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https://www.readbyqxmd.com/read/29166425/anatomy-of-the-sphenopalatine-artery-and-its-implications-for-transnasal-neurosurgery
#1
M Eordogh, A Grimm, I Gawish, L Patonay, R Reisch, H R Briner, G Baksa
BACKGROUND: The knowledge of sinonasal vasculature is inevitable in transnasal neurosurgery. We performed an anatomical study on the sphenopalatine artery from the perspective of skull base procedures. METHODOLOGY: To analyse the anatomical landmarks of the sphenopalatine artery, arterial skull corrosion casts (26 head halves) underwent endoscopic transnasal phantom surgery. Furthermore, we performed microsurgical dissection on formaldehyde-fixated cadavers with arterial perfusion (14 head halves) as well as studied Cone Beam CT-scans of anonymised patients and cadavers (115 head sides)...
November 22, 2017: Rhinology
https://www.readbyqxmd.com/read/29166362/neutrophil-to-lymphocyte-ratio-predicts-the-severity-of-incarcerated-groin-hernia
#2
Xingming Xie, Shu Feng, Zhongling Tang, Longyu Chen, Yongsheng Huang, Xianzhi Yang
BACKGROUND The incarceration of a segment of bowel within a groin hernia can result in intestinal strangulation if hernia treatment is delayed. Once intestinal strangulation occurs, a bowel resection may be required, and there is an overall increased risk for postoperative complications. The aim of this study was to identify biomarkers to predict the severity of an incarcerated groin hernia. MATERIAL AND METHODS We retrospectively evaluated the records of 95 patients with incarcerated groin hernias who underwent emergency surgical correction of the hernias...
November 22, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29165775/re-operative-abdominal-predictive-score-a-prognostic-model-combining-acute-re-intervention-predictive-index-and-intra-abdominal-pressure
#3
Caridad de Dios Soler-Morejón, Tomás Ariel Lombardo-Vaillant, Teddy Osmín Tamargo-Barbeito, Robert Wise, Manu L N G Malbrain
BACKGROUND: The decision to re-operate after abdominal surgery is still difficult, especially in the setting of intra-abdominal sepsis. Mathematical models provide a good aid to both diagnosis and decision-making. METHODS: A prospective observational study was conducted with 300 patients consecutively admitted to the intensive care unit of an academic institution affiliated to Calixto García Medical Faculty following abdominal surgery from January 2008 to January 2010...
November 22, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29165773/laparoscopic-surgery-treatment-of-children-with-appendiceal-abscess
#4
Y-Y Yin, H-W Zhang, H Cao, H-X Zou, B-B Zhuo, Y Li, X Zhang
OBJECTIVE: To evaluate the feasibility of treatment for children with appendiceal abscess by laparoscopic surgery and investigate its superiorities to conventional treatments. PATIENTS AND METHODS: 45 children with appendiceal abscess who were treated with laparoscopic surgery from January 2011 to July 2011 were reviewed and analyzed. The age of children ranged from 7 months to 5 years. 37 children received emergency operations, among which 8 children additionally received laparoscopic surgery...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29165437/endolymphatic-sac-tumour-in-von-hippel-lindau-disease-management-strategies
#5
E Zanoletti, L Girasoli, D Borsetto, G Opocher, A Mazzoni, A Martini
Endolymphatic sac tumour (ELST) is infrequent, as emerges from small series reported in the literature. It is a slow-growing malignancy with local aggressiveness and a low risk of distant metastases. It is often misdiagnosed because of the late onset of symptoms and difficulty in obtaining a biopsy. Its frequency is higher in von Hippel-Lindau (VHL) disease (a genetic systemic syndrome involving multiple tumours), with a prevalence of around 25%. The diagnosis is based on radiology, with specific patterns on contrast-enhanced MRI and typical petrous bone erosion on bone CT scan...
October 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29164804/biomaterials-and-advanced-technologies-for-hemostatic-management-of-bleeding
#6
REVIEW
DaShawn A Hickman, Christa L Pawlowski, Ujjal D S Sekhon, Joyann Marks, Anirban Sen Gupta
Bleeding complications arising from trauma, surgery, and as congenital, disease-associated, or drug-induced blood disorders can cause significant morbidities and mortalities in civilian and military populations. Therefore, stoppage of bleeding (hemostasis) is of paramount clinical significance in prophylactic, surgical, and emergency scenarios. For externally accessible injuries, a variety of natural and synthetic biomaterials have undergone robust research, leading to hemostatic technologies including glues, bandages, tamponades, tourniquets, dressings, and procoagulant powders...
November 22, 2017: Advanced Materials
https://www.readbyqxmd.com/read/29164328/metallosis-after-traumatic-loosening-of-bryan-cervical-disc-arthroplasty-a-case-report-and-literature-review
#7
Chih-Chan Yang, Chien-Lun Tang, Chung-Yuh Tzeng, Hsi-Kai Tsou
PURPOSE: Cervical disc arthroplasty has been a popular alternative to traditional arthrodesis treatment for maintaining postoperative cervical spine mobility. However, certain adverse reactions to cervical disc arthroplasty have emerged during the last few decades. METHODS: Metallosis or metalloma is a rarely reported complication after spinal fusion or spinal arthroplasty surgery. We report on the first metallosis case occurring in a patient who received Bryan Disc implantation approximately 8 years earlier...
November 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29164308/endovascular-repair-of-40-visceral-artery-aneurysms-and-pseudoaneurysms-with-the-viabahn-stent-graft-technical-aspects-clinical-outcome-and-mid-term-patency
#8
Massimo Venturini, Paolo Marra, Michele Colombo, Marta Panzeri, Simone Gusmini, Claudio Sallemi, Marco Salvioni, Carolina Lanza, Giulia Agostini, Gianpaolo Balzano, Yamume Tshomba, Germano Melissano, Massimo Falconi, Roberto Chiesa, Francesco De Cobelli, Alessandro Del Maschio
PURPOSE: Endovascular repair of true visceral artery aneurysms (VAAs) and pseudoaneurysms (VAPAs) with stent-grafting (SG) can simultaneously allow aneurysm exclusion and vessel preservation, minimizing the risk of ischemic complications. Our aim was to report a single-center experience on SG of visceral aneurysms, focusing on technical aspects, clinical outcome and mid-term patency. MATERIALS AND METHODS: Consecutive patients affected by VAAs-VAPAs and submitted to endovascular treatment were retrospectively reviewed, and SG cases with the self-expandable peripheral Viabahn stent-graft were analyzed (2003-2017)...
November 21, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29164078/internal-hernia-masquerading-as-necrotizing-enterocolitis
#9
Ranjit I Kylat
In extremely preterm infants, acute abdominal emergencies are fortunately less common with improving care. Spontaneous intestinal perforation and necrotizing enterocolitis are conditions where emergency surgery is most often needed. Conservative medical management and placement of temporary drain are often used in the initial management. Internal hernia (IH) is an uncommon cause of bowel obstruction in neonates, is difficult to diagnose and unfortunately are found only at autopsy. The presentation in preterm infants, distinction between these conditions, and the need for early diagnosis of IH are discussed...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29162045/serial-pseudoprogression-of-metastatic-malignant-melanoma-in-a-patient-treated-with-nivolumab-a-case-report
#10
Yukinori Ozaki, Junichi Shindoh, Yuji Miura, Hiromichi Nakajima, Ryosuke Oki, Miyuki Uchiyama, Jun Masuda, Keiichi Kinowaki, Chihiro Kondoh, Yuko Tanabe, Tsuyoshi Tanaka, Shusuke Haruta, Masaki Ueno, Shigehisa Kitano, Takeshi Fujii, Harushi Udagawa, Toshimi Takano
BACKGROUND: Pseudoprogression refers to a specific pattern of response sometimes observed in malignant melanoma patients receiving treatment with immune-checkpoint inhibitors. Although cases with pseudoprogression documented once have been reported previously, there have been no case reports yet of pseudoprogression events documented twice during treatment. CASE PRESENTATION: A 55-year-old man underwent surgery for locally advanced esophageal malignant melanoma and received postoperative adjuvant interferon therapy...
November 21, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29161397/abdominal-aortic-aneurysm-repair-in-the-united-kingdom-an-exemplar-for-the-role-of-anaesthetists-in-perioperative-medicine
#11
S J Howell
The past two decades have seen an increasing recognition that the delivery of safe surgery with low complication rates and good long-term outcomes is a team endeavour embracing the whole patient care pathway. The key role of the anaesthetist in managing the patient through the surgical process is widely understood and has driven the emergence of perioperative medicine. In parallel with these developments there has been a sea change in the organisation of the care of patients presenting for elective abdominal aortic aneurysm (AAA) repair...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161390/thiopental-to-desflurane-an-anaesthetic-journey-where-are-we-going-next
#12
J R Sneyd
Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug effect were prioritised. Today's anaesthetists have access to a library of effective drugs whose characteristics offer controllable hypnosis, analgesia and paralysis with manageable off-target effects. The availability of these agents at generic prices inhibits commercial interest and this is reflected in the limited number of current anaesthetic drug development projects...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29160777/motion-compensation-with-skin-contact-control-for-high-intensity-focused-ultrasound-surgery-in-moving-organs
#13
Alessandro Diodato, Andrea Cafarelli, Andrea Schiappacasse, Selene Tognarelli, Gastone C Ciuti, Arianna Menciassi
High Intensity Focused Ultrasound (HIFU) is an emerging therapeutic solution that enables non-invasive treatment of several pathologies, mainly in oncology. On the other hand, accurate targeting of moving abdominal organs (e.g., liver, kidney, pancreas) is still an open challenge. This paper proposes a novel method to compensate the physiological respiratory motion of organs during HIFU procedures, by exploiting a robotic platform for ultrasound-guided HIFU surgery provided with a therapeutic annular phased array transducer...
November 21, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29160136/utility-of-bulging-technique-for-endovascular-treatment-of-small-and-wide-necked-aneurysms-with-a-low-profile-visualized-intraluminal-support-lvis-jr-device-a-case-report-and-review-of-the-literature
#14
Akihiro Inoue, Masahiko Tagawa, Shirabe Matsumoto, Masahiro Nishikawa, Kosuke Kusakabe, Hideaki Watanabe, Takeharu Kunieda
Small and broad-necked aneurysms are generally very difficult to treat using endovascular therapy. The arrival of the low-profile stent (e.g., Low-profile Visualized Intraluminal Support; LVIS) has enabled reconstructive treatment for these aneurysms. In addition, the bulging technique using LVIS is an effective and attractive technique for performing stent-assisted coiling to preserve parent arteries and achieve neck coverage. We report here a patient with a small and wide-necked ruptured basilar artery (BA) top aneurysm, in whom successful treatment was achieved by stent-assisted coiling with LVIS Jr...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29159605/outcomes-of-emergency-laparotomy-el-care-protocol-at-tertiary-care-center-from-low-middle-income-country-lmic
#15
Nitin Vashistha, Dinesh Singhal, Sandeep Budhiraja, Bharat Aggarwal, Raj Tobin, Kamal Fotedar
BACKGROUND: Emergency laparotomy mortality ranges between 10 and 20% in best of Western healthcare systems and is currently a major focus for quality improvement programs. In contrast, emergency surgery scenario in LMIC is largely undefined, often neglected and complex (large burden of diseases but only limited capacity for adequate treatment). We evaluated the efficacy of 'EL care protocol' aimed at cost-effective optimal utilization of best available local expertise and infrastructure...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29158923/diffuse-subcutaneous-emphysema-pneumomediastinum-and-pneumothorax-following-robotic-assisted-laparoscopic-hysterectomy
#16
Laryssa Patti, William Haussner, Grant Wei
Robotic assisted laparoscopic surgery is becoming more widely available, but despite its multiple benefits, it is not without risk. This case is of a 62-year-old female who presented to the emergency department for dyspnea two days after robotic assisted laparoscopic hysterectomy. Physical exam revealed diffuse facial, neck, upper extremity, torso, and lower extremity crepitus, which was diagnosed as diffuse subcutaneous air on computed tomography (CT). Imaging also revealed right apical pneumothorax and pneumomediastinum...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29157798/euglycemic-diabetic-ketoacidosis-secondary-to-dapagliflozin-use-a-case-report
#17
Felicity Brown, Tamara McColl
BACKGROUND: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a novel class of oral antihyperglycemic agents. They are associated with rare cases of euglycemic diabetic ketoacidosis (DKA), which presents a diagnostic challenge in the emergency department (ED) and potentially severe consequences if missed. CASE REPORT: A 53-year-old man with type 2 diabetes mellitus and a recent Roux-en-Y gastric bypass surgery presented to the ED with nausea, vomiting, and generalized abdominal pain...
November 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29157787/a-consultation-phone-service-for-patients-with-total-joint-arthroplasty-may-reduce-unnecessary-emergency-department-visits
#18
Eerik Hällfors, Sami A Saku, Tatu J Mäkinen, Rami Madanat
BACKGROUND: Different measures for reducing costs after total joint arthroplasty (TJA) have gained attention lately. At our institution, a free-of-charge consultation phone service was initiated that targeted patients with TJA. This service aimed at reducing unnecessary emergency department (ED) visits and, thus, potentially improving the cost-effectiveness of TJAs. To our knowledge, a similar consultation service had not been described previously. We aimed at examining the rates and reasons for early postdischarge phone calls and evaluating the efficacy of this consultation service...
October 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29156629/reconstruction-of-craniomaxillofacial-bone-defects-using-tissue-engineering-strategies-with-injectable-and-non-injectable-scaffolds
#19
REVIEW
Bipin Gaihre, Suren Uswatta, Ambalangodage C Jayasuriya
Engineering craniofacial bone tissues is challenging due to their complex structures. Current standard autografts and allografts have many drawbacks for craniofacial bone tissue reconstruction; including donor site morbidity and the ability to reinstate the aesthetic characteristics of the host tissue. To overcome these problems; tissue engineering and regenerative medicine strategies have been developed as a potential way to reconstruct damaged bone tissue. Different types of new biomaterials; including natural polymers; synthetic polymers and bioceramics; have emerged to treat these damaged craniofacial bone tissues in the form of injectable and non-injectable scaffolds; which are examined in this review...
November 20, 2017: Journal of Functional Biomaterials
https://www.readbyqxmd.com/read/29156016/pectus-excavatum-repair-after-sternotomy-the-chest-wall-international-group-experience-with-substernal-nuss-bars
#20
Dawn E Jaroszewski, Paul J Gustin, Frank-Martin Haecker, Hans Pilegaard, Hyung Joo Park, Shao-Tao Tang, Shuai Li, Li Yang, Sadashige Uemura, Jose Ribas Milanez De Campos, Robert Obermeyer, Frazier W Frantz, Michele Torre, Lisa McMahon, Andre Hebra, Chih-Chun Chu, J Duncan Phillips, David M Notrica, Antonio Messineo, Robert Kelly, Mustafa Yüksel
OBJECTIVES: Patients with pectus excavatum (PE) after prior sternotomy for cardiac surgery present unique challenges for repair of PE. Open repairs have been recommended because of concerns about sternal adhesions and cardiac injury. We report a multi-institutional experience with repair utilizing substernal Nuss bars in this patient population. METHODS: Surgeons from the Chest Wall International Group were queried for experience and retrospective data on PE repair using sub-sternal Nuss bars in patients with a history of median sternotomy for cardiac surgery (November 2000 to August 2015)...
October 1, 2017: European Journal of Cardio-thoracic Surgery
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