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https://www.readbyqxmd.com/read/29351789/prevention-of-severe-infectious-complications-after-colorectal-surgery-using-preoperative-orally-administered-antibiotic-prophylaxis-precaution-study-protocol-for-a-randomized-controlled-trial
#1
Tessa Mulder, Marjolein F Q Kluytmans-van den Bergh, Anne Marie G A de Smet, Nils E van 't Veer, Daphne Roos, Stavros Nikolakopoulos, Marc J M Bonten, Jan A J W Kluytmans
BACKGROUND: Colorectal surgery is frequently complicated by surgical site infections (SSIs). The most important consequences of SSIs are prolonged hospitalization, an increased risk of surgical reintervention and an increase in mortality. Perioperative intravenously administered antibiotic prophylaxis is the standard of care to reduce the risk of SSIs. In the last few decades, preoperative orally administered antibiotics have been suggested as additional prophylaxis to further reduce the risk of infection, but are currently not part of routine practice in most hospitals...
January 19, 2018: Trials
https://www.readbyqxmd.com/read/29351243/awake-versus-asleep-deep-brain-stimulation-surgery-technical-considerations-and-critical-review-of-the-literature
#2
REVIEW
Ryan B Kochanski, Sepehr Sani
Advancements in neuroimaging have led to a trend toward direct, image-based targeting under general anesthesia without the use of microelectrode recording (MER) or intraoperative test stimulation, also referred to as "asleep" deep brain stimulation (DBS) surgery. Asleep DBS, utilizing imaging in the form of intraoperative computed tomography (iCT) or magnetic resonance imaging (iMRI), has demonstrated reliable targeting accuracy of DBS leads implanted within the globus pallidus and subthalamic nucleus while also improving clinical outcomes in patients with Parkinson's disease...
January 19, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29350840/a-phase-3-trial-of-mometasone-furoate-sinus-implants-for-chronic-sinusitis-with-recurrent-nasal-polyps
#3
Robert C Kern, J Pablo Stolovitzky, Stacey L Silvers, Ameet Singh, Jivianne T Lee, David M Yen, Alfred M C Iloreta, Francis P J Langford, Boris Karanfilov, Keith E Matheny, James W Stambaugh, Anna K Gawlicka
BACKGROUND: Topical intranasal corticosteroid sprays (INCSs) are standard treatment for nasal polyps (NPs), but their efficacy is reduced by poor patient compliance and impaired access of drug to the sinus mucosa. A corticosteroid-eluting sinus implant was designed to address these limitations in patients with recurrent polyposis after sinus surgery by delivering 1350 μg of mometasone furoate (MF) directly to the ethmoid sinus mucosa over approximately 90 days. METHODS: A randomized, sham-controlled, double-blind trial was undertaken in 300 adults with refractory chronic rhinosinusitis with NPs (CRSwNP), who were candidates for repeat surgery...
January 19, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29346507/activity-and-safety-of-afatinib-in-a-window-pre-operative-eortc-study-in-patients-with-squamous-cell-carcinoma-of-the-head-and-neck-scchn
#4
J P Machiels, P Bossi, J Menis, M Lia, C Fortpied, Y Liu, R Lhommel, M Lemort, S Schmitz, S Canevari, L De Cecco, M Guzzo, R Bianchi, P Quattrone, F Crippa, T Duprez, Y Lalami, M Quiriny, N de Saint Aubain, P M Clement, R Coropciuc, E Hauben, L F Licitra
Background: To investigate the activity and safety of afatinib in the pre-operative treatment of squamous cell carcinoma of the head and neck (SCCHN). Patients and methods: This study was an open-label, randomized, multicenter, phase II window of opportunity trial. Treatment-naïve SCCHN patients selected for primary curative surgery were randomized (5:1 ratio) to receive afatinib during 14 days (day -15 until day -1) before surgery (day 0) or no treatment. Tumor biopsies, 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and magnetic resonance imaging (MRI) were performed at diagnosis and just before surgery...
January 15, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29346042/treatment-of-malignant-pleural-mesothelioma-american-society-of-clinical-oncology-clinical-practice-guideline
#5
Hedy L Kindler, Nofisat Ismaila, Samuel G Armato, Raphael Bueno, Mary Hesdorffer, Thierry Jahan, Clyde Michael Jones, Markku Miettinen, Harvey Pass, Andreas Rimner, Valerie Rusch, Daniel Sterman, Anish Thomas, Raffit Hassan
Purpose To provide evidence-based recommendations to practicing physicians and others on the management of malignant pleural mesothelioma. Methods ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, pathology, imaging, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1990 through 2017. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life...
January 18, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29345011/effectiveness-of-a-patient-education-plan-on-knowledge-ofpost-op-venous-thromboembolism-survival-skills
#6
Julie Green, Esther I Bernhofer
AIMS AND OBJECTIVES: To investigate the effectiveness of a multi-method venous thromboembolism prevention patient education plan on participants' knowledge retention. BACKGROUND: A potential complication of surgery requiring general anesthesia, worldwide, is the development of life-threatening venous thromboembolism. Patients need education on preventing, recognizing, and immediately responding to a suspected thromboembolism. Written instructional materials given to patients at discharge may be inadequate...
January 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29344905/management-of-nfas-medical-treatment
#7
REVIEW
Naomi Even-Zohar, Yona Greenman
INTRODUCTION: Non-functioning pituitary adenomas (NFPAs) are in general large tumors that present with symptoms secondary to local pressure on adjacent structures. Transsphenoidal surgery is the first line of treatment but residual tumor mass is often detected post-operatively. Medical therapy, in any stage of tumor management, is not well established. METHODS: A literature search was performed to review the available data on medical treatment of NFPAs. RESULTS: Medications investigated for the treatment of NFPAs include dopamine receptor agonists (DA) and somatostatin receptor ligands...
January 17, 2018: Pituitary
https://www.readbyqxmd.com/read/29343930/yoga-based-postoperative-cardiac-rehabilitation-program-for-improving-quality-of-life-and-stress-levels-fifth-year-follow-up-through-a-randomized-controlled-trial
#8
Eraballi Amaravathi, Nagendra Hongasandra Ramarao, Nagarathna Raghuram, Balaram Pradhan
Objectives: This study was aimed to assess the efficacy of yoga-based lifestyle program (YLSP) in improving quality of life (QOL) and stress levels in patients after 5 years of coronary artery bypass graft (CABG). Methodology: Three hundred patients posted for elective CABG in Narayana Hrudayalaya Super Speciality Hospital, Bengaluru, were randomized into two groups: YLSP and conventional lifestyle program (CLSP), and follow-up was done for 5 years. Intervention: In YLSP group, all practices of integrative approach of yoga therapy such as yama, niyama, asana, pranayama, and meditation were used as an add-on to conventional cardiac rehabilitation...
January 2018: International Journal of Yoga
https://www.readbyqxmd.com/read/29343448/optimizing-the-dose-of-local-infiltration-analgesia-and-gabapentin-for-total-knee-arthroplasty-a-randomized-single-blind-trial-in-128-patients
#9
Maurik H M van Haagen, Hennie Verburg, Brechtje Hesseling, Lauri Coors, Nick T van Dasselaar, Pim N J Langendijk, Nina M C Mathijssen
BACKGROUND AND PURPOSE: Effective analgesia is essential for postoperative recovery and rehabilitation in TKA. The challenge of analgesic regimes is to obtain adequate pain relief and maximum muscle control to mobilize and rehabilitate patients early. However, the optimal dose and best composition are not known. We hypothesized that there would be no differences in reported postoperative pain on the day of the TKA surgery as well as the first day after surgery when different combinations of ropivacain for LIA and gabapentin are given...
January 14, 2018: Knee
https://www.readbyqxmd.com/read/29343248/minimally-invasive-versus-open-transforaminal-lumbar-interbody-fusion-in-obese-patients-a-meta-analysis
#10
Qingsong Xie, Jing Zhang, Feng Lu, Hao Wu, Zan Chen, Fengzeng Jian
BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) has been employed in increasing cases compared with open TLIF (Open-TLIF). However, it is uncertain whether the advantages of MI-TLIF can also be specifically applied in obese patients. Therefore, the current study was thereby carried out aiming to compare the outcomes of MI-TLIF with those of Open-TLIF in obese patients with lumbar degenerative diseases. METHODS: Electronic databases were systemically retrieved from construction to May 2017...
January 17, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29343048/physiology-intervention-and-outcome-three-critical-questions-about-cerebral-tissue-oxygen-saturation-monitoring
#11
Lingzhong Meng, Shaun E Gruenbaum, Feng Dai, Tianlong Wang
The balance between cerebral tissue oxygen consumption and supply can be continuously assessed by cerebral tissue oxygen saturation (SctO2) monitor. A construct consisting of three sequential questions, targeting the physiology monitored, the intervention implemented, and the outcomes affected, is proposed to critically appraise this monitor. The impact of the SctO2- guided care on patient outcome was examined through a systematic literature search and meta- analysis. We concluded that the physiology monitored by SctO2 is robust and dynamic, fragile (prone to derangement), and adversely consequential when deranged...
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29342060/creep-and-wear-in-vitamin-e-infused-highly-cross-linked-polyethylene-cups-for-total-hip-arthroplasty-a-prospective-randomized-controlled-trial
#12
G Rochcongar, G Buia, E Bourroux, J Dunet, V Chapus, C Hulet
BACKGROUND: Aseptic loosening, the most common indication for revision surgery in total hip arthroplasty, can result from osteolysis caused by polyethylene (PE) wear particles. PE wear is increased by age-related oxidation of PE and free radicals emerging during irradiation cross-linking. Diffusion of vitamin E into PE stabilizes free radicals to maintain the biomechanical properties of PE. The purpose of this study was to determine whether vitamin E-infused highly cross-linked PE cups could reduce wear rates...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#13
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29340826/single-port-laparoscopic-surgery-in-uncomplicated-acute-appendicitis-a-randomized-controlled-trial
#14
Byung Mo Kang, Sung Il Choi, Bum-Soo Kim, Suk-Hwan Lee
BACKGROUND: Single-port laparoscopic surgery (SPLS) is an alternative, minimally invasive surgical approach for managing appendicitis. The aim of this randomized trial was to evaluate the safety and efficacy of SPLS in uncomplicated appendicitis. METHODS: Between December 2009 and November 2010, 194 patients with radiologically diagnosed acute appendicitis were randomly allocated to undergo either SPLS or multiport laparoscopic surgery (MPLS). Patients with intraoperative findings of perforated appendicitis were excluded from the analysis...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340825/laparoscopic-surgery-in-colon-cancer-patients-treated-with-chronic-anti-thrombotic-therapy
#15
Hiroaki Nozawa, Takahide Shinagawa, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Kazuhito Sasaki, Manabu Kaneko, Shigenobu Emoto, Koji Murono
BACKGROUND: Anti-thrombotic medications are commonly used for the treatment and prevention of cardiovascular diseases. Laparoscopic resection of colon cancer has generally been accepted with favorable outcomes being reported in randomized control trials. However, the safety and efficacy of laparoscopic surgery for colon cancer patients receiving chronic anti-thrombotic therapy (AT) remain unclear. METHODS: We identified 951 patients who underwent elective resection for colon cancer between 2009 and 2016 from our database...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340678/lifestyle-intervention-and-medical-management-with-vs-without-roux-en-y-gastric-bypass-and-control-of-hemoglobin-a1c-ldl-cholesterol-and-systolic-blood-pressure-at-5-years-in-the-diabetes-surgery-study
#16
COMMENT
Sayeed Ikramuddin, Judith Korner, Wei-Jei Lee, Avis J Thomas, John E Connett, John P Bantle, Daniel B Leslie, Qi Wang, William B Inabnet, Robert W Jeffery, Keong Chong, Lee-Ming Chuang, Michael D Jensen, Adrian Vella, Leaque Ahmed, Kumar Belani, Charles J Billington
Importance: The Roux-en-Y gastric bypass is effective in achieving established diabetes treatment targets, but durability is unknown. Objective: To compare durability of Roux-en-Y gastric bypass added to intensive lifestyle and medical management in achieving diabetes control targets. Design, Setting, and Participants: Observational follow-up of a randomized clinical trial at 4 sites in the United States and Taiwan, involving 120 participants who had a hemoglobin A1c (HbA1c) level of 8...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29339351/high-target-vs-low-target-blood-pressure-management-during-cardiopulmonary-bypass-to-prevent-cerebral-injury-in-cardiac-surgery-patients-a-randomized-controlled-trial
#17
Anne G Vedel, Frederik Holmgaard, Lars S Rasmussen, Annika Langkilde, Olaf B Paulson, Theis Lange, Carsten Thomsen, Peter Skov Olsen, Hanne Berg Ravn, Jens C Nilsson
Background -Cerebral injury is an important complication following cardiac surgery with the use of cardiopulmonary bypass (CPB). The rate of overt stroke after cardiac surgery is 1-2%, whereas silent strokes, detected by diffusion-weighed magnetic resonance imaging (DWI), are found in up to 50% of patients. It is unclear if a higher versus a lower blood pressure during cardiopulmonary bypass reduces cerebral infarction in these patients. Methods -In a patient- and assessor-blinded randomized trial, we allocated patients to a higher (70-80 mmHg) or lower (40-50 mmHg) target for mean arterial pressure by the titration of norepinephrine during cardiopulmonary bypass...
January 16, 2018: Circulation
https://www.readbyqxmd.com/read/29339230/balanced-crystalloids-vs-0-9-saline-for-adult-patients-undergoing-non-renal-surgery-a-meta-analysis
#18
REVIEW
Lili Huang, Xiaoshuang Zhou, Hai Yu
BACKGROUND: Fluid maintenance and resuscitation is an important strategy during major surgeries. There has been a debate on the choice of crystalloids over the past decades. 0.9% saline (normal saline) is more likely to cause hyperchloremic acidosis when compared to balanced crystalloids with low chloride content. Meta-analyses comparing these two kinds of crystalloids have been performed in renal transplantations. We aim to compare the safety of balanced crystalloids to normal saline among adult patients undergoing non-renal surgery...
January 12, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29338862/new-generation-stents-compared-with-coronary-bypass-surgery-for-unprotected-left-main-disease-a-word-of-caution
#19
Umberto Benedetto, David P Taggart, Miguel Sousa-Uva, Giuseppe Biondi-Zoccai, Antonino Di Franco, Lucas B Ohmes, Mohamed Rahouma, Mohamed Kamel, Massimo Caputo, Leonard N Girardi, Gianni D Angelini, Mario Gaudino
BACKGROUND: With the advent of bare metal stents and drug-eluting stents, percutaneous coronary intervention has emerged as an alternative to coronary artery bypass grafting surgery for unprotected left main disease. However, whether the evolution of stents technology has translated into better results after percutaneous coronary intervention remains unclear. We aimed to compare coronary artery bypass grafting with stents of different generations for left main disease by performing a Bayesian network meta-analysis of available randomized controlled trials...
January 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29338151/oral-prolonged-release-oxycodone-naloxone-offers-equivalent-analgesia-to-intravenous-morphine-patient-controlled-analgesia-after-total-knee-replacement-a-randomized-controlled-trial
#20
Alberto Manassero, Andrea Fanelli, Susanna Ugues, Cristian Bailo, Stefano Dalmasso
BACKGROUND: The purpose of this study was to determine whether oral prolonged- release oxycodone-naloxone combination (OXN) could provide equivalent analgesia and a side-effect profile similar to intravenous morphine patient-controlled analgesia (IVPCA) for the control of pain in the immediate postoperative period after total knee replacement (TKR). METHODS: All patients received a sciatic nerve block with 0.3% ropivacaine 15ml, femoral nerve block with 0.5% ropivacaine 20 ml, spinal anesthesia and postoperative continuous femoral nerve infusion (ropivacaine 0...
January 16, 2018: Minerva Anestesiologica
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