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Trauma surgery

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https://www.readbyqxmd.com/read/29140953/contemporary-management-of-rectal-injuries-at-level-i-trauma-centers-the-results-of-an-american-association-for-the-surgery-of-trauma-multi-institutional-study
#1
Carlos V R Brown, Pedro G Teixeira, Elisa Furay, John P Sharpe, Tashinga Musonza, John Holcomb, Eric Bui, Brandon Bruns, H Andrew Hopper, Michael S Truitt, Clay C Burlew, Morgan Schellenberg, Jack Sava, John VanHorn, Brian Eastridge, Alicia M Cross, Richard Vasak, Gary Vercruysse, Eleanor E Curtis, James Haan, Raul Coimbra, Phillip Bohan, Stephen Gale, Peter G Bendix
INTRODUCTION: Rectal injuries have been historically treated with a combination of modalities including direct repair, resection, proximal diversion, presacral drainage, and distal rectal washout. We hypothesized that intraperitoneal rectal injuries may be selectively managed without diversion and the addition of distal rectal washout and pre-sacral drainage in the management of extraperitoneal injuries are not beneficial. METHODS: This is an American Association for the Surgery of Trauma multi-institutional retrospective study from 2004-2015 of all patients who sustained a traumatic rectal injury and were admitted to one of the 22 participating centers...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29140948/hypertonic-saline-resuscitation-following-emergent-laparotomy-and-temporary-abdominal-closure
#2
Tyler J Loftus, Philip A Efron, Trina M Bala, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Our objective was to establish the safety of 3% hypertonic saline (HTS) resuscitation for trauma and acute care surgery patients undergoing emergent laparotomy and temporary abdominal closure (TAC) with the hypothesis that HTS administration would be associated with hyperosmolar hypercholoremic acidosis, lower resuscitation volumes, and higher fascial closure rates, without adversely affecting renal function. METHODS: We performed a retrospective cohort analysis of 189 trauma and acute care surgery patients who underwent emergent laparotomy and TAC, comparing patients with normal baseline renal function who received 3% HTS at 30 mL/h (n=36) to patients with standard resuscitation (n=153) by baseline characteristics, resuscitation parameters, and outcomes including primary fascial closure and KDIGO stages of acute kidney injury...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29140905/gender-confirmation-surgery-using-the-pedicle-transverse-colon-flap-for-vaginal-reconstruction-a-clinical-outcome-and-sexual-function-evaluation-study
#3
Oscar J Manrique, M Diya Sabbagh, Pedro Ciudad, Jorys Martinez-Jorge, Kidakorn Kiranantawat, Ngamcherd Sitpahul, Todd B Nippoldt, Ali Charafeddine, Hung-Chi Chen
INTRODUCTION: Vaginal reconstruction and vaginoplasty are indicated in vaginal agenesis, following pelvic tumor resection, trauma and for gender confirmation surgery. Different surgical options have been described when using these techniques. Herein, we present the clinical outcomes and sexual function evaluation using the pedicle transverse colon flap (TCF) for gender confirmation surgery in transgender women. METHODS: This is a retrospective chart review of all transgender women who underwent gender confirmation surgery using the pedicle TCF...
November 11, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29140591/preventive-effects-of-tonsil-derived-mesenchymal-stem-cells-on-osteoradionecrosis-in-a-rat-model
#4
Hae Sang Park, Jihae Lee, Jin-Woo Kim, Ha Young Kim, Soo Yeon Jung, Sung Min Lee, Chan Hum Park, Han Su Kim
BACKGROUND: The purpose of this study was to investigate the effects of tonsil-derived mesenchymal stem cells (MSCs) on osteoradionecrosis (ORN). METHOD: We generated a mandibular ORN rat model using a combination of 20-Gy single-dose irradiation and tooth extraction. Study groups were negative control (tooth extraction only), ORN group (irradiation, tooth extraction), Matrigel-1 group (Matrigel; BD Biosciences, San Jose, CA; irradiation, Matrigel application immediately after tooth extraction), tonsil-derived MSC-1 group (irradiation, tonsil-derived MSC application immediately after tooth extraction), Matrigel-4 group (irradiation, Matrigel application 4 weeks after tooth extraction), and tonsil-derived MSC-4 group (irradiation, tonsil-derived MSC application 4 weeks after tooth extraction)...
November 15, 2017: Head & Neck
https://www.readbyqxmd.com/read/29140373/clinical-considerations-of-adapted-drilling-protocol-by-bone-quality-perception
#5
Marco Toia, Michele Stocchero, Francesca Cecchinato, Enrico Corrà, Ryo Jimbo, Denis Cecchinato
PURPOSE: To evaluate insertion torque value (ITV) and marginal bone loss (MBL) of an implant system after a clinically perceived bone quality-adapted drilling. MATERIALS AND METHODS: This multicenter retrospective study included patients treated with implants, conventionally loaded, in completely healed sites. Operators customized the osteotomy preparation according to radiographic assessment and their perception of bone quality. Drilling sequence, bone quality, and ITV were recorded at the time of surgery...
November 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/29137080/a-medium-term-follow-up-of-adult-lumbar-tuberculosis-treating-with-3-surgical-approaches
#6
Qi Hong Zhang, Qiang Guo, Chaofeng Guo, Jianhuang Wu, Jinyang Liu, Qile Gao, Yuxiang Wang
Surgical intervention is an important option for treating lumbar tuberculosis. Previous studies have reported different surgical intervention procedures. To our knowledge, few studies have compared the clinical results of mid-term follow-up of 3 different surgeries in surgical treatment of spinal tuberculosis. This study's purpose is to evaluate the effectiveness of 3 different surgeries for the treatment of lumbar tuberculosis in adult and analyze the mid-term influence of the surgery on quality of life.Between June 2004 and January 2010, a total of 137 adult patients (54 women and 83 men) with lumbar tuberculosis were recruited for this study...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137026/implantation-of-artificialiris-a-customflex-irisprosthesis-in-a-trauma-patient-with-an-artisan-lens-a-case-report-and-review
#7
Farideh Doroodgar, Mahmoud Jabbarvand, Feizollah Niazi, Sana Niazi, Azad Sanginabadi
PURPOSE: To evaluate probable complications of ArtificialIris implantation with iris fixated intraocular lens. METHOD: Development of photophobia, glare, and psychological strain during face-to-face communication in a 23-year-old man with a widespread traumatic iris defect terminate to make a decision for performing implantation of an ArtificialIris (Humanoptics, Erlangen, Germany) under the remnant iris without removing the patient's existing Artisan lens. RESULTS: Without any intraoperative or postoperative complications, the patient's visual acuity increased by 1 line, the endothelial cell loss was comparable with the cell loss associated with standard cataract surgery, and the anterior-chamber depth and anterior-chamber anatomy did not change...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136254/completion-of-multiple-fellowships-by-orthopedic-surgeons-analysis-of-the-american-board-of-orthopaedic-surgery-certification-database
#8
J Mason DePasse, Alan H Daniels, Wesley Durand, Brandon Kingrey, John Prodromo, Mary K Mulcahey
Orthopedic surgeons have become increasingly subspecialized, and recent studies have shown that American Board of Orthopaedic Surgery (ABOS) Step II applicants are performing a higher percentage of their cases within their chosen subspecialties. However, these studies focused exclusively on surgeons who have completed a single fellowship; little data exist on those who pursue a second fellowship. All applicants to the ABOS Part II examination from 2004 to 2016 were classified by their self-reported fellowship training history using the ABOS Part II examination database...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29135866/importance-of-perimodiolar-electrode-position-for-psychoacoustic-discrimination-in-cochlear-implantation
#9
Angel Ramos Macias, Maria Teresa Perez Zaballos, Angel Ramos de Miguel, Javier Cervera Paz
HYPOTHESIS: Modiolar proximity of the cochlear implant electrodes and low impedance values have a positive effect on electrical pitch discrimination. BACKGROUND: The proximity of the cochlear electrode to the modiolar wall can determine changes in tissue and fluid environment. With the onset of soft-surgery techniques, the trauma caused during surgery has been reduced, minimizing fibrous growth. METHODS: Computed tomography-scan measurements of electrode-inner wall distance and psychoacoustic electrode discrimination tests were done...
December 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29133638/comparison-of-the-endosaver-with-noninjector-techniques-in-descemet-s-stripping-endothelial-keratoplasty
#10
Michael Tsatsos, Ioannis Athanasiadis, Nikolaos Kopsachilis, Radhika Krishnan, Parwez Hossain, David Anderson
PURPOSE: Minimal loss of corneal endothelial cells during corneal transplantation is a major target but remains a point of controversy among specialists. Hence, the available method to best achieve this continues to stir progress in the field. The aim of this study is to evaluate the use of the Endosaver injector device for graft insertion in Descemet's stripping endothelial keratoplasty (DSEK) and compare the visual outcomes and endothelial cell survival between the Endosaver injector and Goosey grasping forceps insertion techniques...
November 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29133630/non-contact-lens-related-acanthamoeba-keratitis
#11
REVIEW
Prashant Garg, Paavan Kalra, Joveeta Joseph
The purpose of the study is to describe epidemiology, clinical features, diagnosis, and treatment of Acanthamoeba keratitis (AK) with special focus on the disease in nonusers of contact lenses (CLs). This study was a perspective based on authors' experience and review of published literature. AK accounts for 2% of microbiology-proven cases of keratitis. Trauma and exposure to contaminated water are the main predisposing factors for the disease. Association with CLs is seen only in small fraction of cases. Contrary to classical description experience in India suggests that out of proportion pain, ring infiltrate, and radial keratoneuritis are seen in less than a third of cases...
November 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29132848/lymphedema-pathophysiology-and-clinical-manifestations
#12
REVIEW
Ayman A Grada, Tania J Phillips
Lymphedema is a localized form of tissue swelling resulting from excessive retention of lymphatic fluid in the interstitial compartment and caused by impaired lymphatic drainage. Lymphedema is classified as primary or secondary. Primary lymphedema is caused by developmental lymphatic vascular anomalies. Secondary lymphedema is acquired and arises as a result of an underlying systemic disease, trauma, or surgery. We performed PubMed and Google Scholar searches of the English-language literature (1966-2017) using the terms lymphedema, cancer-related lymphedema, and lymphatic complications...
December 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29132647/normative-data-for-the-patient-rated-wrist-evaluation-questionnaire
#13
Marjolein A M Mulders, Suzanne C Kleipool, Siem A Dingemans, Percy V van Eerten, Tim Schepers, J Carel Goslings, Niels W L Schep
STUDY DESIGN: Cross-sectional study. INTRODUCTION: The Patient-Rated Wrist Evaluation (PRWE) questionnaire is used to evaluate functional outcomes after treatment of wrist and hand injuries and nontraumatic conditions. Since patients commonly present with an injury, it is impossible to assess preinjury physical functioning. Therefore, it is important to be aware of the population-based normative data. PURPOSE OF THE STUDY: The aim of this study was to determine the normative data for the PRWE questionnaire...
November 10, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/29132583/the-evolving-science-of-trauma-resuscitation
#14
REVIEW
Tim Harris, Ross Davenport, Matthew Mak, Karim Brohi
This review summarizes the evolution of trauma resuscitation from a one-size-fits-all approach to one tailored to patient physiology. The most dramatic change is in the management of actively bleeding patients, with a balanced blood product-based resuscitation approach (avoiding crystalloids) and surgery focused on hemorrhage control, not definitive care. When hemostasis has been achieved, definitive resuscitation to restore organ perfusion is initiated. This approach is associated with decreased mortality, reduced duration of stay, improved coagulation profile, and reduced crystalloid/vasopressor use...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132141/shoulder-giant-schwannoma-a-diagnosis-to-be-considered-in-painless-shoulder-masses
#15
Romeu Pinho, Sara Santana, Filipa Farinha, Inês Cunha, Anabela Barcelos, José Brenha
Tumours formed from peripheral nerve sheaths are rare in the shoulder. We present the case of a 80-year-old female referred to an orthopaedic surgery clinic because of a large painless mass of the right shoulder, with one year of evolution. There was no history of trauma, involvement of any other joint or systemic complaints. Given the clinical and imagiological suspicion of a giant synovial cyst, the patient underwent complete surgical resection of the mass, which took place without any complications or functional impairment...
November 5, 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/29131236/chronic-subdural-hematoma-associated-with-arachnoid-cyst-of-the-middle-fossa-surgical-treatment-and-mid-term-results-in-fifteen-patients
#16
Ahmet Murat Müslüman, Barış Özöner, Atilla Kirçelli, Songül Meltem Can, Adem Yilmaz, Ayça Kaldirimoğlu, Balkan Şahin
AIM: We report the neurological and radiological features, surgical management and Mid-term outcome in a series of patients with chronic subdural hematoma (CSDH) and associated ipsilateral arachnoid cyst (AC) of the middle fossa. MATERIAL AND METHODS: Between August 2004 and August 2012, 453 patients were treated with diagnosis of CSDH in our clinic. Of those, 15 patients had ipsilateral arachnoid cyst in the middle fossa. A single burr hole craniostomy was performed to drain the hematoma and the AC left intact at first in 14 patients, one patient had no surgical intervention...
October 18, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29130874/do-routine-radiographs-obtained-at-initial-outpatient-postoperative-visit-change-management
#17
Eric Grenier, Dave Tennent, Jean Patzkowski, Joseph Hsu, Anthony Johnson
Routine postoperative radiographs are commonly obtained at the initial postoperative visit. The purpose of this study was to demonstrate the clinical utility of routine postoperative radiographs and quantify the radiation exposure and cost to the health care system. All orthopaedic surgeries performed during 2007 at a level I trauma center were retrospectively analyzed. Surgical procedures that were likely to require follow-up radiographs were included. Analysis demonstrated 878 procedures with 471 procedures (54%) receiving initial postoperative radiographs...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130872/a-retrospective-comparative-analysis-of-the-use-of-implantable-bone-stimulators-in-nonunions
#18
J Ryan Martin, George Vestermark, Brian Mullis, Jeffrey Anglen
This study details the use of implantable bone stimulators in the setting of nonunion. A retrospective comparative analysis was used to evaluate the efficacy of implantable bone stimulators in achieving union in the setting of atrophic or oligotrophic nonunion by two fellowship-trained orthopaedic trauma surgeons. Initially, 72 patients underwent surgical intervention for nonunion. Twenty-one patients had an implantable bone stimulator placed at the time of nonunion surgery. Thirty-eight patients had a minimum of 1-year follow-up...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130805/rehabilitative-success-after-brain-trauma-by-augmenting-a-subtherapeutic-dose-of-environmental-enrichment-with-galantamine
#19
Patricia B de la Tremblaye, Jody L Wellcome, Benjamin Wells de Witt, Jeffrey P Cheng, Elizabeth R Skidmore, Corina O Bondi, Anthony E Kline
BACKGROUND: Environmental enrichment (EE) confers benefits after traumatic brain injury (TBI) when provided daily for > 6 hours, but not 2 or 4 hours, which more accurately reflects the daily amount of clinical rehabilitation. The lack of benefit with sub-therapeutic EE suggests that augmentation with galantamine (GAL), which enhances cognition after TBI, may be indicated to confer benefits. OBJECTIVE: To test the hypothesis that 2 and 4 hours of EE paired with GAL will provide benefits comparable to 24 hours of EE alone...
November 1, 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/29130230/-protective-measures-in-laparoscopic-resection-for-upper-or-mid-rectal-cancer-and-sigmoid-colon-cancer-with-transrectal-specimen-extraction-surgery
#20
Chuangang Fu, Zhuqing Zhou, Junyi Han, Bin Lu, Wei Gao, Zhe Zhu, Qixin Jiang, Fang Ji, Tao Du
OBJECTIVE: To introduce the use of a self-made specimen protective sleeve in laparoscopic resection for upper or mid rectal cancer and sigmoid colon cancer with transrectal specimen extraction surgery and the improvement of implantation method, so as to avoid and reduce bacterial contamination and tumor cell dissemination in abdominal cavity. METHODS: During June 2015 and May 2017, 48 cases of high located rectal or sigmoid colon cancer were operated laparoscopically with natural orifices specimen extraction surgery (NOSES) using a self-made specimen protecting sleeve...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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