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https://www.readbyqxmd.com/read/28923679/inguinal-hernia-containing-urinary-bladder-a-case-report
#1
Milena Taskovska, Jurij Janež
INTRODUCTION: Inguinal bladder hernia is rare condition found in about 1-5% of inguinal hernias. The condition is usually diagnosed intraoperatively. Patients rarely have symptoms regarding urinary tract. The best management is surgical, open surgical technique is preferred over laparoscopic. Possible urinary tract damage during surgery should be recognized and resolved. CASE PRESENTATION: The following paper presents case of inguinal bladder hernia in 82-year old Caucasian male...
September 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28899594/delayed-detection-of-spontaneous-bilateral-tubal-ectopic-pregnancies-after-methotrexate-treatment
#2
Nicole E Brown, Shereen A Singer, Joe Suyama
BACKGROUND: Bilateral tubal ectopic pregnancies are a rare subset of ectopic pregnancy that can pose a diagnostic dilemma for clinicians. There is no distinct clinical presentation for bilateral tubal ectopic pregnancies, although they are typically associated with assistive reproductive techniques. In addition, there is no single diagnostic feature to help clinicians delineate bilateral tubal ectopic pregnancies from other types of ectopic pregnancy prior to passing the discriminatory zone (such as heterotopic pregnancy or twin ectopic [two gestational sacs in one tube])...
September 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28890674/treating-symptomatic-uterine-fibroids-with-myomectomy-current-practice-and-views-of-uk-consultants
#3
R Fusun Sirkeci, Anna Maria Belli, Isaac T Manyonda
BACKGROUND: The demand for uterus-sparing treatments is increasing as more women postpone childbirth to their 30-40s, when fibroids are more symptomatic. With an increasing choice of treatment options and changing care-provider profiles, now is an opportune time to survey current practices and opinions. Using a 25-stem questionnaire, a web-based survey was used to capture the practices and opinions of UK consultant gynecologists on the treatment of symptomatic fibroids, including the types of procedure most frequently used, methods used to reduce blood loss, and awareness and acceptability of treatment options, and to assess the impact of gender and experience of the treating gynecologist...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/28888738/three-dimensional-analysis-of-accuracy-of-patient-matched-instrumentation-in-total-knee-arthroplasty-evaluation-of-intraoperative-techniques-and-postoperative-alignment
#4
Umito Kuwashima, Hideki Mizu-Uchi, Ken Okazaki, Satoshi Hamai, Yukio Akasaki, Koji Murakami, Yasuharu Nakashima
BACKGROUND: It is questionable that the accuracies of patient-matched instrumentation (PMI) have been controversial, even though many surgeons follow manufacturers' recommendations. The purpose of this study was to evaluate the accuracy of intraoperative procedures and the postoperative alignment of the femoral side using PMI with 3-dimensional (3D) analysis. METHODS: Eighteen knees that underwent total knee arthroplasty using MRI-based PMI were assessed. Intraoperative alignment and bone resection errors of the femoral side were evaluated with a CT-based navigation system...
September 6, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28852473/evaluation-of-operating-room-reverse-trendelenburg-positioning-and-its-effect-on-postoperative-hypoxemia-aspiration-and-length-of-stay-a-retrospective-study-of-consecutive-patients
#5
C Michael Dunham, Barbara M Hileman, Amy E Hutchinson, Tamara Antonaccio, Elisha A Chance, Gregory S Huang, Gregory Szmaj, Kristen Calabro, Cynthia Bishop, Tyson T Schrickel
BACKGROUND: In 2014, this group published an investigation of surgical patients from 2012 who had substantial rates of postoperative hypoxemia (POH) and perioperative pulmonary aspiration (POPA). Therefore, we investigated whether intraoperative reverse Trendelenburg positioning (RTP) decreases POH and POPA rates. METHODS: Consecutive ASA I-IV surgical patients who had preoperative pulmonary stability requiring general anesthesia with endotracheal intubation were evaluated...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28840256/-neurophysiological-monitoring-during-surgical-procedures
#6
REVIEW
P Michels, A Bräuer, M Bauer, M Söhle
The application of intraoperative neurophysiological monitoring (IONM) is gaining more and more importance in daily clinical practice. The use of IONM allows the localization of neural structures and to control functioning of the peripheral and central nervous systems in anesthetized patients. This enables surgeons to identify and to protect neural structures and cerebral areas. The use of IONM also enables anesthesiologists to adjust anesthesia and cardiopulmonary therapy to the individual needs of the patient...
August 24, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28828722/the-changing-sella-internal-carotid-artery-shift-during-transsphenoidal-pituitary-surgery
#7
Carlo Serra, Nicolai Maldaner, Giovanni Muscas, Victor Staartjes, Athina Pangalu, David Holzmann, Michael Soyka, Christoph Schmid, Luca Regli
PURPOSE: Injuries to the internal carotid artery (ICA) are potentially lethal complications in transsphenoidal surgery (TSS) for pituitary lesions. The intercarotid distance (ICD) is thus a major parameter, determining the width of the surgical corridor in TSS. The purpose of the study is to investigate changes in ICD at different levels of the ICA during and after TSS using high definition intraoperative MRI (3T-iMRI). METHODS: Pre-, intra- and 3 months postoperative MRI images of 85 TSS patients were reviewed...
August 21, 2017: Pituitary
https://www.readbyqxmd.com/read/28822671/surgical-ultrasound-guided-carpal-tunnel-release
#8
T Apard, G Candelier
Ultrasound-guided surgery is a new trend stemming from the introduction of high-frequency linear probes and better quality screens. Surgical treatment of carpal tunnel syndrome is increasingly being performed under ultrasound guidance. Knowledge of musculoskeletal ultrasonography is obviously mandatory. Several types of cutting instruments (miniature knife, Gigli saw or hook) and surgical approaches (wrist or palm) have been described. Ultrasonography allows the wide-awake and local anesthesia with no tourniquet (WALANT) technique to be used in the context of ambulatory patient care...
August 16, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28810991/posterior-cruciate-ligament-injuries-associated-with-military-survival-swim-training
#9
Michael S Crowell, John S Mason, Matthew A Posner, Chad A Haley
OBJECTIVES: Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28793141/factors-associated-with-discordance-between-preoperative-parathyroid-4-dimensional-computed-tomographic-scans-and-intraoperative-findings-during-parathyroidectomy
#10
Shonan Sho, Alexander D Yuen, Michael W Yeh, Masha J Livhits, Ali R Sepahdari
Importance: Parathyroid 4-dimensional computed tomographic scans (4D-CTs) have emerged as an accurate and cost-effective initial localization study for patients with primary hyperparathyroidism. However, potential limitations and factors affecting the accuracy of preoperative 4D-CTs remain poorly defined. Objectives: To characterize factors associated with missed parathyroid lesions on preoperative 4D-CTs and to investigate patterns of commonly observed errors. Design, Setting, and Participants: A prospectively accrued patient database was analyzed from September 1, 2011, through October 31, 2016...
August 9, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28777229/the-modified-rambo-transcanal-approach-for-cochlear-implantation-in-charge-syndrome
#11
Cameron C Wick, Amy M Moore, Daniel E Killeen, Brandon Isaacson
OBJECTIVE: CHARGE syndrome is associated with a variety of temporal bone anomalies and deafness. The lack of surgical landmarks and facial nerve irregularities make cochlear implantation in this population a challenging endeavor. This study aims to describe a safe and efficacious transcanal approach for cochlear implantation that obviates the need to perform a mastoidectomy and facial recess. PATIENTS: Three children with profound hearing loss secondary to CHARGE syndrome...
October 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28761524/selective-dorsal-rhizotomy-a-multidisciplinary-approach-to-treating-spastic-diplegia
#12
Hussam Abou Al-Shaar, Muhammad Tariq Imtiaz, Hazem Alhalabi, Shara M Alsubaie, Abdulrahman J Sabbagh
BACKGROUND: Spasticity is a motor disorder that interferes with mobility and affects the quality of life. Different approaches have been utilized to address patients with spastic diplegia, among which is selective dorsal rhizotomy (SDR). Although SDR has been shown to be efficacious in treating spastic patients, many neurologists and neurosurgeons are not well aware of the procedure, its indications, and expected outcomes due to the limited number of centers performing this procedure...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28758184/motor-evoked-potentials-and-bis-guided-anaesthesia-in-image-guided-mini-invasive-neurosurgery-of-supratentorial-tumors-nearby-the-cortico-spinal-tract
#13
Roberto Cordella, Eleonora Orena, Francesco Acerbi, Elena Beretta, Dario Caldiroli, Francesco Dimeco, Carla Carozzi
AIM: to describe and evaluate the anaesthesiological regimen used in neurophysiologically monitored image-guided mini-invasive neurosurgery. MATERIAL AND METHODS: 24 patients underwent elective surgery under general anaesthesia that was administered through Target Controlled Infusion (TCI) for effect-site concentration (Ce) of Propofol and Remifentanil, targeting Bispectral Index (BIS) in the 40-60 intervals. Stimulating intensity of transcranial motor evoked potentials (tMEP), BIS index, Propofol and Remifentanil Ce were collected at MEPs threshold (T) definition (respectively BIS@T, CeProp@T and CeRemi@T)...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28753862/validation-of-the-clavien-dindo-grading-system-in-urology-by-the-european-association-of-urology-guidelines-ad-hoc-panel
#14
REVIEW
Dionysios Mitropoulos, Walter Artibani, Chandra Shekhar Biyani, Jørgen Bjerggaard Jensen, Morgan Rouprêt, Michael Truss
CONTEXT: Since 2012 uniformed reporting of complications after urological procedures has been advocated by the European Association of Urology (EAU) guidelines. The Clavien-Dindo grading system was recommended to report the outcomes of urologic procedures. OBJECTIVE: To validate the Clavien-Dindo grading system in urology. DESIGN, SETTING, AND PARTICIPANTS: Members of the EAU working group compiled a list of case scenarios including those with minor and major complications...
March 7, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28735464/radiation-dose-reduction-in-thoracic-and-lumbar-spine-instrumentation-using-navigation-based-on-an-intraoperative-cone-beam-ct-imaging-system-a-prospective-randomized-clinical-trial
#15
Nathalie Pireau, Virginie Cordemans, Xavier Banse, Nadia Irda, Sébastien Lichtherte, Ludovic Kaminski
PURPOSE: Spine surgery still remains a challenge for every spine surgeon, aware of the potential serious outcomes of misplaced instrumentation. Though many studies have highlighted that using intraoperative cone beam CT imaging and navigation systems provides higher accuracy than conventional freehand methods for placement of pedicle screws in spine surgery, few studies are concerned about how to reduce radiation exposure for patients with the use of such technology. One of the main focuses of this study is based on the ALARA principle (as low as reasonably achievable)...
July 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28734751/how-many-people-work-in-your-operating-room-an-assessment-of-factors-associated-with-instrument-recounts-within-plastic-surgery
#16
Derek D Reformat, Joshua A David, J Rodrigo Diaz-Siso, Natalie M Plana, Annie Wang, Nicholas D Brownstone, Daniel J Ceradini
BACKGROUND: Intraoperative instrument recounts are performed to avoid retained foreign surgical items. These additional counts, however, beget risks of their own, including prolonged operative times, exposure to radiation, and increased cost. Our study aimed to identify factors that increase the likelihood of instrument recounts during plastic surgery procedures, and use our findings to guide potential solutions for preventing unnecessary recounts across all surgical fields. STUDY DESIGN: This is a retrospective review of all plastic surgical cases in the main operating setting at New York University Langone Medical Center (NYULMC) between March 2014 and February 2015...
September 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28733690/do-obstetric-patients-opt-to-undergo-general-anaesthesia-to-avoid-being-conscious-despite-safer-alternatives
#17
Daryl Ja Tan, Melissa Mh Chan
There are various modes of anaesthesia available in the community today. This gives anaesthesiologists the freedom to select those that are safe, efficacious and most suitable for patients. However, patients may not always agree with their anaesthesiologist on the preferred mode of anaesthesia because they may have a different set of priorities, with many of them electing to have the lack of intraoperative awareness as the primary objective. Hence, disagreements between anaesthesiologists and patients may arise and could potentially disrupt doctor-patient relationship...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28732621/generic-trypan-blue-as-possible-cause-of%C3%A2-a%C3%A2-cluster-of-toxic-anterior-segment-syndrome-cases-after-uneventful-cataract%C3%A2-surgery
#18
Artemis Matsou, Argyrios Tzamalis, Nikolaos Chalvatzis, Asimina Mataftsi, Ioannis Tsinopoulos, Periklis Brazitikos
Five of 16 patients having uneventful cataract surgery over 2 consecutive days presented on the first postoperative day with painless, unexpected blurry vision; marked limbus-to-limbus corneal edema; and severe anterior chamber inflammation with hypopyon and fibrin formation. Review of the records showed the 5 patients had received an intracameral injection of generic trypan blue solution 0.06% to facilitate the capsulorhexis. Patients who had not received the trypan blue injection had an uneventful first-day check and subsequent course...
June 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28699067/intraoperative-clinical-testing-overestimates-the-therapeutic-window-of-the-permanent-dbs-electrode-in-the-subthalamic-nucleus
#19
Josefine Blume, J Schlaier, E Rothenfußer, J Anthofer, F Zeman, A Brawanski, U Bogdahn, M Lange
BACKGROUND: Intraoperative test stimulation is established to optimize target localization in STN DBS, but requires a time-consuming awake surgery in off-medication state. The aim of this study was to compare the thresholds of stimulation-induced effects of test stimulation and the permanent electrode. METHODS: Fifty-nine PD patients receiving bilateral STN DBS were clinically examined with stepwise increasing monopolar stimulation during surgery and DBS programming at matched stimulation depths...
July 12, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28696881/persistent-left-superior-vena-cava-incidence-and-management-in-patients-undergoing-repair-of-partial-anomalous-pulmonary-venous-connection
#20
Nicholas S Clarke, Raghav A Murthy, Kristine J Guleserian
INTRODUCTION: A association between partial anomalous pulmonary venous connection (PAPVC) and systemic venous anomalies has been described in the literature, but the true incidence is yet to be elucidated. At our institution, we sought to find the incidence of a persistent left superior vena cava (PLSVC) in patients undergoing an operation for PAPVC. METHODS: A retrospective review of all pediatric and adult patients with PAPVC who underwent surgical repair from February 2006 to February 2016...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
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