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https://www.readbyqxmd.com/read/29456356/the-current-state-of-rural-neurosurgical-practice-an-international-perspective
#1
REVIEW
Pavan S Upadhyayula, John K Yue, Jason Yang, Harjus S Birk, Joseph D Ciacci
Introduction: Rural and low-resource areas have diminished capacity to care for neurosurgical patients due to lack of infrastructure, healthcare investment, and training programs. This review summarizes the range of rural neurosurgical procedures, novel mechanisms for delivering care, rapid training programs, and outcome differences across international rural neurosurgical practice. Methods: A comprehensive literature search was performed for English language manuscripts with keywords "rural" and "neurosurgery" using the National Library of Medicine PubMed database (01/1971-06/2017)...
January 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29455686/cost-utility-analysis-of-private-contracting-to-reduce-public-waiting-times-for-joint-replacement-surgery
#2
Jonathan Karnon, Bahareh Mesgarian Haghighi, Babu Sajjad, Sokunthea Yem, Anuji Gamage, Aaron Thorpe
OBJECTIVES: Earlier treatment of publicly funded patients may achieve health gains that justify the additional costs of reducing waiting times. This study reports on the cost-effectiveness of implementing a private contracting model to meet alternative maximum waiting time targets for publicly funded patients undergoing total knee replacement surgery in Australia. METHODS: A linked decision tree and cohort Markov model was developed and populated and validated using secondary data sources to represent the pathways, costs, and quality adjusted life-years (QALYs) gained of non-urgent patients with alternative waiting times for total knee replacement surgery to a maximum age of 100 years...
February 19, 2018: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29455035/sustainability-of-anaesthesia-components-of-an-enhanced-recovery-program-erp-in-colorectal-and-orthopaedics-surgery
#3
Helene Beloeil, Karem Slim, The Francophone Group Of Enhanced Recovery After Surgery
BACKGROUND: Sustainability of ERP is a challenge and data are scarce on the subject. The aim of this study was to assess if application of enhanced recovery elements through the Francophone Group of Enhanced Recovery after Surgery (Grace) in the anaesthesia management was sustainable 2 years after its implementation. MATERIALS AND METHODS: We conducted a retrospective analysis of the prospective Grace database between October 2014 and October 2016. The evolution of each recommendation item over time was analysed using non-parametric Spearman correlation coefficient...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29452891/effect-of-topical-application-of-2-lidocaine-gel-on-corneal-sensitivity-of-clinically-normal-equine-eyes
#4
Alain Regnier, Iris Berton, Didier Concordet, Jean-Yves Douet
OBJECTIVE: To assess the degree and duration of corneal anaesthesia provided by topical application of a non-ophthalmic 2% lidocaine gel in horses. STUDY DESIGN: Experimental, 'blinded', randomized prospective study. ANIMALS: Twelve adult horses without relevant ocular abnormalities. METHODS: Baseline corneal touch threshold (CTT) measurements were obtained bilaterally by use of a Cochet-Bonnet aesthesiometer just prior to topical treatment...
September 15, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29452631/the-evaluation-of-the-implementation-of-the-vascular-preventative-bundle-and-development-of-suggested-interventions-for-improvement-and-sustainability
#5
Jennifer Franklin, Kathleen Turner, John S Hudson, Kimberly Guest, Ellen D Dillavou
Postoperative infections can complicate patient care and increase health care costs. A vascular preventative bundle was implemented at a large teaching/research intensive hospital to decrease surgical site infections (SSIs) with vascular surgery patients. The aim of this study was to measure fidelity to the bundle and determine if implementation of the vascular SSI bundle reduced the rate of SSIs. Three periods of data were collected, and they are identified as preimplementation (period 1), early implementation (period 2), and postimplementation (period 3)...
March 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/29450207/fixation-of-traumatic-chondral-only-fragments-of-the-knee-in-pediatric-and-adolescent-athletes-a-retrospective-multicenter-report
#6
Peter D Fabricant, Yi-Meng Yen, Dennis E Kramer, Mininder S Kocher, Lyle J Micheli, J Todd R Lawrence, Theodore J Ganley, Benton E Heyworth
Background: While traditional biological principles have suggested that fragments consisting of cartilage alone cannot be reaffixed to bone with expectable long-term healing, case reports of successful healing after fixation in younger patients indicate that this concept remains incompletely explored. Purpose: To evaluate the presenting features, techniques, healing rates, and clinical and radiological results in a cohort of pediatric and adolescent athletes who underwent fixation of traumatic chondral-only fragments in the knee...
February 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29449632/inducible-nitric-oxide-synthase-during-the-late-phase-of-sepsis-is-associated-with-hypothermia-and-immune-cell-migration
#7
Yudai Takatani, Kenji Ono, Hiromi Suzuki, Masato Inaba, Makoto Sawada, Naoyuki Matsuda
Hypothermia is a significant sign of sepsis, which is associated with poor prognosis, but few mechanisms underlying the regulation of hypothermia are known. Inducible nitric oxide synthase (iNOS) is a key inflammatory mediator of sepsis. However, the therapeutic benefit of iNOS inhibition in sepsis is still controversial, and requires elucidation in an accurate model system. In this study, wild-type (WT) mice showed temperature drops in a biphasic manner at the early and late phase of sepsis, and all mice died within 48 h of sepsis...
February 14, 2018: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/29448827/outcomes-after-primary-repair-of-insertional-ruptures-of-the-achilles-tendon
#8
Oliver Nickolaas Schipper, Robert Bentley Anderson, Bruce E Cohen
BACKGROUND: Achilles tendon insertional sleeve avulsions occur when the Achilles distal tendon sleeve ruptures off of its insertion into the calcaneal tuberosity, sometimes with a small bony fragment from calcific tendinosis. Little evidence exists describing the outcomes and rerupture rate after operative management of Achilles tendon sleeve avulsions. METHODS: A retrospective chart review was performed to identify patients who sustained an Achilles sleeve avulsion injury treated with operative repair between October 2005 and July 2014...
February 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29447348/transcriptome-analysis-reveals-intermittent-fasting-induced-genetic-changes-in-ischemic-stroke
#9
Joonki Kim, Sung-Wook Kang, Karthik Mallilankaraman, Sang-Ha Baik, James C Lim, Priyanka Balaganapathy, David T She, Ker-Zhing Lok, David Y Fann, Uma Thambiayah, Sung-Chun Tang, Alexis M Stranahan, S Thameem Dheen, Mathias Gelderblom, Raymond C Seet, Vardan T Karamyan, Raghu Vemuganti, Christopher G Sobey, Mark P Mattson, Dong-Gyu Jo, Thiruma V Arumugam
Genetic changes due to dietary intervention in the form of either calorie restriction (CR) or intermittent fasting (IF) are not reported in detail until now. However, it is well established that both CR and IF extend the lifespan and protect against neurodegenerative diseases and stroke. The current research aims were first to describe the transcriptomic changes in brains of IF mice and, second, to determine whether IF induces extensive transcriptomic changes following ischemic stroke to protect the brain from injury...
February 13, 2018: Human Molecular Genetics
https://www.readbyqxmd.com/read/29444638/unusual-elevation-in-entropy-but-not-in-psi-during-general-anesthesia-a-case-report
#10
Young Sung Kim, Dongik Chung, Seok Kyeong Oh, Young Ju Won, Il Ok Lee
BACKGROUND: EEG monitoring is useful for determining an adequate level of anesthesia. However it is sometimes interfered by various reasons. We describe a case in which we successfully confirmed the adequate depth of anesthesia by monitoring the patient state index (PSI), which was computed from the SedLine monitor data in Root (Masimo) during general anesthesia. Our case showed unusual elevations in entropy, but not in PSI. CASE PRESENTATION: A 34-year-old woman was scheduled for emergency surgery for a left tibial open fracture and a right femoral closed fracture, which were sustained during a traffic accident...
February 14, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29444559/concurrent-alzheimer-s-pathology-in-patients-with-clinical-normal-pressure-hydrocephalus
#11
I Jonathan Pomeraniec, Davis G Taylor, Aaron E Bond, M Beatriz Lopes
BACKGROUND: Patients with normal pressure hydrocephalus (NPH) and Alzheimer's dementia (AD) can often present with similar symptoms. NPH remains a clinical diagnosis and there are reported shared underlying dynamics of cerebrospinal fluid (CSF) flow and histopathology with patients with biopsy-proven AD. METHODS: This is a review on the histopathology and cerebrospinal fluid dynamics of both NPH and AD. In a prior study at the University of Virginia, the authors reviewed patients over a 15 year period who were shunted for a preoperative diagnosis of NPH...
February 13, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29443766/meta-analysis-study-comparing-percutaneous-coronary-intervention-drug-eluting-stent-versus-coronary-artery-bypass-surgery-of-unprotected-left-main-coronary-artery-disease-clinical-outcomes-during-short-term-versus-long-term-1-year-follow-up
#12
Waleed E Ali, Satyanarayana R Vaidya, Sylvester U Ejeh, Kingsley U Okoroafor
BACKGROUND: Results on the safety and long-term efficacy of drug-eluting stent placement in unprotected left main coronary artery disease (ULMCAD) compared with those of coronary artery bypass surgery (CABG) remain inconsistent across randomized clinical trials and recent meta-analysis studies. We aimed to compare the clinical outcomes and safety over short- and long-term follow-ups by conducting a meta-analysis of large pooled data from randomized controlled trials and up-to-date observational studies...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29442238/two-point-measurement-of-amylase-in-drainage-fluid-predicts-severe-postoperative-pancreatic-fistula-after-gastric-cancer-surgery
#13
Satoshi Kamiya, Naoki Hiki, Koshi Kumagai, Michitaka Honda, Souya Nunobe, Manabu Ohashi, Takeshi Sano, Toshiharu Yamaguchi
BACKGROUND: Early identification of patients at risk of postoperative pancreatic fistula (POPF) allows appropriate management after gastrectomy. Although some reports have suggested a correlation between POPF and the concentration of amylase in drained abdominal fluid (D-AMY), this has not been proven to impact sufficiently on clinical decision-making. A sustained high level of D-AMY is often assumed to be due to unsatisfactory drainage or excessive pancreatic leakage. We assessed the clinical utility of measuring D-AMY on postoperative day (POD) 1 and POD3 for prediction of POPF...
February 13, 2018: Gastric Cancer
https://www.readbyqxmd.com/read/29441909/the-effect-of-continuous-perfusion-of-esmolol-on-cardiovascular-risk-in-elderly-patients-undergoing-noncardiac-surgery
#14
X K Zhang, Q Hu, Q H Chen, W X Wang
We evaluated the effect of continuous perfusion of esmolol on cardiovascular risk during curative laparoscopic surgery for gastrointestinal cancer in elderly patients. Sixty patients with gastrointestinal cancer, aged from 60 to 80 years, were divided into an esmolol group (ES, n = 30) and a control group (NS, n = 30). ES patients were treated with esmolol at a dose of 0.3 mg/kg 3 min before tracheal intubation, and received continuous perfusion of esmolol at a dose of 50 μg/kg/min during operation. In NS, esmolol was replaced by saline...
August 1, 2017: Die Pharmazie
https://www.readbyqxmd.com/read/29439691/what-matters-most-protocol-for-a-randomized-controlled-trial-of-breast-cancer-surgery-encounter-decision-aids-across-socioeconomic-strata
#15
Marie-Anne Durand, Renata West Yen, A James O'Malley, Mary C Politi, Shubhada Dhage, Kari Rosenkranz, Katie Weichman, Julie Margenthaler, Anna N A Tosteson, Eloise Crayton, Sherrill Jackson, Ann Bradley, Robert J Volk, Karen Sepucha, Elissa Ozanne, Sanja Percac-Lima, Julia Song, Jocelyn Acosta, Nageen Mir, Glyn Elwyn
BACKGROUND: Breast cancer is the most commonly diagnosed malignancy in women. Mastectomy and breast-conserving surgery (BCS) have equivalent survival for early stage breast cancer. However, each surgery has different benefits and harms that women may value differently. Women of lower socioeconomic status (SES) diagnosed with early stage breast cancer are more likely to experience poorer doctor-patient communication, lower satisfaction with surgery and decision-making, and higher decision regret compared to women of higher SES...
February 13, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29433865/electricity-and-generator-availability-in-lmic-hospitals-improving-access-to-safe-surgery
#16
Sagar Chawla, Shaheen Kurani, Sherry M Wren, Barclay Stewart, Gilbert Burnham, Adam Kushner, Thomas McIntyre
BACKGROUND: Access to reliable energy has been identified as a global priority and codified within United Nations Sustainable Goal 7 and the Electrify Africa Act of 2015. Reliable hospital access to electricity is necessary to provide safe surgical care. The current state of electrical availability in hospitals in low- and middle-income countries (LMICs) throughout the world is not well known. This study aimed to review the surgical capacity literature and document the availability of electricity and generators...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29432321/evaluation-of-intramedullary-fixation-for-pediatric-femoral-shaft-fractures-in-developing-countries
#17
Andrew T Chen, William Z Morris, Lewis G Zirkle, Raymond W Liu
OBJECTIVES: To report the clinical results following treatment of pediatric femoral shaft fractures with the SIGN Fracture Care International (SIGN) pediatric and standard fin nails. DESIGN: Retrospective review of prospectively collected data SETTING:: Sixteen global SIGN centers from 2003-2013 PATIENTS/PARTICIPANTS:: One hundred and twelve pediatric patients who sustained a diaphyseal pediatric femoral shaft fracture INTERVENTION:: Intramedullary fixation with the standard or pediatric SIGN nail MAIN OUTCOME MEASUREMENTS:: Main outcome measurements include clinical and radiographic healing and postoperative complications RESULTS:: The mean age of the pediatric fin patients was 9...
January 24, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29429942/pooled-human-serum-a-new-culture-supplement-for-bioreactor-based-cell-therapies-preliminary-results
#18
Sara Savelli, Luisa Trombi, Delfo D'Alessandro, Stefania Moscato, Simone Pacini, Simone Lapi, Fabrizio Scatena, Stefano Giannotti, Mario Petrini
BACKGROUND AIMS: Bone marrow mesenchymal stromal cells (MSCs) are an appealing source for several cell-based therapies. Many bioreactors, such as the Quantum Cell Expansion System, have been developed to generate a large number of MSCs under Good Manufacturing Practice conditions by using human platelet lysate (HPL). Previously, we isolated a novel cell population in human bone marrow, mesodermal progenitor cells (MPCs), which we identified as precursors of MSCs. MPCs may represent an important cell source for regenerative medicine applications...
February 8, 2018: Cytotherapy
https://www.readbyqxmd.com/read/29425720/nanoengineered-injectable-hydrogels-from-kappa-carrageenan-and-two-dimensional-nanosilicates-for-wound-healing-application
#19
Giriraj Lokhande, James K Carrow, Teena Thakur, Janet R Xavier, Madasamy Parani, Kayla J Bayless, Akhilesh K Gaharwar
We report injectable nanoengineered hemostats for enhanced wound healing and tissue regeneration. The nanoengineered system consists of the natural polysaccharide, κ-carrageenan (κCA), loaded with bioactive two-dimensional (2D) nanosilicates. Nanoengineered hydrogels showed shear-thinning characteristics and can be injected for a minimally invasive approach. The hydrogel can be physically crosslinked in presence of monovalent ions and result in mechanically strong hydrogels. By controlling the ratio between κCA and nanosilicates, compressive stiffness of nanoengineered hydrogels can be modulated between 20 to 200kPa...
February 6, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29423219/the-effect-of-protein-supplementation-on-body-muscle-mass-and-fat-mass-in-post-bariatric-surgery-a-randomized-controlled-trial-rct-study-protocol
#20
Sahar D Al-Shamari, Mohamed Aly ElSherif, Wahiba Hamid, Fahad Hanna
Background: Severe weight loss through means of bariatric surgery has been associated with loss of muscle mass due to lack of absorption of protein. The aim of this RCT is to investigate the effectiveness of protein supplementation in reducing the risk of developing protein malnutrition and muscle wasting in post-bariatric surgery patients in Qatar. Methods and analysis: The study was based at the Department of bariatric and metabolic surgery, Doha metropolitan and regional areas...
2018: Archives of Public Health, Archives Belges de Santé Publique
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