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Medical surgery

Daniel H Wiznia, Theodore Zaki, Julianna Maisano, Chang-Yeon Kim, Thomas M Halaszynski, Michael P Leslie
BACKGROUND AND OBJECTIVES: The Affordable Care Act intended to "extend affordable coverage" and "ensure access" for vulnerable patient populations. This investigation examined whether the type of insurance (Medicaid, Medicare, Blue Cross, cash pay) carried by trauma patients influences access to pain management specialty care. METHODS: Investigators phoned 443 board-certified pain specialists, securing office visits with 235 pain physicians from 8 different states...
October 21, 2016: Regional Anesthesia and Pain Medicine
Katelyn G Bennett, Theodore A Kung, James A Hayman, David L Brown
BACKGROUND: Management of keloids has remained a conundrum, because an optimum treatment regimen has yet to be elucidated. Currently, treatment varies widely between more conservative measures, such as steroid injections, topical medications, and silicone sheeting, to more aggressive options, such as surgery and postoperative radiation. The latter combination has been touted to have superior results, with the lowest rates of pathologic scar recurrence. METHODS: We performed a retrospective review to critically evaluate the effectiveness of surgical excision and radiation treatment in patients with keloids...
October 19, 2016: Annals of Plastic Surgery
Erwin Santo, Anna Itshak, Liat Mlynarsky, Moshe Leshno, Nathan Gluck
BACKGROUND: Biliary strictures (BS) are a common complication of liver transplantation. The standard treatment is sequential insertion of increasing numbers of plastic stents by endoscopic retrograde cholangiopancreatography (ERCP). Despite high success rates, some strictures fail to resolve and require surgery as definitive treatment. GOALS: To identify predictors of response or failure of standard endoscopic treatment, allowing earlier referral to alternative modalities when needed and avoiding unnecessary procedures...
October 21, 2016: Journal of Clinical Gastroenterology
E Calleja Aguayo, A E Hernández Calvarro, C Marhuenda Irastorza
OBJECTIVES: Balanitis xerotica obliterans (BXO) is a chronic inflamatory disease, a genital form of Lichen Sclerosus in males. MATERIAL AND METHODS: This retrospective and descriptive analysis was carried out by rewiew of the medical records of boys who underwent circumcision from April 2013 to April 2014. The study group consisted of boys that were circumcised due it persistant phimosis at 4 years of age, urinary symptoms or painful erection. The histopathological examination was performed only in patients with clinical suspicion of BXO...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
N Albertos Mira-Marcelí, N Gallego Mellado, P Deltell Colomer, J Mira Navarro, A Encinas Goenechea, O Sánchez París, E Liceras Liceras, F González López, M E Martín Hortigüela, C Navarro de la Calzada, J Gonzálvez Piñera
OBJECTIVE: To compare the results of laparoscopic versus open adhesiolysis in children affected by postoperative bowel obstruction. METHODS: Retrospective study reviewing charts of all patients who were operated on due to postoperative adhesions in our Department. Demographic data, clinical characteristics and postoperative data were collected. RESULTS: During the last 8 years, 37 patients were operated on for postoperative intestinal obstructions...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
R M Paredes Esteban, J I Garrido Pérez, A Ruiz Palomino, G Guerrero Peña, F Vázquez Rueda, M J Berenguer García, R Miñarro Del Moral, M Tejedor Fernández
OBJECTIVES: In 2014 our department starts to apply the PatientSafety Strategic in Pediatric Surgery. Our aim is to describe the results obtained. METHODS: For the measurement of adverse events (AE) we used a modification of the Global Trigger Tool of the Institute for Healthcare Improvement. Population analysed: patients undergoing surgery with hospitalization. On a monthly basis, audits of the medical records of 12 patients discharged in the prior week of the assessment were performed...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
M Ortega Escudero, J M Gutiérrez Dueñas, C Hernández Díaz, C Ruiz Hierro, R Chamorro Juárez, E Ardela Díaz
OBJECIVES: The aim of this study is to assess the outcome of surgery (Lynn's myectomy) in patients with chronic persistent constipation and failure of medical treatment. MATERIAL AND METHODS: Descriptive study of patients with severe chronic constipation treated by posterior anorectal myectomy (Lynn's technique). We report data from the last 15 years, with a minimum postoperative follow-up of one year. Patients included in the study suffered from a long-term constipation refractory to medical management...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
P Deltell Colomer, N Albertos Mira-Marcelí, N Gallego Mellado, M E Kuan Argüello, M F Bordallo Vázquez, J Mira Navarro, J Gonzálvez Piñera
INTRODUCTION: In more than 50% of the necrotizing enterocolitis that underwent surgery will require an ileostomy. The optimal time to reestablish intestinal transit still is a controversial subject. Many times ileostomies cause medical issues that require early intestinal reconstruction. Our objective is to compare the early closure against late close, being the shift point 35 days according to other published research. MATERIAL AND METHODS: Retrospective study off all patients that in the last 10 years have had an episode of necrotizing enterocolitis which required an intestinal derivation like ileostomy...
January 15, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Hacı Ahmet Kasapkara, Abdullah Nabi Aslan, Hüseyin Ayhan, Serdal Baştuğ, Hakan Süygün, Telat Keleş, Tahir Durmaz, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) has been accepted as an alternative to surgery in high risk or inoperable patients with severe aortic stenosis (AS). Although transfemoral approach is the most often preferred means of access, in patients with severe ilio-femoral arteriopathy, other vascular access sites may be required. The aim of the present study was to report our experience with trans-subclavian approach for TAVR using different valve systems. METHODS: Among 273 patients undergoing TAVR between June 2011 and May 2016, 10 patients (mean age: 68...
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
M M F Aubuchon, L J J Bolt, M L G Janssen-Heijnen, S T H P Verleisdonk-Bolhaar, A van Marion, C L H van Berlo
BACKGROUND: Malignant melanoma (MM) is the most aggressive type of skin cancer, accounting for 90% of all the skin cancer mortality. The objective of this study was providing an overview of current patient- and tumour characteristics, treatment strategies, complications and survival in patients with MM over the past ten years. Hereby, an up-to-date view of every day clinical practice is obtained. METHODS: Files of patients treated for primary cutaneous melanoma (n = 686) in the VieCuri Medical Centre in the Netherlands between January 2002 and December 2013 were retrospectively reviewed...
October 23, 2016: Acta Chirurgica Belgica
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Shay McGuinness, Kelly Byrne, Matthew T V Chan, Giovanni Landoni, Sophie Wallace
Background Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects. Methods In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo. The results of the tranexamic acid comparison are reported here...
October 23, 2016: New England Journal of Medicine
Phillip Ertel, Burkay Adalig, Ipek Demircan, Belinda Lartey, Michael J Manyak
AIM: To assess attitudes and beliefs towards benign prostatic hyperplasia (BPH)/ lower urinary tract symptoms (LUTS) and its treatment among patients and physicians in Latin America, Asia Pacific and the Commonwealth of Independent States (CIS). METHODS: Cross-sectional, quantitative study conducted between December 2014 and September 2015. Separate questionnaires were administered to BPH/LUTS patients receiving drug treatment for their condition and to practising physicians who treat patients with BPH/LUTS...
October 2016: International Journal of Clinical Practice
Sean D McGarry, Sarah L Hurrell, Amy L Kaczmarowski, Elizabeth J Cochran, Jennifer Connelly, Scott D Rand, Kathleen M Schmainda, Peter S LaViolette
Magnetic resonance imaging (MRI) is used to diagnose and monitor brain tumors. Extracting additional information from medical imaging and relating it to a clinical variable of interest is broadly defined as radiomics. Here, multiparametric MRI radiomic profiles (RPs) of de novo glioblastoma (GBM) brain tumors is related with patient prognosis. Clinical imaging from 81 patients with GBM before surgery was analyzed. Four MRI contrasts were aligned, masked by margins defined by gadolinium contrast enhancement and T2/fluid attenuated inversion recovery hyperintensity, and contoured based on image intensity...
September 2016: Tomography: a Journal for Imaging Research
Alexander J Sweidan, Navneet K Singh, Natasha Dang, Vinh Lam, Jyoti Datta
INTRODUCTION: Amiodarone is often used in the suppression of tachyarrhythmias. One of the more serious adverse effects includes amiodarone pulmonary toxicity (APT). Several pulmonary diseases can manifest including interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary nodules or masses, and pleural effusion. Incidence of APT varies from 5-15% and is correlated to dosage, age of the patient, and preexisting lung disease...
2016: Clinical Medicine Insights. Case Reports
Travis E Wright, K Keely Boyle, Thomas R Duquin, John K Crane
BACKGROUND: Many studies have noted an increase in the number of recognized cases of invasive infections due to Propionibacterium acnes, especially after shoulder replacement surgery. The increase in the number of recognized cases of P. acnes, a nonspore-forming, anaerobic, Gram-positive organism, appears due to both an increase in the number of shoulder operations being performed and more specimens being sent for anaerobic cultures. Nevertheless, the optimal surgical and antibiotic management of P...
2016: Infectious Diseases
Mana Doi-Kanno, Hiroki Fukahori
AIM: This study identified the factors associated with depression in patients diagnosed with myocardial infarction (MI) who underwent percutaneous coronary intervention (PCI). METHODS: We searched the literature using PubMed and CINAHL from their inception in 1946 to December 2014. The search terms were "myocardial infarction," "depression," and "percutaneous coronary intervention." Studies which investigated factors associated with depression in patients diagnosed with MI who underwent typical medical procedures were searched...
2016: Journal of Medical and Dental Sciences
Lukas Andereggen, Janine Frey, Robert H Andres, Marwan El-Koussy, Jürgen Beck, Rolf W Seiler, Emanuel Christ
OBJECTIVE: In men with prolactinomas, an impaired bone density is the principle consequence of hyperprolactinemia-induced hypogonadism. While dopamine (DA-) agonists are the first-line approach in prolactinomas, surgery can be considered in selected cases. In the present study, we aimed to investigate on the long-term control of hyperprolactinemia, hypogonadism and bone health comparing primary medical and surgical therapy in men who had not had prior DA-agonist treatment. METHODS: Retrospective case-note study of 44 consecutive men with prolactinomas and no prior DA-agonists managed in a single tertiary referral center...
October 20, 2016: World Neurosurgery
A D Darwish, A M Helal, N H Aly El-Din, L L Solaiman, A Amin
OBJECTIVE: The aim is to identify the epidemiological and clinicopathological features associated with young breast cancer (BC) patients and to discuss factors affecting tumor recurrence and DFS. PATIENTS & METHODS: A retrospective analysis was conducted based on medical records from young females patients aged ≤35 years with pathologically confirmed primary breast cancer treated during 2008-2010 at NCI. Cases with non invasive cancer and non carcinoma histology are excluded...
October 20, 2016: Breast: Official Journal of the European Society of Mastology
Ram A Pathak, Gregory A Broderick, Todd C Igel, Steven P Petrou, Paul R Young, Michael J Wehle, Michael G Heckman, Nancy N Diehl, Emily R Vargas, Kandarp Shah, David D Thiel
OBJECTIVE: To compare the frequency of postoperative encounters in the 30-day and 90-day postoperative periods for various bladder outlet obstruction surgical therapies. METHODS: All patients who underwent transurethral resection of the prostate (TURP), GreenLight laser photovaporization of the prostate (GL-PVP) (American Medical Systems Inc.), and holmium laser enucleation of the prostate (HoLEP) from January 1(st), 2012 through December 31(st), 2014 were followed for 6 months postoperatively...
October 19, 2016: Urology
Sorena Afshar, Keith Seymour, Seamus B Kelly, Sean Woodcock, Vincent T van Hees, John C Mathers
BACKGROUND: Many studies using self-reported physical activity (PA) assessment tools have suggested there is an increase in PA after bariatric surgery. OBJECTIVES: Our aim was to assess PA and sedentary behavior before bariatric surgery and at 6 months after, using subjective and objective tools. SETTING: Bariatric surgery candidates were recruited from a single center. METHODS: Demographic data, medical history, current medications, and anthropometric measurements were recorded...
September 13, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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