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Remote surgery

Sylvie Breton, Dennis Brown
BACKGROUND: Serious and often fatal acute kidney injury (AKI) is frequently seen after major surgery, local and remote organ damage, and sepsis. It is associated with uncontrolled inflammation, and is usually diagnosed only after the kidneys have gone through significant and often irreversible damage. SUMMARY: During our work involving another type of kidney disease that leads to acid-base disorders of the blood, we unexpectedly found high levels of a protein called the P2Y14 "purinergic" receptor, in specialized kidney epithelial cells called intercalated cells (ICs)...
2018: Annals of Nutrition & Metabolism
D F Beloiartsev, O L Talybly
BACKGROUND: It is known that namely long-term presence of suture material as the only foreign body in autologous conditions may lead to restenosis in the remote period. Such hypothesis was put forward based on good results of reconstructive cardiovascular operations in case of using absorbable suture material. OBJECTIVE: Our study was aimed at comparative analysis of remote results of using absorbable suture material polydioxanone and non-absorbable suture material polypropylene in eversion carotid endarterectomy...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
K A Kuznetsov, M V Khar'kova, A A Karpenko, P P Laktionov
Using stents for endovascular restoration of blood flow made a revolution in vascular surgery, however, despite numerous variants of stents presented on the pharmacological market, there are no stents which would completely solve the problem of restenosis in the area of stent placement. In order to decrease growth of the neointima of the stented portions of vessels, stents coated with cytostatic and cytotoxic agents were worked out. To optimize the rate of drug release it was suggested to apply them in a mixture with biodegradable or biostable polymers...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Loren S Schechter, Bauback Safa
Phalloplasty represents the most complete genitoperineal transformation. Because it requires complex, staged procedures as well as the use of tissue from remote sites, patients must be well informed as to the nature of surgery. Surgical techniques for phalloplasty continue to evolve. Although many surgeons prefer the radial forearm free flap technique, a visible flap donor site makes this procedure less desirable for some patients. Other surgical options are available and include the anterolateral thigh flap, sometimes in conjunction with secondary flaps, and the musculocutaneous latissimus dorsi flap...
July 2018: Clinics in Plastic Surgery
Cecile A Ferrando
Complications after vaginoplasty surgery for the transgender woman exist. These adverse outcomes can be minor and easily treatable, whereas others are considered major events and require ongoing care. Adverse outcomes can be immediate or remote after surgery and include bleeding, hematoma, infection, delayed wound healing, neovaginal stenosis, visceral injury, and fistula. Patients may also experience pelvic floor disorders after surgery. Providers performing these surgeries and those providers caring for postoperative patients should be aware of the incidence of these complications and the treatment options that exist to manage them...
July 2018: Clinics in Plastic Surgery
Kendall R McEachron, Melena D Bellin
PURPOSE OF REVIEW: We reviewed the current state of total pancreatectomy with islet autotransplantation (TPIAT) for chronic pancreatitis and recurrent acute pancreatitis (RAP). RECENT FINDINGS: An increasing number of centers in the United States and internationally are performing TPIAT. In selected cases, TPIAT may be performed partially or entirely laparoscopically. Islet isolation is usually performed at the same center as the total pancreatectomy surgery, but new data suggest that diabetes outcomes may be nearly as good when a remote center is used for islet isolation...
June 8, 2018: Current Opinion in Gastroenterology
Timothy L Miao, Holger Joswig, Sachin K Pandey, Andrew G Parrent
Intradiploic cerebrospinal fluid cysts are rare entities which have been reported to occur following trauma and surgery. We present a case of an incidental intradipoloic cerebrospinal fluid cyst in communication with a Dandy-Walker malformation likely related to a remote history of childhood surgery for occipital encephalocele.
June 8, 2018: World Neurosurgery
Paul S Pagel, George J Crystal
No abstract text is available yet for this article.
June 5, 2018: Anesthesia and Analgesia
Carol C Hasler
Early-onset scoliosis (EOS) describes a wide array of diagnoses and deformities exposed to growth. This potentially life-threatening condition is still 1 of the biggest challenges in pediatric orthopaedics. The enlightenment of Bob Campbell's thoracic insufficiency syndrome concept and the negative impact of the earlier short and straight spine fusion approach on respiratory function and survival have fueled the evolution of EOS care. Despite all the progress made, growth-friendly spine surgery remains to be a burden to patients and caregivers...
July 2018: Journal of Pediatric Orthopedics
Florent Femy, Arnaud Follin, Philippe Juvin, Anne-Laure Feral-Pierssens
OBJECTIVE: On 13 November 2015, Paris was the target of multiple terrorist attacks responsible for a massive influx of casualties in emergency departments (EDs). Because of the activation of a local crisis plan and the arrival of extra staff, our capacities increased markedly. Our aim was to analyze whether our center, in this challenging context, efficiently managed this massive influx of patients. PATIENTS AND METHODS: We carried out a monocentric retrospective study...
June 5, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Geng Zhou, Ming Hua Li, Gabriel Tudor, Hai Tao Lu, Ramanathan Kadirvel, David Kallmes
Cerebral ischemia and stroke are increasing in prevalence and are among the leading causes of morbidity and mortality in both developed and developing countries. Despite the progress in endovascular treatment, ischemia/reperfusion (IR) injury is an important contributor to post-surgical mortality and morbidity affecting a wide range of neurointerventional procedures. However, pharmacological recruitment of effective cerebral protective signaling has been largely disappointing to date. In remote ischemic conditioning (RIC), repetitive transient mechanical obstruction of vessels at a limb remote from the IR injury site protects vital organs from IR injury and confers infarction size reduction following prolonged arterial occlusion...
2018: Frontiers in Neurology
Soila Järvenpää, Eija Rosti-Otajärvi, Sirpa Rainesalo, Linda Laukkanen, Kai Lehtimäki, Jukka Peltola
Background: Deep brain stimulation (DBS) of the anterior nucleus of thalamus (ANT) is an emerging treatment option for patients suffering from refractory epilepsy. ANT has extensive connections with hippocampus and retrosplenial cingulum, areas associated mainly with spatial memory and with anterior cingulum which is important in executive functions. As refractory epilepsy is often associated with cognitive decline and neuronal damage, the decreased connectivity between ANT and remote structures might impact on the effects of DBS...
2018: Frontiers in Neurology
Marina V Basalay, Sean M Davidson, Andrey V Gourine, Derek M Yellon
Remote ischaemic conditioning (RIC) is a promising method of cardioprotection, with numerous clinical studies having demonstrated its ability to reduce myocardial infarct size and improve prognosis. On the other hand, there are several clinical trials, in particular those conducted in the setting of elective cardiac surgery, that have failed to show any benefit of RIC. These contradictory data indicate that there is insufficient understanding of the mechanisms underlying RIC. RIC is now known to signal indiscriminately, protecting not only the heart, but also other organs...
June 1, 2018: Basic Research in Cardiology
Vianney Behaghel, Sophie Tamareille, Marion Rabant, Delphine Mirebeau-Prunier, Loïc Bière, Laurent Macchi, Fabrice Prunier
Ischemia-reperfusion (I/R) injury is a leading cause of acute renal dysfunction. Remote ischemic conditioning (rIC) is known to protect organs exposed to I/R. We sought to investigate whether rIC would influence renal function recovery in a severe renal I/R injury rat model. Rats were randomly assigned to four experimental groups following median laparotomy and right nephrectomy: Sham (n = 6); 30-min left renal ischemia (RI) only (n = 20); RI+rIC (n = 20) (four 5-min cycles of limb ischemia interspersed with 5-min limb reperfusion during RI); RI+erythropoietin pre-treatment (EPO) (n = 20)...
May 24, 2018: Shock
Rohan Bhimani, Fardeen Bhimani, Preeti Singh
Introduction: Intracranial hypotension may occur when CSF leaks from the subarachnoid space. Formation of intracranial, subdural, and subarachnoid hemorrhage has been observed after significant CSF leak as seen in lumbar puncture or ventricular shunt placement. However, very few cases, referring to these remote complications following spine surgery, have been described in literature. We present a case of a 10-year-old male child operated for idiopathic scoliosis with low-lying conus medullaris who postoperatively developed subdural hemorrhage...
2018: Case Reports in Medicine
Torres Woolley, Tarun Sen Gupta, Sarah Larkins
OBJECTIVE: The James Cook University medical school's mission is to produce a workforce appropriate for the health needs of northern Australia. DESIGN, SETTING AND PARTICIPANTS: James Cook University medical graduate data were obtained via cross-sectional survey of 180 early-career James Cook University medical graduates from 2005-2011 (response rate of 180/298 contactable graduates = 60%). Australian medical practitioner data for 2005-2009 graduates were obtained via the 2015 'Medicine in Australia: Balancing Employment and Life' wave 8 dataset...
May 25, 2018: Australian Journal of Rural Health
Hai-Yan Chen, Shu-Mei Wei, Jie-Yu Chen, Xiu-Liang Zhu, Ri-Sheng Yu
INTRODUCTION: Ciliated retroperitoneal foregut cysts are rare, and to obtain a preoperative definitive diagnosis of this condition is relatively difficult. In addition, the exact mechanism and formation of ciliated retroperitoneal foregut cysts remains unknown. CASE PRESENTATION: Here, we report a case of a 47-year-old woman who presented with an unusual shaped cystic lesion associated with a patch of solid components between the pancreas and the left kidney, initially misdiagnosed as a cystic pancreatic lesion 5 years previously to presentation at our clinic...
May 2018: Medicine (Baltimore)
Taylor Wapshott, Christine M G Schammel, David P Schammel, Luminita Rezeanu, Michael Lynn
BACKGROUND AND IMPORTANCE: Sarcomas make up 1% of all cases of adult cancer, with 5-10% of those classified as undifferentiated pleomorphic sarcomas (UPS/PUS) and 0.1-4.3% primary intracranial sarcomas. Intracranial undifferentiated sarcoma is characterized by an earlier age of onset and generally poorer prognosis compared to extracranial undifferentiated sarcomas. Current therapies involve surgical excision with wide margins and radiotherapy, with minimal data available regarding the efficacy of chemotherapy...
May 21, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hideaki Matsumura, Eiichi Ishikawa, Masahide Matsuda, Noriaki Sakamoto, Hiroyoshi Akutsu, Shingo Takano, Akira Matsumura
A 43-year-old man was operated on for right frontal oligoastrocytoma. 14 years after the surgery, magnetic resonance imaging and positron emission tomography revealed a new lesion near the surgical cavity. He underwent gross total resection of the lesion and implantation of bis-chloroethylnitrosourea (BCNU) wafers after intraoperative pathological diagnosis of recurrent high-grade glioma. A few days after the operation, the level of consciousness gradually worsened and left hemiparesis developed. A computed tomography scan revealed a cyst remote to the surgical cavity which did not exist 3 days prior...
May 21, 2018: Neurologia Medico-chirurgica
Jessica Rauh, Alexander Klein, Andrea Baur-Melnyk, Thomas Knösel, Lars Lindner, Falk Roeder, Volkmar Jansson, Hans Roland Dürr
BACKGROUND: Atypical lipomatous tumours (ALT) are common adipocytic tumours. Due to their large size and deep-seated location, wide resection might result in severe functional deficits. The question which margins should be aimed is hence discussed controversially. METHODS: Forty consecutive patients underwent limb-sparing resections. Margins were defined as R0 (wide resection), R1 (marginal resection) or R2 if tumour was left. All patients were followed for evidence of local recurrence or remote metastases...
May 17, 2018: BMC Musculoskeletal Disorders
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