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https://www.readbyqxmd.com/read/29908405/objective-predictors-of-early-tolerance-to-ventral-intermediate-nucleus-of-thalamus-deep-brain-stimulation-in-essential-tremor-patients
#1
Shabbir Hussain Merchant, Sheng-Han Kuo, Yu Qiping, Linda Winfield, Guy McKhann, Sameer Sheth, Seth L Pullman, Blair Ford
OBJECTIVE: To identify pre-operative clinical and computerized spiral analysis characteristics that may help ascertain which patients with Essential Tremor (ET) will exhibit 'early tolerance' to ventral intermediate nucleus of thalamus (Vim) deep brain stimulation (DBS). METHODS: Identification of comparative characteristics of defined cases of 'early tolerance' versus patients with sustained satisfactory response treated with Vim DBS surgery for medically-refractory ET, based on retrospective chart review by a clinician blinded to the findings of computerized spiral analysis...
June 5, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29908198/in-hospital-delays-result-in-worse-patient-outcomes-and-higher-cost-after-cardiac-surgery
#2
Diane R M Somlo, Nelson P Repenning, Abeel A Mangi
BACKGROUND: Contemporary reimbursement systems allow hospitals to maintain profitability by offering procedural services. However, increasing procedural volume can be met with structural inefficiencies that in turn cause delays, worse patient outcomes, and increased cost. METHODS: A multidisciplinary team assessed operations and outcomes at the Heart and Vascular Center at Yale New Haven Hospital, a tertiary academic medical center. Data were analyzed retrospectively to assess delays in transferring patients between care environments, patient outcomes, and cost...
June 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29907941/the-clinical-outcome-of-postoperative-invasive-fungal-infections-complicating-laparoscopic-sleeve-gastrectomy
#3
Yoav Bichovsky, Leonid Koyfman, Michael Friger, Boris Kirshtein, Abraham Borer, Gilbert Sebbag, Dmitry Frank, Amit Frenkel, Jochanan G Peiser, Moti Klein, Evgeni Brotfain
PURPOSE: Peritonitis is a major complication of bariatric surgery due to direct damage to the natural barriers to infection. Most such secondary peritoneal infections are caused by Gram-negative microorganisms; however, under certain conditions, Candida species can infect the peritoneal cavity following bariatric surgery. MATERIALS AND METHODS: We retrospectively analyzed the clinical and microbiological data of morbidly obese patients who suffered infectious complications following laparoscopic sleeve gastrectomy (LSG) at the Soroka Medical Center between January 2010 and June 2015...
June 15, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29907496/-where-do-we-stand-with-benign-prostatic-hyperplasia-day-case-surgery-a-laser-effect
#4
L Gury, G Robert, H Bensadoun
INTRODUCTION AND OBJECTIVES: Despite its feasibility has been proven, Benign Prostatic Hyperplasia (BPH) day-case surgery remains uncommon. Our objective was to describe the evolution of BPH day-case surgery in France according to the surgical technique employed. MATERIALS AND METHODS: We extracted data from the Information System of Medicalization Program (PMSI) including all of the hospital stays in France from 2010 to 2016. Patients belonging to the transurethral prostatectomy homogeneous group of patients (GHM 12C04) and having as a main diagnosis prostatic hyperplasia (N40) or benign prostatic tumor (D291) were included in the analysis...
June 12, 2018: Progrès en Urologie
https://www.readbyqxmd.com/read/29907461/vascular-anomalies
#5
REVIEW
Amir H Taghinia, Joseph Upton
Vascular anomalies encompass a wide variety of clinical conditions involving the vasculature. Over the past several decades, the terminology has changed as our understanding of these conditions has improved. A well-accepted classification scheme has evolved with constant additions, updates, and revisions. Imaging techniques have also advanced with greater resolution and a better understanding of the correlation between imaging, clinical behavior, and natural history. Meanwhile, the treatment of these conditions has also changed, with greater focus on minimally invasive techniques as opposed to radical surgery...
June 12, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29907250/evaluating-risk-factors-for-differences-in-fibroid-size-and-number-using-a-large-electronic-health-record-population
#6
Michael J Bray, Eric S Torstenson, Sarah H Jones, Todd L Edwards, Digna R Velez Edwards
OBJECTIVE: To evaluate individual characteristics of women with fibroids in relation to fibroid size and number. METHODS: This cross-sectional study involved 2302 women (black and white, age range 18-87) with image- or surgery-confirmed fibroids from the Synthetic Derivative, a database of de-identified demographic and clinical information from patient electronic health records (EHRs) from the Vanderbilt University Medical Center. We performed multivariate regression analyses on the following outcomes: volume of largest fibroid, largest dimension of all fibroids, and number of fibroids (single vs multiple)...
August 2018: Maturitas
https://www.readbyqxmd.com/read/29907223/an-evidence-based-intraoperative-communication-tool-for-emergency-general-surgery-a-pilot-study
#7
Alexandra B Columbus, Manuel Castillo-Angeles, William R Berry, Adil H Haider, Ali Salim, Joaquim M Havens
BACKGROUND: Emergency general surgery (EGS) is characterized by high rates of morbidity and mortality. Though checklists and associated communication-based huddle strategies have improved outcomes, these tools have never been specifically examined in EGS. We hypothesized that use of an evidence-based communication tool aimed to trigger intraoperative discussion could improve communication in the EGS operating room (OR). MATERIALS AND METHODS: We designed a set of discussion prompts based on modifiable factors identified from previously published studies aimed to encourage all team members to speak up and to centralize awareness of patient disposition and intraoperative transfusion practices...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907220/validation-of-the-american-association-for-the-surgery-of-trauma-s-emergency-general-surgery-breast-infection-grading-system
#8
Brittany L Murphy, Matthew C Hernandez, Nimesh D Naik, Amy E Glasgow, Victor Y Kong, Damian L Clarke, Humza Y Saleem, Jennifer M Racz, Elizabeth B Habermann, Martin D Zielinski
BACKGROUND: The American Association for the Surgery of Trauma (AAST) developed emergency general surgery (EGS) grading systems for multiple diseases to standardize classification of disease severity. The grading system for breast infections has not been validated. We aimed to validate the AAST breast infection grading system. METHODS: Multi-institutional retrospective review of all adult patients with a breast infection diagnosis at Mayo Clinic Rochester 1/2015-10/2015 and Pietermaritzburg South African Hospital 1/2010-4/2016 was performed...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907211/comparison-of-dexmedetomidine-versus-propofol-on-hemodynamics-in-surgical-critically-ill-patients
#9
Ya-Fei Chang, Anne Chao, Po-Yuan Shih, Yen-Chun Hsu, Chen-Tse Lee, Yu-Wen Tien, Yu-Chang Yeh, Lee-Wei Chen
BACKGROUND: Sedation with dexmedetomidine and propofol may cause hypotension or bradycardia. This study aimed to compare the effects of dexmedetomidine and propofol on hemodynamics and clinical outcomes in surgical intensive care unit (ICU) patients after major abdominal surgery. MATERIALS AND METHODS: Enrolled patients were randomly allocated to the dexmedetomidine or propofol group. Cardiac index was measured using a continuous noninvasive cardiac output monitor on the basis of chest bioreactance...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907208/well-differentiated-thyroid-cancer-and-robotic-transaxillary-surgery-at-a-north-american-institution
#10
Meghan Garstka, Khuzema Mohsin, Daniah Bu Ali, Hosam Shalaby, Kareem Ibraheem, Mahmoud Farag, Sang-Wook Kang, Emad Kandil
BACKGROUND: Recent studies from Asia have reported the safety and feasibility of robotic-assisted thyroid surgery. In the United States, several small series and case reports have been published, mostly regarding treatment of benign disease. The aim of our study is to report the safety and feasibility of robotic surgery for well-differentiated thyroid cancer patients at a North American institution. MATERIALS AND METHODS: We performed a retrospective cohort study using a prospectively collected single-center clinical database at Tulane University Medical Center...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907201/a-qualitative-study-of-gender-differences-in-the-experiences-of-general-surgery-trainees
#11
Sara P Myers, Katherine A Hill, Kristina J Nicholson, Matthew D Neal, Megan E Hamm, Galen E Switzer, Leslie R M Hausmann, Giselle G Hamad, Matthew R Rosengart, Eliza B Littleton
BACKGROUND: Women surgeons continue to face unique challenges to professional advancement. Higher attrition rates and lower confidence among female surgical residents suggest that experiences during residency differ by gender. Few studies have investigated gender-specific experiences during training. This study identifies gender-based differences in the experiences of general surgery residents that could affect professional development. MATERIALS AND METHODS: Male and female general surgery residents at the University of Pittsburgh Medical Center participated in a semi-structured interview study exploring the significance of gender in training...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907149/changes-in-bone-mineral-density-after-total-parathyroidectomy-without-autotransplantation-in-the-end-stage-renal-disease-patients-with-secondary-hyperparathyroidism
#12
Li Fang, Jining Wu, Jing Luo, Ping Wen, Mingxia Xiong, Jinlong Cao, Xiaolan Chen, Junwei Yang
BACKGROUND: The patients with secondary hyperparathyroidism (SHPT) usually had reduced bone mineral density, which might lead to a substantial increase in osteoporosis, fracture and mortality. Although surgical intervention is effective in reducing parathyroid hormone (PTH) levels in suitable candidates refractory to medical therapy, the effect of surgery on bone mass changes still requires further evaluation. Thus, the aim of this study was to evaluate the characteristics of BMD changes after total parathyroidectomy (PTX) without autotransplantation and its associated factors...
June 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29906265/transcatheter-mitral-valve-in-valve-and-valve-in-ring-replacement-in-high-risk-surgical-patients-feasibility-safety-and-longitudinal-outcomes-in-a-single-center-experience
#13
Ashleigh Long, Paul Mahoney
BACKGROUND: Transcatheter mitral valve-in-valve (TMVIV) or valve-in-ring (TMVIR) replacement has shown early promise in patients deemed poor surgical candidates as a less invasive alternative to conventional reoperative mitral valve (MV) replacement. OBJECTIVE: This retrospective, single-center study reviewed the procedural outcomes of all TMVIV and TMVIR procedures between 2013-2018 at a large tertiary referral center serving the southeastern United States. An analysis of patient safety measures was also performed, with a retrospective assessment of relative procedural safety that included preoperative risk stratification and postoperative mortality predictors, operative time, average blood loss, length of hospital stay, and readmission rates...
June 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29906218/associations-between-parenting-stress-at-school-entry-and-later-psychosocial-adjustment-a-longitudinal-study-of-children-with-congenital-craniofacial-anomalies
#14
Emily D Wolodiger, Alice W Pope
OBJECTIVE: To examine the reciprocal relationships between parenting stress and psychosocial adjustment of children with congenital craniofacial anomalies (CFAs) at 2 time points: school entry and approximately 2.5 years later, after children had time to adjust to school. DESIGN: Retrospective review of medical charts of children with CFAs. SETTING: Department of reconstructive plastic surgery at an urban medical center. PARTICIPANTS: Parents of 42 children aged 3...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29905765/pleural-mesothelioma-is-the-surgeon-still-there
#15
I Opitz, W Weder
MPM is a rare malignancy with some unique characteristics. Tumor biology is aggressive and prognosis is poor. Despite more knowledge on histology, tumor biology and staging, there is still a relevant discrepancy between clinical and pathologic staging resulting in difficult prediction of prognosis and treatment outcome, making treatment allocation more challenging than in most other malignancies.After years of nihilism in the late eighties, a period of activism started evaluating different treatment protocols combined with research driven mainly by academic centers; at the time, selection was based on histology and stage only...
June 14, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29905538/comparative-evaluation-of-tapp-hernioplasty-with-use-of-various-methods-of-fixing-the-reticular-endoprosthesis-and-tep-in-the-treatment-of-inguinal-hernias
#16
D Krikunov, V Akimov, V Toidze, M Churgulia, L Dvаladze
The study was conducted with the aim to improve the results of treatment of patients with inguinal hernia by the mode of glue fixation of mesh implant in laparoscopic hernioplasty. Laparoscopic hernioplasty was performed on 96 patients at the N.D. Monastyrsky Department of Surgery of North-Western State Medical University named after I.I. Mechnikov, on the base of L.G. Sokolov Clinical Hospital № 122, in the period from 2014 to 2016. The patients were divided into three groups: I group - 36 patients, who underwent laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP) without supplying of mesh implant under spermatic cord and its fixation with cyanoacrylate glue "B-Braun" with elimination of peritoneum defect above the implant with a thread V-loc; II group consisted of 34 patients, treated with laparoscopic TAPP without cutting of mesh implant and its fixation along the periphery with titanium staples with the subsequent closing of peritoneum defect with titanium staples...
May 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29905510/bleeding-risk-of-cerebral-cavernous-malformations-in-patients-on-%C3%AE-blocker-medication-a-cohort-study
#17
Johannes Goldberg, Christian Jaeggi, Daniel Schoeni, Pasquale Mordasini, Andreas Raabe, David Bervini
OBJECTIVE Cerebral cavernous malformations (CCMs) are frequently diagnosed vascular malformations of the brain. Although most CCMs are asymptomatic, some can be responsible for intracerebral hemorrhage or seizures. In selected cases, microsurgical resection is the preferred treatment option. Treatment with the unselective β-blocker propranolol has been presumed to stabilize and eventually lead to CCM size regression in a limited number of published case series; however, the underlying mechanism and evidence for this effect remain unclear...
June 15, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29905359/-robotic-surgery-who-is-the-boss
#18
Patrick J Schuler
In the head and neck region, great potential is seen in robot-assisted surgery (RAS). Mainly in cancer surgery, the use of robotic systems seems to be of interest. Until today, two robotic systems (DaVinci® und FLEX®) have gained approval for clinical use in the head and neck region, and multiple other systems are currently in pre-clinical testing. Although, certain groups of patients may benefit from RAS, no unbiased randomized clinical studies are available. Until today, it was not possible to satisfactorily prove any advantage of RAS as compared to standard procedures...
March 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29904825/the-effect-of-residency-training-on-arthroscopic-knot-tying-and-knot-stability-which-knot-is-best-tied-by-orthopaedic-surgery-residents
#19
Kevin J Cronin, Jacob L Cox, Timothy M Hoggard, Scott T Marberry, Brandon G Santoni, Charles C Nofsinger
BACKGROUND: The aim of this study is to evaluate which of three arthroscopic knots are most reliably taught to and executed by residents at varying levels of training. METHODS: Three arthroscopic knots, the Samsung Medical Center (SMC), the Weston, and the surgeon's knot, were taught to 16 orthopaedic surgery residents. Each knot was tied in triplicate at two sessions 1 week apart. The knots were then biomechanically tested for strength. Corresponding knots tied by a sports medicine fellow served as the respective controls...
June 15, 2018: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29904819/perioperative-management-of-patients-with-addiction-to-opioid-and-non-opioid-medications
#20
REVIEW
Donna-Ann Thomas, Praba Boominathan, Jyotsna Goswami, Sudipta Mukherjee, Nalini Vadivelu
PURPOSE OF REVIEW: With the rise of the opioid epidemic, anesthesiologists will find themselves faced with opioid-addicted patients more frequently. Addiction to opioids may also occur concurrently with abuse of other non-opioid medications. Our review article seeks to outline an armamentarium of pain management strategies in the perioperative period for these patients with addiction to opioid and non-opioid medications. RECENT FINDINGS: Statistics from the CDC demonstrate a shocking increase in opioid prescription rates and opioid-related deaths...
June 14, 2018: Current Pain and Headache Reports
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