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https://www.readbyqxmd.com/read/28079861/endoscopic-vs-surgical-interventions-for-painful-chronic-pancreatitis-what-is-needed-for-future-clinical-trials
#1
REVIEW
John A Windsor, Nageshwar D Reddy
The treatment of painful chronic pancreatitis remains controversial. The available evidence from two randomized controlled trials favor surgical intervention, whereas an endotherapy-first approach is widely practiced. Chronic pancreatitis is complex disease with different genetic and environmental factors, different pain mechanisms and different treatment modalities including medical, endoscopic, and surgical. The widely practiced step-up approach remains unproven. In designing future clinical trials there are some important pre-requisites including a more comprehensive pain assessment tool, the optimization of conservative medical treatment and interventional techniques...
January 12, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28079809/a-comparison-of-the-surgical-mortality-due-to-colorectal-perforation-at-different-hospitals-with-data-from-10-090-cases-in-the-japanese-national-clinical-database
#2
Takeshi Ohki, Masakazu Yamamoto, Hiroaki Miyata, Yasuto Sato, Yoshihisa Saida, Tsuyoshi Morimoto, Hiroyuki Konno, Yasuyuki Seto, Koichi Hirata
Colorectal perforation has a high rate of mortality. We compared the incidence and fatality rates of colorectal perforation among different hospitals in Japan using data from the nationwide surgical database.Patients were registered in the National Clinical Database (NCD) between January 1st, 2011 and December 31st, 2013. Patients with colorectal perforation were identified from surgery records by examining if acute diffuse peritonitis (ADP) and diseases associated with a high probability of colorectal perforation were noted...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28079580/a-predictive-model-for-extended-postanesthesia-care-unit-length-of-stay-in-outpatient-surgeries
#3
Rodney A Gabriel, Ruth S Waterman, Jihoon Kim, Lucila Ohno-Machado
BACKGROUND: A predictive model that can identify patients who are at an increased risk for prolonged postanesthesia care unit (PACU) stay could help optimize resource utilization and case sequencing. Although previous studies identified some predictors, there is not a model that only utilizes various patients demographic and comorbidities, that are already known preoperatively, and that may affect PACU length of stay for outpatient procedures requiring the care of an anesthesiologist...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28051988/ultraportable-oxygen-concentrator-use-in-u-s-army-special-operations-forward-area-surgery-a-proof-of-concept-in-multiple-environments
#4
Michael Rybak, Lynn C Huffman, Richard Nahouraii, John Loden, Marcos Gonzalez, Ramey Wilson, Paul D Danielson
INTRODUCTION: A limitation to surgical care in an austere environment is the supply of oxygen to support mechanical ventilation and general anesthesia. Portable oxygen concentrators (OCs) offer an alternative to traditional compressed oxygen tanks. OBJECTIVES: We set out to demonstrate that a low-pressure OC system could supply the mechanical ventilation needs in an austere operating environment. METHODS: An ultraportable OC (SAROS Model 3000, SeQual Technologies, Ball Ground, Georgia) was paired with an Impact 754 ventilator (Impact Instrumentation, West Caldwell, New Jersey) to evaluate the delivered fraction of inspired oxygen (FiO2) to a test lung across a range of minute ventilations and at altitudes of 1,200 and 6,500 feet above sea level...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28050972/registration-of-mri-to-intraoperative-radiographs-for-target-localization-in-spinal-interventions
#5
T De Silva, A Uneri, M D Ketcha, S Reaungamornrat, J Goerres, M W Jacobson, S Vogt, G Kleinszig, A J Khanna, J-P Wolinsky, J H Siewerdsen
Decision support to assist in target vertebra localization could provide a useful aid to safe and effective spine surgery. Previous solutions have shown 3D-2D registration of preoperative CT to intraoperative radiographs to reliably annotate vertebral labels for assistance during level localization. We present an algorithm (referred to as MR-LevelCheck) to perform 3D-2D registration based on a preoperative MRI to accommodate the increasingly common clinical scenario in which MRI is used instead of CT for preoperative planning...
January 4, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28046226/su-f-r-22-malignancy-classification-for-small-pulmonary-nodules-with-radiomics-and-logistic-regression
#6
W Huang, S Tu
PURPOSE: We conducted a retrospective study of Radiomics research for classifying malignancy of small pulmonary nodules. A machine learning algorithm of logistic regression and open research platform of Radiomics, IBEX (Imaging Biomarker Explorer), were used to evaluate the classification accuracy. METHODS: The training set included 100 CT image series from cancer patients with small pulmonary nodules where the average diameter is 1.10 cm. These patients registered at Chang Gung Memorial Hospital and received a CT-guided operation of lung cancer lobectomy...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28042714/current-status-of-iol-implantation-in-pediatric-eyes-an-update
#7
Abhay R Vasavada, Vaishali Vasavada
Pediatric cataracts are a huge problem worldwide, and with improving techniques and technology, the surgical treatment and postoperative visual rehabilitation are improving. Despite intraocular lenses(IOLs) being the standard of care for adult cataract surgery, this issue is still somewhat controversial, particularly in young children and infants due to lack of unequivocal evidence. This review therefore summarises the findings from recent studies on the aspect of IOL implantation in pediatric eyes. Areas covered: An extensive literature search was undertaken for published articles on congenital/developmental pediatric cataracts, and IOL implantation, where literature pertinent to traumatic and subluxated cataracts was not included in the review...
January 2, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28041609/postoperative-nausea-and-vomiting-physiopathology-risk-factors-prophylaxis-and-treatment
#8
L Veiga-Gil, J Pueyo, L López-Olaondo
Recognising the importance of the prevention and early treatment of postoperative nausea and vomiting (PONV) is essential to avoid postoperative complications, improve patient satisfaction and enable the development of major outpatient surgery and fast-track surgery. The topic of PONV might seem to have become stagnant, but we are moving forward. New concepts and problems like post-discharge nausea and vomiting, new risk factors and new drugs are appearing. However, there continue to be mistaken notions about PONV, such as the association between PONV and post-anaesthesia care unit stays, or assuming that it is a risk factore characteristic of the patient, anaesthesia or surgery when it is not...
December 29, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28035424/clinical-outcome-and-prognostic-factors-of-revision-arthroscopic-rotator-cuff-tear-repair
#9
Maria Valencia Mora, Diana Morcillo Barrenechea, Maria Dolores Martín Ríos, Antonio M Foruria, Emilio Calvo
PURPOSE: The aim of this study was to evaluate the clinical outcome of arthroscopic rotator cuff revision surgery in a cohort of patients and to identify prognostic factors for this procedure. METHODS: Fifty-one consecutive patients undergoing revision arthroscopic rotator cuff repair were prospectively followed over a minimum period of one year. Radiologic findings and clinical data regarding primary and revision surgery were collected. Clinical evaluation was performed pre- and post-operatively by means of Constant Score and Simple Shoulder Test...
December 29, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28033253/postoperative-cognitive-changes-after-total-knee-arthroplasty-under-regional-anesthesia
#10
Young-Tae Jeon, Byung-Gun Kim, Young Ho Park, Hye-Min Sohn, Jungeun Kim, Seung Chan Kim, Seong Soo An, SangYun Kim
BACKGROUND: The type of postoperative cognitive decline after surgery under spinal anesthesia is unknown. We investigated the type of postoperative cognitive decline after total knee arthroplasty (TKA). Neuropsychological testing was conducted and the changes in cerebrospinal fluid (CSF) biomarkers after surgery were evaluated. METHODS: Fifteen patients who required bilateral TKA at a 1-week interval under spinal anesthesia were included. Neuropsychological tests were performed twice, once the day before the first operation and just before the second operation (usually 1 week after the first test) to determine cognitive decline...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28032849/reflections-on-a-decade-of-face-transplantation
#11
Giorgio Giatsidis, Indranil Sinha, Bohdan Pomahac
On November 27, 2005, Isabelle Dinoire underwent the world's first partial face transplant in Amiens (France) after a dog attack had left her face severely disfigured. The abrupt surgical leap found the medical community and society unprepared to deal with the scientific, ethical, and societal implications of a surgical procedure that was striving to transition from sci-fi novels to science. Today, 10 years and over 35 transplants later, public opinion has become accustomed to the concept of "face restoration" through transplantation...
April 26, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/28028979/a-controlled-trial-of-the-efficacy-of-a-training-walking-program-in-patients-recovering-from-abdominal-aortic-aneurysm-surgery
#12
Bartosz R Wnuk, Jacek Durmała, Krzysztof Ziaja, Przemysław Kotyla, Marek Woźniewski, Edward Błaszczak
BACKGROUND: Major surgical procedures as well as general anesthesia contribute to muscle weakness and posture instability and may result in increased postoperative complications and functional disorders resulting from an elective operation. OBJECTIVES: We aim to state the significance of backward walking as a form of interval march training with patients after abdominal aortic aneurysm surgery. MATERIAL AND METHODS: Sixty-five patients were randomly divided into three subgroups and three various models of physiotherapy were applied...
November 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28025601/implementation-of-study-results-in-guidelines-and-adherence-to-guidelines-in-clinical-practice
#13
REVIEW
Frank Waldfahrer
Guidelines were introduced in hospital- and practice-based otorhinolaryngology in the 1990ies, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head & Neck Surgery. The society has cooperated in further 34 guidelines. The quality of the guidelines has been continuously improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e...
2016: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
https://www.readbyqxmd.com/read/28024870/arthroscopic-assisted-latissimus-dorsi-tendon-transfer-for-massive-irreparable-rotator-cuff-tears-technique-and-short-term-follow-up-of-patients-with-pseudoparalysis
#14
Ulunay Kanatlı, Mustafa Özer, Muhammet Baybars Ataoğlu, Burak Yağmur Öztürk, Orkun Gül, Mehmet Çetinkaya, Tacettin Ayanoğlu
PURPOSE: To describe a modified technique for arthroscopic-assisted transfer of the latissimus dorsi tendon in a selected group of patients with irreparable rotator cuff tears and pseudoparalysis and to evaluate its short-term results. METHODS: Fifteen patients with irreparable rotator cuff tears and pseudoparalysis treated by arthroscopic-assisted latissimus dorsi tendon transfer were included. The mean patient age was 61.53 ± 6.24 years (range, 52-71 years)...
December 23, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28007407/variable-selection-methods-for-multiple-regressions-influence-the-parsimony-of-risk-prediction-models-for-cardiac-surgery
#15
Md Nazmul Karim, Christopher M Reid, Lavinia Tran, Andrew Cochrane, Baki Billah
OBJECTIVE: To compare the impact of different variable selection methods in multiple regression to develop a parsimonious model for predicting postoperative outcomes of patients undergoing cardiac surgery. METHODS: Data from 84,135 patients in the Australian and New Zealand Society of Cardiac and Thoracic Surgeons registry between 2001 and 2014 were analyzed. Primary outcome was 30-day-mortality. Mixed-effect logistic regressions were used to build the model. Missing values were imputed by the use of multiple imputations...
November 19, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28003043/genetic-impact-on-the-treatment-management-of-hirschsprung-disease
#16
REVIEW
Sam W Moore
BACKGROUND: The identification of Hirschsprung's disease (HD) as a genetic condition has been a major step forward in understanding the development of the enteric nervous system and conditions arising from ganglion cell maldevelopment. METHOD: A study of the role of genetics in HD was carried out based on previously published findings from more than 400 cases of HD. RESULTS: There are at least 7 pertinent clinical questions related to HD which were further investigated...
November 13, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27998313/embryonal-rhabdomyosarcoma-of-the-perineum-in-an-adult-a-case-report
#17
Sidy Ka, Freddy Gnangnon, Mamadou Moustapha Dieng, Doudou Diouf, Jaafar Thiam, Pape Macoumba Gaye, Ahmadou Dem
BACKGROUND: We report the case of an adult patient with embryonal rhabdomyosarcoma of the perineum admitted to our practice at Joliot Curie Institute in Dakar. It is a rare tumor at this age and has a bad prognosis at this localization. CASE PRESENTATION: We describe the case of a 22-year-old African man admitted for a perineal mass that had evolved over 6 months. He complained of tenesmus, obstinate constipation, and dysuria. A clinical examination revealed perineal swelling spread over his anus, scrotum, penis, testicles, and inguinal lymph nodes...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27997447/combined-counterclockwise-maxillomandibular-advancement-and-uvulopalatopharyngoplasty-surgeries-for-severe-obstructive-sleep-apnea
#18
Wenwen Yu, Meng Wang, Jiande He, Liyan Lu, Ming Cai, Hongxia Sun, Xiaofeng Lu
As the most effective surgical technique maxillomandibular advancement (MMA) has been used to treat severe obstructive sleep apnea (OSA) in adults, particularly for those who are intolerant of continuous positive airway pressure. Yet for large-scale advancement, it is faced with esthetic problems with marked skeletal protrusion especially for people with convex facial profile. In this study, the authors performed counterclockwise MMA combined with quantified uvulopalatopharyngoplasty (UPPP) surgeries on Chinese adult patients with severe OSA, in order to initially explore the efficacy of these procedures on Chinese populations and provide evidence for esthetic advantages...
December 16, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27997428/quality-and-safety-in-health-care-part-xxi-psos-and-the-vascular-quality-initiative
#19
Jay A Harolds
Congress provided for the formation of patient safety organizations (PSOs) so that physicians and other providers would come forward to improve the safety and quality of health care. Important legal safeguards for the providers and patients were put in place for PSOs. The Society for Vascular Surgery (SVS) PSO operates the Vascular Quality Initiative. The latter gathers information from certain commonly done vascular procedures. First, information is collected so a risk adjustment determination of each individual patient can be done...
December 16, 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27990273/advances-in-the-management-of-osteosarcoma
#20
REVIEW
Stefan S Bielack, Stefanie Hecker-Nolting, Claudia Blattmann, Leo Kager
Osteosarcoma, a bone cancer most commonly seen in adolescents and young adults, is usually a high-grade malignancy characterized by a very high risk for the development of pulmonary metastases. High-grade osteosarcomas are usually treated by preoperative and postoperative chemotherapy and surgery, with a very limited number of active agents available. Rarer lower-grade variants such as parosteal and periosteal osteosarcoma or low-grade central osteosarcoma are treated by surgery only. Imaging to search for possible metastases focuses on the lung...
2016: F1000Research
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