma diagnoses present as clinically localized T1 melanoma, yet sentinel lymph node biopsy (SLNB) is controversial in this population given the overall low yield. Guidelines for SLNB have focused on pathologic factors, but patient factors, such as age, are not routinely considered. Objectives: To identify indicators of lymph node (LN) metastasis in thin melanoma in a large, generalizable data set and to evaluate the association between patient age and LN positivity...
July 19, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28724055/bone-turnover-after-bariatric-surgery
#6
Thalita Lima Melo, Leila Froeder, Leandro da Cunha Baia, Ita Pfeferman Heilberg
Objective: The aim of the present study was to evaluate parameters of bone and mineral metabolism after bariatric surgery. Subjects and methods: This sectional study included data from medical records from 61 bariatric surgery (BS) patients (minimum period of 6 months after the procedure) and from 30 class II and III obese patients as a control group (Cont), consisting of daily dietary intake of macronutrients, calcium and sodium, serum 25(OH)D and parathyroid hormone (PTH) and other biochemical serum and urinary parameters...
July 13, 2017: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28723878/evolution-of-surgery-for-adolescent-idiopathic-scoliosis-over-20-years-have-outcomes-improved
#7
Baron S Lonner, Yuan Ren, Burt Yaszay, Patrick J Cahill, Suken A Shah, Randal R Betz, Amer F Samdani, Harry L Shufflebarger, Peter O Newton
STUDY DESIGN: Retrospective review of a prospective Adolescent Idiopathic Scoliosis (AIS) registry OBJECTIVE.: To study the evolution of the operative approach, outcomes and complication rates in AIS surgery over the past 20 years. METHODS: 1819 AIS patients (1995-2013) with 2-year F/U were studied. Operative approach, perioperative parameters, major complication rates, and SRS outcomes were assessed. Linear regression was used to assess the trend of changes over 5-year quartiles...
July 18, 2017: Spine
https://www.readbyqxmd.com/read/28723873/total-disc-arthroplasty-and-anterior-interbody-fusion-in-the-lumbar-spine-have-relatively-few-differences-in-readmission-and-short-term-adverse-events
#8
Blake N Shultz, Alexander T Wilson, Nathaniel T Ondeck, Patawut Bovonratwet, Ryan P McLynn, Jonathan J Cui, Jonathan N Grauer
STUDY DESIGN: Retrospective matched cohort study of prospectively collected data. OBJECTIVE: To compare rates of adverse events and readmission between lumbar total disc arthroplasty (TDA) and anterior lumbar interbody fusion (ALIF) using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. SUMMARY OF BACKGROUND DATA: TDA and ALIF may be considered for similar degenerative indications. However, there have been few large-cohort comparison studies of short-term clinical outcomes for these procedures...
July 18, 2017: Spine
https://www.readbyqxmd.com/read/28723861/medicaid-and-uninsured-hepatocellular-carcinoma-patients-have-more-advanced-tumor-stage-and-are-less-likely-to-receive-treatment
#9
Jennifer Wang, John Ha, Aristeo Lopez, Taft Bhuket, Benny Liu, Robert J Wong
GOALS: To evaluate the impact of insurance status on tumor stage at diagnosis, treatment received, and overall survival among adults with hepatocellular carcinoma (HCC). BACKGROUND: Insurance status affects access to care, which impacts timely access to cancer screening for early detection and treatment. STUDY: Using the 2007 to 2012 Surveillance, Epidemiology, and End Results (SEER) database, we retrospectively evaluated US adults with HCC...
July 18, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28723847/blindness-related-to-presumed-retinal-toxicity-after-using-perfluorocarbon-liquid-during-vitreoretinal-surgery
#10
Silvia Méndez-Martínez, Pilar Calvo, Nelson Arturo Rodriguez-Marco, Fernando Faus, Emilio Abecia, Luis Pablo
PURPOSE: To describe the presumed retinal toxicity after using specific batches of perfluorocarbon liquid ALA OCTA (Alamedics, Dornstadt, Germany) in pars plana vitrectomy. METHODS: This is an observational retrospective consecutive case series analyses of patients operated on pars plana vitrectomy for retinal detachment or intraocular lens subluxation, using the 150141 or 200114 batches of perfluorocarbon liquid ALA OCTA as assistance during the surgery in a single center...
July 18, 2017: Retina
https://www.readbyqxmd.com/read/28723837/minimum-effective-volume-of-lidocaine-for-ultrasound-guided-costoclavicular-block
#11
Thitipan Sotthisopha, Maria Francisca Elgueta, Artid Samerchua, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Aida Gordon, Roderick J Finlayson, De Q Tran
BACKGROUND AND OBJECTIVES: This dose-finding study aimed to determine the minimum effective volume in 90% of patients (MEV90) of lidocaine 1.5% with epinephrine 5 μg/mL for ultrasound-guided costoclavicular block. METHODS: Using an in-plane technique and a lateral-to-medial direction, the block needle was positioned in the middle of the 3 cords of the brachial plexus in the costoclavicular space. The entire volume of lidocaine was deposited in this location. Dose assignment was carried out using a biased-coin-design up-and-down sequential method, where the total volume of local anesthetic administered to each patient depended on the response of the previous one...
July 19, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28723805/acute-pancreatitis-induced-by-etoposide-lobaplatin-combination-chemotherapy-used-for-the-treatment-of-lung-cancer-a-case-report-and-literature-review
#12
Cheng-Liang Cao, Peng-Yu Duan, Wang-Jun Zhang, Le Li, Feng-Zhi Qu, Bei Sun, Gang Wang
RATIONALE: Drug-induced pancreatitis (DIP) is a rare type of pancreatitis that is not usually observed in the clinical practice. It is generally difficult to distinguish from acute pancreatitis (AP) induced by other causes. PATIENT CONCERNS: Here, we report a 62-year-old Chinese female patient with "small cell lung cancer" as the initial presentation. Because the patient could not bear the surgical treatment, the chemotherapy composed of lobaplatin and etoposide was performed...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723803/leukoencephalopathy-with-calcifications-and-cysts-a-case-report
#13
Yubao Ma, Xingwen Zhang, Chen Cheng, Quangang Xu, Hai Di, Jiao Zhao, Dehui Huang, Shengyuan Yu
RATIONALE: Leukoencephalopathy with calcifications and cysts (LCC) is an uncommon entity characterized by edematous leukoencephalopathy, cerebral calcifications, and parenchymal cysts. Due to its rarity, the clinical, radiological, and histopathological features have yet to be well elucidated. PATIENT CONCERNS: The first case is a 35-year-old female who was asymptomatic. A giant intracranial cyst was incidentally detected radiologically, and it was slowly growing in the recent 10 years...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723783/novel-surgical-management-of-cyclodialysis-cleft-via-anterior-chamber-perfusion-case-report
#14
Jinfei Tang, Ergang Du, Jie Wang
RATIONALE: Cyclodialysis cleft is a relatively rare but severe condition with persistent ocular hypotony, which can cause morphologic changes and visual loss. Here we report a case of a traumatic cyclodialysis cleft that was successfully managed with direct cyclopexy via anterior chamber perfusion. During the operation, if there is aqueous humor flowing out of the deep scleral incision, the cleft is not closed, and surgery should continue until there is no aqueous outflow. PATIENT CONCERNS: A 66-year-old man was treated for severe blunt ocular trauma of the left eye and a resultant cyclodialysis cleft, lens subluxation, choroidal detachment and a cataract...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723779/can-operations-achieve-good-outcomes-in-elderly-patients-with-sanders-ii-iii-calcaneal-fractures
#15
Jun Su, Xuecheng Cao
The aim of this study was to compare the clinical effect of operative treatment and nonoperative treatment for elderly patients with Sanders II-III calcaneal fractures.The study consisted of 60 patients with Sanders II-III calcaneal fractures who were treated in our institution from January 2007 to April 2012. The clinical effect between the operative treatment group of 32 patients and the nonoperative treatment group of 28 patients was studied. Böhler angle, Gissane angle, subtalar joint motion, calcaneal width, and calcaneal height were measured before and after treatment, and these indexes were also measured on the uninjured foot...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723776/a-case-of-idiopathic-hypertrophic-pachymeningitis-presenting-with-chronic-headache-and-multiple-cranial-nerve-palsies-a-case-report
#16
Yuanyuan Huang, Jun Chen, Li Gui
RATIONALE: Idiopathic hypertrophic pachymeningitis (IHP) is a rare condition, characterized by a chronic fibrosing inflammatory process usually involving either the intracranial or spinal dura mater, but rarely both. Here, we report a rare case of IHP affecting both the intracranial and spinal dura mater. We also discussed the diagnosis, management, and outcome of IHP. PATIENT CONCERNS: We reviewed the case of a 60-year-old woman presenting with chronic headache, multiple cranial nerve palsies and gait disturbance...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723770/initial-application-of-transanal-endoscopic-microsurgery-for-high-risk-lower-rectal-gastrointestinal-stromal-tumor-after-imatinib-mesylate-neoadjuvant-chemotherapy-a-case-report
#17
Qiaofei Liu, Guangxi Zhong, Weixun Zhou, Guole Lin
RATIONALE: The lower rectal gastrointestinal stromal tumor (GIST) is a rare entity and warrants special attentions because of the considerations of preserving of anal and urinal functions. Neoadjuvant therapy with imatinib mesylate (IM) has achieved great success in GIST, which potentially extends the applications of function-preserving minimally invasive surgical procedures. Transanal endoscopic microsurgery (TEM) is a well-developed minimally invasive technique for benign tumors in lower rectum...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723767/return-of-the-cadaver-key-role-of-anatomic-dissection-for-plastic-surgery-resident-training
#18
Swenn Maxence Krähenbühl, Paul Čvančara, Thomas Stieglitz, Raphaël Bonvin, Murielle Michetti, Marjorie Flahaut, Sébastien Durand, Lina Deghayli, Lee Ann Applegate, Wassim Raffoul
Successful Plastic Surgery Residency training is subjected to evolving society pressure of lower hourly work weeks imposed by external committees, labor laws, and increased public awareness of patient care quality. Although innovative measures for simulation training of surgery are appearing, there is also the realization that basic anatomy training should be re-enforced and cadaver dissection is of utmost importance for surgical techniques.In the development of new technology for implantable neurostimulatory electrodes for the management of phantom limb pain in amputee patients, a design of a cadaveric model has been developed with detailed steps for innovative transfascicular insertion of electrodes...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#19
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723756/pulmonary-pleomorphic-carcinoma-a-case-report-and-review-of-the-literature
#20
Xiangwei Zhang, Yang Wang, Linping Zhao, Haiyan Jing, Shaowei Sang, Jiajun Du
RATIONALE: Pleomorphic carcinoma (PC) is a rare malignancy of the lung. It has a dual-cell component of spindle and/or giant cells, and of epithelial cells. PATIENT CONCERNS AND DIAGNOSES: We presented a case of PC. A 69-year-old healthy asymptomatic woman who was occasionally found an abnormal shadow on her chest X-rays. A computerized tomography scan showed a mass located in the left lingular lobe and the percutaneous lung biopsy pathology confirmed sarcomatoid cancer...
July 2017: Medicine (Baltimore)
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