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https://www.readbyqxmd.com/read/28821646/location-of-the-mesopontine-neurons-responsible-for-maintanance-of-anesthetic-loss-of-consciousness
#1
Anne Minert, Shai-Lee Yatziv, Marshall Devor
The transition from wakefulness to general anesthesia is widely attributed to suppressive actions of anesthetic molecules distributed by the systemic circulation to the cerebral cortex (for amnesia and loss-of-consciousness) and to the spinal cord (for atonia and antinociception). An alternative hypothesis proposes that anesthetics act on one or more brainstem or diencephalic nuclei, with suppression of cortex and spinal cord mediated by dedicated axonal pathways. We previously documented induction of an anesthesia-like state in rats by microinjection of small amounts of GABAA-R agonists into an upper brainstem region named the mesopontine tegmental anesthesia area(MPTA)...
August 16, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28821471/non-surgical-management-of-myomas
#2
Shannon K Laughlin-Tommaso
Uterine myomas are a common condition and the leading cause of hysterectomy. Clinically, myomas can be challenging because they range from being asymptomatic to causing severe, debilitating symptoms and occur in many women before child-bearing is complete. Thus, women often seek uterine- conserving and non-surgical management of their myomas. In this review, the available uterine-conserving treatment options from medical management through minimally invasive procedures will be discussed. To the extent of research available, the sustainability of symptom improvement and the effects on future fertility will be reviewed...
August 15, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28816960/successful-open-reduction-and-internal-fixation-for-displaced-femoral-fracture-in-a-patient-with-osteopetrosis-case-report-and-lessons-learned
#3
Jiangfa Huang, Jianke Pan, Mingtao Xu, Shuchai Xu
RATIONALE: Osteopetrosis is a rare disease that predominantly occurs in descendants of inbreeding families. In the case of fractures happen in patients with osteopetrosis, the choice between operative or conservative treatment is still controversial. Open reduction and internal fixation (ORIF) is a conventional treatment for fractures, and it possesses more applicability than conservative treatment. During this surgical treatment, ensure that bone union in the right way is pivotal to success and simultaneously prevents refracture and displacement after the operation...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28816894/the-clavicle-trial-a-multicenter-randomized-controlled-trial-comparing-operative-with-nonoperative-treatment-of-displaced-midshaft-clavicle-fractures
#4
Philip M Ahrens, Nicholas I Garlick, Julie Barber, Emily M Tims
BACKGROUND: The treatment of displaced midshaft clavicle fractures remains controversial. METHODS: We undertook a multicenter randomized controlled trial to compare effectiveness and safety between nonoperative management and ORIF (open reduction and internal fixation) for displaced midshaft clavicle fractures in adults. Three hundred and one eligible adult patients were randomized to 1 of the 2 treatment groups and followed at 6 weeks, 3 months, and 9 months after recruitment...
August 16, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28816690/complications-of-the-middle-cranial-fossa-approach-for-acoustic-neuroma-removal
#5
Matthias Scheich, Christian Ginzkey, Desiree Ehrmann Müller, Wafaa Shehata Dieler, Rudolf Hagen
OBJECTIVE: To analyze postoperative complications after microsurgery for acoustic neuroma (AN) via the middle fossa approach (MFA). MATERIALS AND METHODS: In total, 203 consecutive patients of a tertiary skull base referral center at a university hospital were included in this retrospective chart and database analysis. All patients had undergone primary microsurgery at the Otorhinolaryngology department via MFA between December 2005 and October 2014. Postoperative complications were documented during the inpatient stay and outpatient follow-up...
August 2017: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/28815416/what-is-the-evidence-for-paediatric-adolescent-bariatric-surgery
#6
REVIEW
Natalie Durkin, Ashish P Desai
PURPOSE OF REVIEW: In spite of the increasing prevalence of severe and complex obesity in children, surgery as a potential management option is still not widely accepted. The purpose of this review is to examine the evidence for surgical options in the severely obese paediatric population. Increasing evidence supports early rather than later use of bariatric surgery in the treatment of extreme obesity. RECENT FINDINGS: Prior to 2007, the feasibility and safety of surgery have been reported by predominantly small, sporadic single-centre retrospective case series...
August 16, 2017: Current Obesity Reports
https://www.readbyqxmd.com/read/28815070/supracarinal-dissection-of-the-oesophagus-and-lymphadenectomy-by-mie
#7
REVIEW
Harushi Osugi, Kousuke Narumiya, Kenji Kudou
Since 1995, video-assisted thoracoscopic oesophagectomy (VATS), according the same surgical principles as the Japanese open surgery, has been completed in 700 patients with oesophageal cancer. Our indication for VATS is (I) no extensive pleural adhesion; (II) no contiguous tumor spread; (III) pulmonary function capable of sustaining single-lung ventilation, and (IV) non radiated patients. We use 4 ports around a 5 cm mini-thoracotomy on 5th intercostal space. We laid emphasis on utilizing magnifying effect of video (5 to 20 magnifications), obtained by positioning the camera at close vicinity to the dissection...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#8
Mehrdad Nikfarjam, Jeremy S Wilson, Ross C Smith
In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28814172/novel-endovascular-management-of-proximal-type-a-debakey-ii-aortic-dissection-with-a-patent-foramen-ovale-occluder
#9
Xun Yuan, Andreas Mitsis, David Mozalbat, Christoph A Nienaber
PURPOSE: To present a novel endovascular management option that avoids open surgery in selected patients with subacute type A aortic dissection (DeBakey II). CASE REPORT: A 75-year-old woman with previous infrarenal abdominal aortic aneurysm repaired in 2006 and multiple comorbidities (EURO score II 20.5%) was admitted with chest pain; computed tomography angiography (CTA) showed a new dissection in the ascending aorta just above the right coronary ostium. As the patient was considered unfit to undergo surgery, an endovascular solution was suggested after multidisciplinary team discussion...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28813488/role-of-post-chemotherapy-radiation-in-the-management-of-children-and-adolescents-with-primary-advanced-malignant-mediastinal-germ-cell-tumors
#10
Junting Huang, Yuting Tan, Zijun Zhen, Suying Lu, Feifei Sun, Jia Zhu, Juan Wang, Ru Liao, Xiaofei Sun
OBJECTIVE: Primary malignant mediastinal germ cell tumors (MMGCTs) are rare in children and adolescents and have a poorer prognosis than their gonadal counterparts. We report a single institutional experience of a 10-year period of primary advanced MMGCTs treated with chemotherapy, followed by radiotherapy in those who had residual mass. METHODS: Children and adolescents with primary advanced MMGCTs between 2005 and 2014 were identified from the Cancer Center, Sun Yat-Sen University...
2017: PloS One
https://www.readbyqxmd.com/read/28812042/visual-outcomes-24%C3%A2-months-after-laserace
#11
AnnMarie Hipsley, David Hui-Kang Ma, Chi-Chin Sun, Mitchell A Jackson, Daniel Goldberg, Brad Hall
BACKGROUND: To evaluate the effects on near and intermediate visual performance after bilateral Laser Anterior Ciliary Excision (LaserACE) procedure. METHODS: LaserACE surgery was performed using the VisioLite 2.94 μm erbium: yttrium-aluminum-garnet (Er:YAG) ophthalmic laser system in 4 oblique quadrants on the sclera over the ciliary muscle in 3 critical zones of physiological importance (over the ciliary muscles and posterior zonules) with the aim to improve natural dynamic accommodative forces...
2017: Eye and Vision (London, England)
https://www.readbyqxmd.com/read/28812037/a-retrospective-analysis-of-concurrent-pathology-in-acl-reconstructed-knees-of-elite-alpine-ski-racers
#12
Matthew J Jordan, Patricia Doyle-Baker, Mark Heard, Per Aagaard, Walter Herzog
BACKGROUND: Anterior cruciate ligament (ACL) tear is the most frequent injury in alpine ski racing, and there is a high prevalence of ACL reinjury. Limited data exist on the concurrent pathology with primary ACL tears in elite alpine ski racers and the magnitude of injury progression after primary ACL reconstruction (ACLR). PURPOSE: To evaluate (1) the involvement of intra-articular and multiligament pathologies at the time of primary ACLR, (2) the subsequent progression in meniscal/chondral injuries, and (3) the occurrence of ACL reinjury in elite alpine ski racers...
July 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28812033/epidemiology-of-injuries-identified-at-the-nfl-scouting-combine-and-their-impact-on-performance-in-the-national-football-league-evaluation-of-2203-athletes-from-2009-to-2015
#13
Brendin R Beaulieu-Jones, William H Rossy, George Sanchez, James M Whalen, Kyle P Lavery, Kevin J McHale, Bryan G Vopat, Joseph J Van Allen, Ramesses A Akamefula, Matthew T Provencher
BACKGROUND: At the annual National Football League (NFL) Scouting Combine, the medical staff of each NFL franchise performs a comprehensive medical evaluation of all athletes potentially entering the NFL. Currently, little is known regarding the overall epidemiology of injuries identified at the combine and their impact on NFL performance. PURPOSE: To determine the epidemiology of injuries identified at the combine and their impact on initial NFL performance. STUDY DESIGN: Cohort study; Level of evidence, 3...
July 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28810991/posterior-cruciate-ligament-injuries-associated-with-military-survival-swim-training
#14
Michael S Crowell, John S Mason, Matthew A Posner, Chad A Haley
OBJECTIVES: Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28809623/how-to-choose-between-the-implant-materials-steel-and-titanium-in-orthopedic-trauma-surgery-part-2-biological-aspects
#15
S M Perren, P Regazzoni, A A Fernandez
BIOLOGICAL ASPECTS OF STEEL AND TITANIUM AS IMPLANT MATERIAL IN ORTHOPEDIC TRAUMA SURGERY The following case from the ICUC database, where a titanium plate was implanted into a flourishing infection, represents the clinical experience leading to preferring titanium over steel. (Fig. 1) (6). Current opinions regarding biological aspects of implant function. The "street" opinions regarding the biological aspects of the use of steel versus titanium as a surgical trauma implant material differ widely. Statements of opinion leaders range from "I do not see any difference in the biological behavior between steel and titanium in clinical application" to "I successfully use titanium implants in infected areas in a situation where steel would act as foreign body "sustaining" infection...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28809180/exploring-socio-technical-insights-for-safe-nursing-handover
#16
Ming Chao Wong, Kwang Chien Yee, Paul Turner
Current efforts to improve nursing handover frequently use prescriptive approaches based on research evidence of handover issues within a single nursing ward or nursing specialty. Despite reported handover improvement, few studies adequately consider the transferability of results to other nursing handover environments or acknowledge the unique attributes that supported sustained improvement. With the increasing diffusion of electronic tools it has become even more critical to ensure that socio-technical issues that may impact on the quality and safety of nursing handovers are identified...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28807476/a-model-for-a-career-in-a-specialty-of-general-surgery-one-surgeon-s-opinion
#17
Bona Ko, Christopher R McHenry
BACKGROUND: The integration of general and endocrine surgery was studied as a potential career model for fellowship trained general surgeons. METHODS: Case logs collected from 1991-2016 and academic milestones were examined for a single general surgeon with a focused interest in endocrine surgery. Operations were categorized using CPT codes and the 2017 ACGME "Major Case Categories" and there frequencies were determined. RESULTS: 10,324 operations were performed on 8209 patients...
August 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28807141/psychosocial-predictors-of-quality-of-life-and-weight-loss-two-years-after-bariatric-surgery-results-from-the-toronto-bari-psych-study
#18
Sanjeev Sockalingam, Raed Hawa, Susan Wnuk, Vincent Santiago, Matthew Kowgier, Timothy Jackson, Allan Okrainec, Stephanie Cassin
OBJECTIVES: Studies exploring the impact of pre-surgery psychiatric status as a predictor of health related quality of life (QOL) after bariatric surgery have been limited to short-term follow-up and variable use of psychosocial measures. We examined the effect of pre-operative psychiatric factors on QOL and weight loss 2-years after surgery. METHODS: 156 patients participated in this prospective cohort study, the Toronto Bariatric Psychosocial Cohort Study, between 2010 and 2014...
July 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28803898/electrospun-fibrous-membranes-featuring-sustained-release-of-ibuprofen-reduce-adhesion-and-improve-neurological-function-following-lumbar-laminectomy
#19
Shen Liu, Guoqing Pan, Guangwang Liu, José das Neves, Sa Song, Shuai Chen, Bangjun Cheng, Zhiyong Sun, Bruno Sarmento, Wenguo Cui, Cunyi Fan
Electrospun fibrous membranes provide suitable physical anti-adhesion barriers for reducing tissue anti-adhesion following surgery. However, often during the biodegradation process, these barriers trigger inflammation and cause a foreign body reaction with subsequent decrease in anti-adhesion efficacy. Here, a facile strategy comprising the incorporation of ibuprofen (IBU) into implantable membranes and its sustained release was proposed in order to improve anti-adhesion effects and neurological outcomes, namely to prevent failed back surgery syndrome (FBSS)...
August 10, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28803514/investigation-sensitivity-analysis-and-multi-objective-optimization-of-effective-parameters-on-temperature-and-force-in-robotic-drilling-cortical-bone
#20
Vahid Tahmasbi, Majid Ghoreishi, Mojtaba Zolfaghari
The bone drilling process is very prominent in orthopedic surgeries and in the repair of bone fractures. It is also very common in dentistry and bone sampling operations. Due to the complexity of bone and the sensitivity of the process, bone drilling is one of the most important and sensitive processes in biomedical engineering. Orthopedic surgeries can be improved using robotic systems and mechatronic tools. The most crucial problem during drilling is an unwanted increase in process temperature (higher than 47 °C), which causes thermal osteonecrosis or cell death and local burning of the bone tissue...
August 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
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