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Forward surgery

Shuangshuang Lu, Jiayi Wu, Yan Fang, Wei Wang, Yu Zong, Xiaosong Chen, Ou Huang, Jian-Rong He, Weiguo Chen, Yafen Li, Kunwei Shen, Li Zhu
Introduction: Approximately 5% of primary breast cancer patients present de novo stage IV breast cancer, for whom systematic therapy is the mainstream treatment. The role of surgical excision of the primary tumor has been controversial due to inconsistent results of relevant studies. Recently, with the reports of some relevant preclinical data, retrospective studies and randomized clinical trials, we've got more evidence to reexamine the issue. Based on those above, a literature review and meta-analysis was performed to determine whether surgery of the primary tumor could improve overall survival in the setting of stage IV breast cancer...
February 20, 2018: Oncotarget
A Yu Lubnin
We present an analytical review of various neurosurgical interventions in conscious patients. An analysis of the literature indicates growing interest in this problem. Craniotomy in conscious patients has been extensively used in resection of space-occupying cerebral lesions in the eloquent hemispheric areas and in epilepsy surgery. In recent years, there have been a number of reports on interventions in conscious patients with other neurosurgical pathologies, which may be regarded as a new emerging tendency in neurosurgery and neuroanesthesiology...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Sajith C Senadeera, Simon V Vun, Nicholas Butterfield, Tim W Eglinton, Frank A Frizelle
BACKGROUND: Lower gastrointestinal bleeding (LGIB) is a common acute general surgical condition that is typically self-limiting; however in refractory cases it can necessitate life-saving intervention. When bleeding is refractory, super-selective embolization (SSE) becomes an important management strategy. This study aims to evaluate outcomes of this procedure at our institution and identify predictors of clinical success. METHODS: A retrospective analysis of patients with positive computed tomography angiograms for LGIB at a tertiary centre between December 2007 and May 2017...
March 14, 2018: ANZ Journal of Surgery
David Macku, Pavel Hedvicak, John Quinn, Vladimir Bencko
Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Hyun-Kyung Do, Joong-Hoon Lee, Jae-Young Lim
OBJECTIVE: Polydeoxyribonucleotide as adenosine receptor (A2A ) agonist has been used in plastic surgery and dermatology related to its regenerative property. The aim of this pilot study is to evaluate the safety and efficacy of polydeoxynucleotide injection in patients with rotator cuff tears by a variety of outcomes including pain, disability, physical performance test, and ultrasonography (US). METHODS: Seventeen patients (9 men, 8 women, age: 57.9 ± 9.1) with partial-thickness tear of supraspinatus tendon were evaluated in a prospective, open-label, and pre-and-post study...
March 14, 2018: Physician and Sportsmedicine
Tsunehiko Konomi, Kota Suda, Satoko Matsumoto, Miki Komatsu, Masahiko Takahata, Norimasa Iwasaki, Akio Minami
Introduction: There are considerable risks for vertebral artery (VA) injury in case of corrective surgery for a severe and rigid cervical kyphotic deformity. This case report describes a rare case of surgical management for pre-existing traumatic rigid cervical kyphosis associated with unilateral VA occlusion. Case presentation: A 73-year-old male fell down and injured his neck. He was referred to our hospital 10 months after injury because his degree of head drop progressed gradually to a chin-on-chest position such that he could not look straight forward...
2018: Spinal Cord Series and Cases
Prem N Ramkumar, Heather S Haeberle, Sergio M Navarro, Assem A Sultan, Michael A Mont, Eric T Ricchetti, Mark S Schickendantz, Joseph P Iannotti
BACKGROUND: Mobile technology offers the prospect of delivering high-value care with increased patient access and reduced costs. Advances in mobile health (mHealth) and telemedicine have been inhibited by the lack of interconnectivity between devices and software and inability to process consumer sensor data. The objective of this study was to preliminarily validate a motion-based machine learning software development kit (SDK) for the shoulder compared with a goniometer for 4 arcs of motion: (1) abduction, (2) forward flexion, (3) internal rotation, and (4) external rotation...
March 7, 2018: Journal of Shoulder and Elbow Surgery
Adam Mutsaers, Hanbo Chen, Alexander V Louie
PURPOSE OF REVIEW: Significant advances have been made in the field of stereotactic ablative radiotherapy (SABR) for the treatment of pulmonary neoplasms in recent years. This review aims to summarize recent salient evidence on SABR for early-stage nonsmall cell lung cancer (ES-NSCLC). RECENT FINDINGS: In medically inoperable patients, SABR remains the standard of care. The optimal SABR dosing regimen is being studied. Comparisons with non-SABR radiotherapy regimens with lower doses per fraction revealed benefit of SABR...
March 7, 2018: Current Opinion in Pulmonary Medicine
Yi-Ling Cai, Jin-Tao Ju, Wen-Bao Liu, Jian Zhang
Introduction: Forward surgical teams (FSTs) have been used as highly mobile surgical facilities that provide "damage control" medical support in modern wars. FST regiments differ greatly in different armed services and nations. We systemically reviewed the utilization of FSTs around the world with an emphasis on the medical conditions and workloads encountered by FSTs in modern wars. Materials and Methods: We searched for terms related to FSTs, such as "Forward Surgical Team" and "Field Surgical Team," in the PubMed, EMBASE, Web of Science, and MEDLINE databases and collected any articles that provided numerical data on the organization of medical personnel combat casualty characteristics, including the casualty composition, injury types and locations, and mechanisms of injury, and surgical procedures performed...
March 1, 2018: Military Medicine
George Hahalis, Grigorios Tsigkas, Nikos Kounis, Sotirios Patsilinakos, Nikolaos Kafkas, Antonios Ziakas, Nikolaos Patsourakos, George Almpanis, Ioanna Koniari, Ioanna Xanthopoulou, Nikolaos Koutsogiannis, Stefanos Despotopoulos, Marianna Leopoulou, Vasiliky Tassi, Ioannis Miliordos, Maria Anastasopoulou, Anastasios Roumeliotis, Athina Dapergola, Konstantinos Aznaouridis, Dimitrios Chatzis, Periklis Davlouros
Radial artery (RA) occlusion (RAO) remains the Achilles heel of transradial coronary procedures. Although of silent nature, RAO is relatively frequent, results in graft shortage for future coronary artery bypass surgery, and may occur even after short-lasting, 5F coronary angiography (CAG). The most frequent predictors of RAO are RA size, body size, female gender, and periprocedural anticoagulation intensity. Methods to detect RAO are variable, of which the Barbeau test and ultrasonography have similar diagnostic accuracy...
January 1, 2018: Angiology
Patricia Dayrell Neiva, Letícia Paiva Franco, Renata Noce Kirkwood, Helena Gonçalves Becker
The clinical decision for surgical treatment of children diagnosed with mouth breathing depends on the percentage of mechanical obstruction correlated with exacerbation of upper respiratory tract infections and systemic changes. The benefits of adenotonsillectomy include changes in the nasopharyngeal space, the mandibular plane and myofunctional alterations. Post-adenotonsilectomy postural benefits have not yet been described. OBJECTIVES: To investigate the kinematics of the shoulder girdle, cervical and thoracic spine in children with mouth breathing before and after adenotonsillectomy...
April 2018: International Journal of Pediatric Otorhinolaryngology
Joham Choque-Velasquez, Roberto Colasanti, Julio C Resendiz-Nieves, Kléber E Gonzáles-Echevarría, Rahul Raj, Behnam Rezai Jahromi, Felix Goehre, Ann-Christine Lindroos, Juha Hernesniemi
OBJECTIVE: Nowadays, the sitting position has lost favor among neurosurgeons partly due to assumptions of increased complications, such as venous air embolisms (VAEs) and hemodynamic disturbances. Moreover, it may oblige the surgeon to a tiring posture. Herein, we describe our protocol for the "praying (steeper sitting) position" for pineal region surgery, a variant which may reduce some of the risks of the sitting position while providing a more ergonomic surgical position...
February 27, 2018: World Neurosurgery
Erica Y Xue, Laurel K Chandler, Stephen L Viviano, Jonathan D Keith
OBJECTIVE: Forward-looking infrared (FLIR) thermography technology uses a handheld camera that measures skin infrared emissivity, captures photographs, and can be analyzed through specialized software. Forward-looking infrared images can be used to analyze and correlate burn wound temperature with burn depth, burn progression, and the number of days needed for healing. FLIR ONE is a miniature, smartphone-compatible thermal imaging camera that has been used to assess inflammation in diabetic foot ulcers, as well as locating perforators in flap surgery...
February 28, 2018: Annals of Plastic Surgery
Carlos Torrens, Eduard Alentorn-Geli, Felipe Mingo, Carlo Gamba, Fernando Santana
PURPOSE: To investigate the influence of greater tuberosity healing on the functional outcomes of reverse shoulder arthroplasty (RSA) for the treatment of acute complex proximal humeral fractures (PHFs), and to investigate the influence of patient- and surgery-related factors in the healing of the greater tuberosity. METHODS: Retrospective study including 41 consecutive PHFs treated using RSA with minimum 2-year follow-up. In all the cases, tuberosities were reattached with a standardized technique...
January 2018: Journal of Orthopaedic Surgery
Paola Gripari, Massimo Mapelli, Ilaria Bellacosa, Concetta Piazzese, Maria Milo, Laura Fusini, Manuela Muratori, Sarah Ghulam Ali, Gloria Tamborini, Mauro Pepi
Successful mitral valve (MV) repair for degenerative mitral regurgitation (DMR) is mainly related to surgical expertise and MV anatomy. Although 2D echocardiography, specifically transoesophageal (TOE), provides precise information regarding MV anatomy, recent advancements in matrix technology meant a decisive step forward to the point where segmental MV analysis can be accurately performed from a noninvasive 3D transthoracic (TTE) approach. The aims of this study were: (a) to evaluate the feasibility and time required for real-time 3D TTE in a large consecutive cohort of patients with severe DMR in the assessment of MV anatomy; (b) to compare the accuracy of 3D TTE and 2D TOE versus surgical inspection in the recognition and localization of all components of the MV leaflets; (c) to establish the added diagnostic value of 3D colourDoppler examination to pure 3D morphologic evaluation...
February 26, 2018: International Journal of Cardiovascular Imaging
Jennifer M Gurney, Philip C Spinella
PURPOSE OF REVIEW: Hemorrhage remains the primary cause of preventable death on the battlefield and in civilian trauma. Hemorrhage control is multifactorial and starts with point-of-injury care. Surgical hemorrhage control and time from injury to surgery is paramount; however, interventions in the prehospital environment and perioperative period affect outcomes. The purpose of this review is to understand concepts and strategies for successful management of the bleeding military patient...
April 2018: Current Opinion in Anaesthesiology
Hannah Hughes, Andrew Hughes, Colin Murphy
Aim Social media (SoMe) platforms have become leading methods of communication and dissemination of scientific information in the medical community. They allow for immediate discussion and widespread engagement around important topics. It has been hypothesized that the activity on Twitter positively correlates with highly cited articles. The purpose of this study was to analyze the prevalence and activity of Trauma and Orthopaedic Surgery journals on Twitter, with the hypothesis that the impact factor is positively associated with the Twitter usage...
December 10, 2017: Curēus
Ken Lee Puah, Muhammad Sabith Salieh, William Yeo, Andrew Hwee Chye Tan
INTRODUCTION: Diabetic patients have been known to have a higher incidence of frozen shoulder. Arthroscopic capsular release has been described for diabetic frozen shoulder refractory to non-surgical treatment. We describe our single-surgeon experience of this procedure done in Asian patients presenting with diabetic frozen shoulder. RESULTS: Data were prospectively collected from 25 patients from 2007 to 2008, who underwent arthroscopic capsular release for frozen shoulder with diabetes mellitus...
January 2018: Journal of Orthopaedic Surgery
Stephanie E Combs, Kerstin A Kessel, Josefine Hesse, Christoph Straube, Claus Zimmer, Friederike Schmidt-Graf, Jürgen Schlegel, Jens Gempt, Bernhard Meyer
BACKGROUND: Generally, re-irradiation (Re-RT) is offered to patients with glioma recurrences with macroscopic lesions. Results are discussed controversially, and some centers postulate limited benefit of Re-RT. Re-RT is generally offered to tumors up to 4 cm in diameter. Re-resection is also discussed controversially; however, recent studies have shown significant benefit. OBJECTIVE: To combine proactive re-resection and early Re-RT in patients with recurrent glioma...
February 16, 2018: Neurosurgery
Christopher Finkemeier, John D Adams, Mitchell Bernstein, Mark A Lee, Ed Harvey, Brett D Crist
Orthopaedic surgery and biomechanics are intimately partnered topics in medicine. Biomechanical principles are used to design implants and fashion treatment protocols. Although it would seem that biomechanical principles in the design of fixation devices and fracture repair constructs have been already finalized, there are several points of controversy remaining. New technology has raised new questions, while at the same time, we still do not fully understand simple clinical principles such as time of fracture healing depending on the construct used...
March 2018: Journal of Orthopaedic Trauma
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