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Intraoperative awareness

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https://www.readbyqxmd.com/read/28620562/delayed-chyle-leak-following-anterior-cervical-spinal-surgery-a-case-report-and-management-algorithm
#1
Kyle Mueller, Hasan R Syed, Jay W Rhee, Mani N Nair
Injury to the thoracic duct during anterior cervical spine surgery is a rare occurrence. A delayed chyle leak following an elective anterior cervical spinal surgery has not been reported in the literature. We present a report of a 59-year-old female with multiple prior neck surgeries who underwent an anterior cervical corpectomy and fusion (ACCF). The patient developed a delayed thoracic duct injury on postoperative day (POD) one, as no injury was noted intraoperatively. She was managed with conservative care involving a low-fat diet along with octreotide which led to the resolution of her symptoms...
May 9, 2017: Curēus
https://www.readbyqxmd.com/read/28614170/implications-of-left-sided-gallbladder-in-the-emergency-setting-retrospective-review-and-top-tips-for-safe-laparoscopic-cholecystectomy
#2
Hariscine K Abongwa, Belinda De Simone, Laura Alberici, Maurizio Iaria, Gennaro Perrone, Antonio Tarasconi, Gianluca Baiocchi, Nazario Portolani, Salomone Di Saverio, Massimo Sartelli, Federico Coccolini, Jennifer E Manegold, Luca Ansaloni, Fausto Catena
BACKGROUND: Left-sided gallbladder without situs viscerum inversus (LSG-woSVI) is a rare congenital anomaly. Clinical features and routine presurgical imaging could miss the anomalous position, thereby producing complications during surgery. Laparoscopic cholecystectomy can be performed safely, but the risk of bile duct injury (BDI) is greater than in cholecystectomy of the orthotopic gallbladder. We present a retrospective review of all scientific literature for diagnosed cases of LSG-woSVI undergoing cholecystectomy from 1996 to 2014...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28607941/radiographic-diagnosis-of-pincer-type-femoroacetabular-impingement-a-systematic-review
#3
REVIEW
Chanseok Rhee, Tina Le Francois, J W Thomas Byrd, Mark Glazebrook, Ivan Wong
BACKGROUND: Femoroacetabular impingement (FAI) is a well-recognized condition that causes hip pain and can lead to early osteoarthritis if not managed properly. With the increasing awareness and efficacy of operative treatments for pincer-type FAI, there is a need for consensus on the standardized radiographic diagnosis. PURPOSE: To perform a systematic review of the evidence regarding imaging modalities and radiographic signs for diagnosing pincer-type FAI. STUDY DESIGN: Systematic review; Level of evidence, 4...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28600996/lower-limb-alignment-and-laxity-measures-before-during-and-after-total-knee-arthroplasty-a-prospective-cohort-study
#4
Jon V Clarke, Angela H Deakin, Frederic Picard, Philip E Riches
BACKGROUND: This study compared knee alignment and laxity in patients before, during and after total knee arthroplasty, using methodologically similar procedures, with an aim to help inform pre-operative planning. METHODS: Eighteen male and 13 female patients were recruited, mean age 66years (51-82) and mean body mass index of 33 (23-43). All were assessed pre- and postoperatively using a non-invasive infrared position capture system and all underwent total knee arthroplasty using a navigation system...
May 26, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28580893/appropriateness-of-surgical-antibiotic-prophylaxis-in-pediatric-patients-in-italy
#5
Mariavalentina Giordano, Lorena Squillace, Maria Pavia
OBJECTIVES Appropriate use of surgical antibiotic prophylaxis (SAP) reduces intraoperative wound contamination in pediatric surgery, thus minimizing the risk of surgical site infection (SSIs). Conversely, inappropriate use of SAP exposes patients to the risk of antibiotic side effects and contributes to the emergence of antimicrobial resistance. Our aims were to describe SAP administration and to analyze factors associated with nonadherence in pediatric patients. DESIGN Descriptive study. SETTING Overall, 955 pediatric patients underwent 1,038 surgical procedures...
June 5, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28580500/vascular-calcifications-on-the-preoperative-radiograph-harbinger-of-tourniquet-failure-in-patients-undergoing-total-knee-arthroplasty
#6
Julia Verena Woelfle-Roos, Laura Dautel, Benjamin Mayer, Ralf Bieger, Klaus-Dieter Woelfle, Heiko Reichel
OBJECTIVE: Vascular calcifications on the preoperative radiograph of patients scheduled for total knee arthroplasty (TKA) often give rise to concern, as their clinical relevance remains uncertain. The aim of this study was to investigate whether these vascular calcifications-especially medial artery calcifications (MACs), which increase arterial stiffness-were associated with tourniquet failure and thus with increased intraoperative blood loss. MATERIALS AND METHODS: A total of 765 patients who underwent primary TKA with a tourniquet (cuff pressure 350 mmHg) between 2009 and 2011 were screened for vascular calcifications on the preoperative radiograph...
June 5, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28553445/a-cross-sectional-analysis-of-glove-perforation-in-primary-and-revision-total-hip-arthroplasty
#7
D Kumar, K Shantanu, M Kumar, A Kumar, V Sharma
The number of total hip arthroplasties is ever increasing. Literature about glove perforation rates in arthroplasties in India is very scarce. The purpose of our study was to determine the incidence of glove perforation and increasing the awareness of possible glove perforations to decrease the risk of infection. We performed a prospective study in which we tested gloves worn by all scrubbed personnel. A total of 1408 gloves were collected from 42 primary total hip and 13 revision total hip arthroplasties. Incidence of glove perforation was found to be more in revision total hip arthroplasty...
November 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28542808/ascending-aortic-rupture-through-a-penetrating-atherosclerotic-ulcer-a-rare-cause-of-sudden-unexpected-death
#8
Supawon Srettabunjong
Spontaneous rupture of the aorta through an atherosclerotic lesion without preexisting aortic aneurysm, dissection, or history of trauma is very rare. Without prompt aortic repair, all cases result in sudden death with a definitive diagnosis made only intraoperatively or during autopsy. The phenomenon has been uniformly found in individuals with hypertension. The author reports a sudden unexpected death caused by spontaneous rupture of the ascending aorta in a 57-year-old man with a history of hypertension...
May 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28529743/omental-synovial-sarcoma-mimicking-an-ovarian-malignancy-a-case-report
#9
Naoyuki Iwahashi, Yoko Deguchi, Yuko Horiuchi, Kazuhiko Ino, Kenichi Furukawa
Synovial sarcoma is clinically rare, and cases of synovial sarcoma arising in the omentum are particularly rare. Only 3 cases have been reported in the literature to dtae, and they were associated with a poor prognosis. We herein report a rare case of aggressive primary omental synovial sarcoma presenting as an ovarian malignancy. A 53-year-old multigravida woman was referred to our hospital due to progressive abdominal distension. Magnetic resonance imaging revealed a large heterogeneous mass with an irregular component occupying the lower abdominal cavity, with an intact uterus...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28528047/sclerosing-aortic-and-coronary-arteritis-due-to-igg4-related-disease
#10
Mikael Barbu, Ulf Lindström, Claes Nordborg, Andreas Martinsson, Christian Dworeck, Anders Jeppsson
We present the case of a 55-year-old woman admitted for a coronary artery bypass operation because of three-vessel coronary artery disease based on angiographic findings and clinical symptoms. Unexpected intraoperative findings with diffuse tissue thickening of the ascending aorta and coronary arteries indicated an alternate pathogenesis rather than coronary artery atherosclerosis. Histopathologic findings and clinical evaluation could confirm IgG4-related disease (IgG4-RD). IgG4-RD is a newly recognized fibroinflammatory condition that can present in a variety of organs and is characterized by common histopathologic features...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28526569/total-joint-replacement-for-neglected-posterior-knee-dislocation-following-septic-arthritis-after-arthroscopy
#11
Yusuf Öztürkmen, Yunus Emre Akman, Ethem Ayhan Ünkar, Erhan Şükür
This report presents the first case of a knee dislocation following septic arthritis after arthroscopy. A 65-year-old woman had an arthroscopy with irrigation and debridement (I&D) of the joint and microfracture for the chondral lesions. She had complaints of postarthroscopic infection but non-steroidal anti-inflammatory medication and local ice compression was recommended. She revisited her physician twice and at the last visit she had a large purulent effusion in her knee. The gram stain of the joint fluid aspirate demonstrated gram-positive cocci and the cultures grew methicilline-sensitive Staphylococcus aureus...
May 16, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28521354/surgical-microanatomy-of-the-posterior-condylar-emissary-vein-and-its-anatomical-variations-for-the-transcondylar-fossa-approach
#12
Nakao Ota, Rokuya Tanikawa, Tsutomu Yoshikane, Masataka Miyama, Takanori Miyazaki, Yu Kinoshita, Hidetoshi Matsukawa, Takeshi Yanagisawa, Fumihiro Sakakibara, Go Suzuki, Norihiro Saito, Shiro Miyata, Kosumo Noda, Toshiyuki Tsuboi, Rihei Takeda, Hiroyasu Kamiyama, Sadahisa Tokuda, Kyousuke Kamada
BACKGROUND: It is essential to identify and be aware of the anatomy of the posterior condylar emissary vein (PCEV) for achieving an adequate operative field for the transcondylar fossa approach (TCFA). OBJECTIVE: To describe the variations in the drainage patterns of PCEVs and the technical issues encountered in such cases. METHODS: This was a retrospective analysis of the anatomy of PCEVs in 104 sides in 52 cases treated by the TCFA. Preoperative findings of multidetector-row computed tomography (CT) and CT venography (CTV) were compared with the intraoperative findings...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28499624/acetabular-placement-accuracy-with-the-direct-anterior-approach-freehand-technique
#13
Melissa C Soderquist, Ryan Scully, Anthony S Unger
BACKGROUND: Acetabular cup placement in total hip arthroplasty (THA) has been recognized as an important factor in operative success, and accurate cup placement has been the impetus for novel medical technologies. METHODS: This article examines the cup placement in 955 THAs using a freehand Direct Anterior Approach on a standard operating table. Acetabular anteversion and inclination were determined using the circle theorem. Measurements were divided into safe zone placement determined by Callanan et al as 5°-25° for anteversion and 30°-45° for inclination, as well as by Lewinnek et al as 5°-25° for anteversion and 30°-50° for inclination...
April 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28491202/just-a-mirage-heterotopic-intrauterine-and-twin-ectopic-pregnancy-mimicked-by-mirror-imaging-on-ultrasound
#14
Rimsha Ahmed, Dejan Samardzic, Michael A Santos, Anna Mesina, Jaimie Maines
Heterotopic pregnancies are rare and are usually diagnosed by transvaginal ultrasound. Despite the routine use of sonography in early pregnancy, artifact created by mirror imaging can drastically and erroneously alter medical decision making by interfering with image interpretation. A heterotopic pregnancy with a single intrauterine gestation and twin left adnexal ectopic gestational sacs was observed on ultrasound in a woman presenting with abdominal pain. During laparoscopy, an ectopic pregnancy was not identified, and subsequent intraoperative ultrasound reproduced the heterotopic pregnancy through manipulation of bowel, confirming mirror image artifact...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28486286/practical-aspects-of-posttrauma-reconstruction-with-an-intramedullary-lengthening-nail
#15
Mitchell Bernstein
Limb equalization using the Ilizarov method has evolved and adapted the use of internal lengthening devices. One of the newest devices, termed "PRECICE," is a magnetically controlled telescoping nail. Complications such as pin site infection and skin irritation are eliminated. Despite trauma surgeons' familiarity with intramedullary nailing, the Ilizarov method requires sound knowledge of deformity analysis and awareness of specific complications associated with distraction osteogenesis. This manuscript discusses some of the practical preoperative and intraoperative components of limb lengthening...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28474122/survey-on-current-cognitive-practices-within-the-european-low-grade-glioma-network-towards-a-european-assessment-protocol
#16
Adrià Rofes, Emmanuel Mandonnet, John Godden, Marie Hélène Baron, Henry Colle, Amelie Darlix, Vânia de Aguiar, Hugues Duffau, Guillaume Herbet, Martin Klein, Vincent Lubrano, Juan Martino, Ryan Mathew, Gabriele Miceli, Sylvie Moritz-Gasser, Johan Pallud, Costanza Papagno, Fabien Rech, Erik Robert, Geert-Jan Rutten, Thomas Santarius, Djaina Satoer, Joanna Sierpowska, Anja Smits, Miran Skrap, Giannantonio Spena, Evy Visch, Elke De Witte, Maria Zetterling, Michel Wager
BACKGROUND: The European Low-Grade Glioma network indicated a need to better understand common practices regarding the managing of diffuse low-grade gliomas. This area has experienced great advances in recent years. METHOD: A general survey on the managing of diffuse low-grade gliomas was answered by 21 centres in 11 European countries. Here we focused on specific questions regarding perioperative and intraoperative cognitive assessments. RESULTS: More centres referred to the same speech and language therapist and/or neuropsychologist across all assessments; a core of assessment tools was routinely used across centres; fluency tasks were commonly used in the perioperative stages, and object naming during surgery; tasks that tapped on attention, executive functions, visuospatial awareness, calculation and emotions were sparsely administered; preoperative assessments were performed 1 month or 1 week before surgery; timing for postoperative assessments varied; finally, more centres recommended early rehabilitation, whenever needed...
July 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28472777/anesthetic-dreaming-anesthesia-awareness-and-patient-satisfaction-after-deep-sedation-with-propofol-target-controlled-infusion-a-prospective-cohort-study-of-patients-undergoing-day-case-breast-surgery
#17
Marco Cascella, Roberta Fusco, Domenico Caliendo, Vincenza Granata, Domenico Carbone, Maria Rosaria Muzio, Giuseppe Laurelli, Stefano Greggi, Francesca Falcone, Cira Antonietta Forte, Arturo Cuomo
BACKGROUND: Anesthetic dreaming and anesthesia awareness are well distinct phenomena. Although the incidence of intraoperative awareness is more common among patients who reported a dream after surgery, the exact correlation between the two phenomena remains an unsolved rebus. The main purpose of this study was to investigate anesthetic dreaming, anesthesia awareness and psychological consequences eventually occurred under deep sedation. Intraoperative dreaming experiences were correlated with dream features in natural sleep...
April 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28463534/incidence-and-detection-of-meniscal-ramp-lesions-on-magnetic-resonance-imaging-in-patients-with-anterior-cruciate-ligament-reconstruction
#18
Nicholas N DePhillipo, Mark E Cinque, Jorge Chahla, Andrew G Geeslin, Lars Engebretsen, Robert F LaPrade
BACKGROUND: Meniscal ramp lesions have been reported to be present in 9% to 17% of patients undergoing anterior cruciate ligament (ACL) reconstruction. Detection at the time of arthroscopy can be accomplished based on clinical suspicion and careful evaluation. Preoperative assessment via magnetic resonance imaging (MRI) has been reported to have a low sensitivity in identifying meniscal ramp lesions. PURPOSE: To investigate the incidence of meniscal ramp lesions in patients with ACL tears and the sensitivity of preoperative MRI for the detection of ramp lesions...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28461988/endoscopic-extraperitoneal-radical-prostatectomy-an-initial-report-following-the-first-30-cases
#19
Bartłomiej Jakóbczyk, Marek Wrona, Marta Wrona-Lis, Elżbieta Oszukowska, Piotr Lipiński, Mariusz Szewczyk, Marek Lipiński, Waldemar Różański
INTRODUCTION: To present initial observations after the first 30 cases of endoscopic extraperitoneal radical prostatectomy carried out at our department, which so far has had no experience with this surgical procedure. MATERIAL AND METHODS: In the period of 15 months a group of 30 patients with organ confined prostate cancer, underwent endoscopic extraperitoneal radical prostatectomy using Montsouris technique. All procedures were performed by the same team of two urologists and one resident...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28459719/profound-obstructive-hypotension-from-prone-positioning-documented-by-transesophageal-echocardiography-in-patient-with-scoliosis-a-case-report
#20
Arnoley S Abcejo, Juan Diaz Soto, Courtney Castoro, Sarah Armour, Timothy R Long
In a healthy 12-year-old female with scoliosis, prone positioning resulted in pressor-refractory cardiovascular collapse. Resumption of supine position immediately improved hemodynamics. Intraoperative transesophageal echocardiography (TEE) revealed a collapsed left atrium and biventricular failure. Repeat prone positioning resulted in a recurrence of hypotension. However, hemodynamic stabilization was restored and maintained by repositioning chest pads caudally. The patient successfully underwent a 6-hour scoliosis repair without perioperative morbidity...
April 28, 2017: A & A Case Reports
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