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https://www.readbyqxmd.com/read/28102530/surgeon-preparedness-for-mass-casualty-events-adapting-essential-military-surgical-lessons-for-the-home-front
#1
Kyle N Remick, Stacy Shackelford, John S Oh, Jason M Seery, Daniel Grabo, John Chovanes, Kirby R Gross, Shawn C Nessen, Nigel Rm Tai, Rory F Rickard, Eric Elster, C W Schwab
Military surgeons have gained familiarity and experience with mass casualty events (MCEs) as a matter of routine over the course of the last two conflicts in Afghanistan and Iraq. Over the same period of time, civilian surgeons have increasingly faced complex MCEs on the home front. Our objective is to summarize and adapt these combat surgery lessons to enhance civilian surgeon preparedness for complex MCEs on the home front. The authors describe the unique lessons learned from combat surgery over the course of the wars in Afghanistan and Iraq and adapt these lessons to enhance civilian surgical readiness for a MCE on the home front...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28102467/mypod-an-emr-based-tool-that-facilitates-quality-improvement-and-maintenance-of-certification
#2
Loren Berman, Brian Duffy, B Randall Brenn, Charles Vinocur
Maintenance of Certification (MOC) was designed to assess physician competencies including operative case volume and outcomes. This information, if collected consistently and systematically, can be used to facilitate quality improvement. Information automatically extracted from the electronic medical record (EMR) can be used as a prompt to compile these data. We developed an EMR-based program called MyPOD (My Personal Outcomes Data) to track surgical outcomes at our institution. We compared occurrences reported in the first 18 months to those captured in the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) over the same time period...
March 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28102173/in-vitro-evaluation-of-the-antibacterial-and-osteogenic-activity-promoted-by-selenium-doped-calcium-phosphate-coatings
#3
Cosme Rodriguez-Valencia, Paula Freixeiro, Julia Serra, Carlos Ferreiros, Pio Gonzalez, Miriam Lopez-Alvarez
Selenium is an essential trace element present in 25 selenoenzymes, playing critical roles in a variety of physiological processes, such as anti-oxidative defense and the modulation of cell proliferation and differentiation. This paper characterizes selenium-doped calcium phosphate coatings and evaluates their effects on the osteogenic activity, the proliferation of osteosarcoma cells and biofilm formation. To do so, the structure and elemental composition of the obtained coatings were analyzed, in addition to their thicknesses, and they were compared to pure calcium phosphate coatings...
January 19, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28101720/enhanced-recovery-after-surgery-programs-for-liver-resection-a-meta-analysis
#4
Cheng Wang, Guoqun Zheng, Wenlong Zhang, Fabiao Zhang, Shangdong Lv, Aidong Wang, Zheping Fang
BACKGROUND AND AIMS: Due to the limited number of high-quality randomized controlled trials on enhanced recovery after surgery for hepatectomy, previous reviews have not been sufficiently comprehensive. Our objectives were to evaluate and compare the safety and efficacy of enhanced recovery after surgery programs and traditional care in patients undergoing open or laparoscopic surgery and to assess the optimized items for hepatectomy. METHODS: We searched the PubMed, Embase, and the Cochrane Library databases for all the relevant studies regardless of study design...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28100248/mediastinal-lymph-node-dissection-and-distal-esophagectomy-is-not-essential-in-early-esophagogastric-junction-adenocarcinoma
#5
In-Seob Lee, Ji-Yong Ahn, Jeong-Hwan Yook, Byung-Sik Kim
BACKGROUND: Optimal extent of surgery remains controversial in types 2 and 3 adenocarcinoma of esophagogastric junction (AEG). We aimed to determine whether the extended procedure including mediastinal lymphadenectomy is essential in all patients with AEG by comparing prognosis and recurrence of proximal gastric adenocarcinoma based on total gastrectomy with intra-abdominal lymphadenectomy. METHODS: The clinicopathologic characteristics of 672 patients (type 2: 90, type 3: 211, upper third of the stomach: 371 cases) who underwent curative total gastrectomy with lymphadenectomy between 2003 and 2009 were reviewed...
January 18, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28097213/fully-automated-quantitative-cephalometry-using-convolutional-neural-networks
#6
Sercan Ö Arık, Bulat Ibragimov, Lei Xing
Quantitative cephalometry plays an essential role in clinical diagnosis, treatment, and surgery. Development of fully automated techniques for these procedures is important to enable consistently accurate computerized analyses. We study the application of deep convolutional neural networks (CNNs) for fully automated quantitative cephalometry for the first time. The proposed framework utilizes CNNs for detection of landmarks that describe the anatomy of the depicted patient and yield quantitative estimation of pathologies in the jaws and skull base regions...
January 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28096706/balancing-standardized-testing-with-personalized-training-in-surgery
#7
REVIEW
Aadil Ahmed, Muhammad Abbas Abid, Nasir I Bhatti
Students pursuing a medical career in the US are subject to standardized testing at regular intervals. These standardized tests not only quantify the milestones students have already achieved, but also define the path for future achievements. The purpose of these examinations is to help students become self-directed, lifelong learners - an essential attribute of a medical professional. However, whether preparing for these examinations actually makes students such disciplined learners needs to be examined. Especially during residency training with its limited time and unpredictable exposure, trainees must learn in the most efficient way for their learning styles, and thus develop attributes that will be helpful to them in their medical career...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28094907/better-nurse-autonomy-decreases-the-odds-of-30-day-mortality-and-failure-to-rescue
#8
Aditi D Rao, Aparna Kumar, Matthew McHugh
RESEARCH PURPOSE: Autonomy is essential to professional nursing practice and is a core component of good nurse work environments. The primary objective of this study was to examine the relationship between nurse autonomy and 30-day mortality and failure to rescue (FTR) in a hospitalized surgical population. STUDY DESIGN: This study was a secondary analysis of cross-sectional data. It included data from three sources: patient discharge data from state administrative databases, a survey of nurses from four states, and the American Hospital Association annual survey from 2006-2007...
January 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28093768/short-term-and-long-term-follow-up-of-pulmonary-function-in-patients-with-copd-after-total-laryngectomy-a-prospective-study
#9
Charlotte Schönwald, Maria Isabel Körber, Dirk Beutner, Roman Pfister, Konrad Frank, Orlando Guntinas-Lichius, Guido Michels
OBJECTIVE: There exists no standardized method for examining lung function in laryngectomized patients. STUDY DESIGN AND METHODS: We established a base plate adapter (BPA) system for patients after laryngectomy. In 10 patients with chronic obstructive pulmonary disease (COPD), we evaluated pulmonary function before laryngectomy, as well as 2 weeks and 3 months after laryngectomy. RESULTS: The BPA system was well tolerated and delivered reliable results comparable to measurements with a mouthpiece...
January 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28092251/-acute-appendicitis-surgical-and-non-surgical-treatment
#10
Luis Manuel Souza-Gallardo, José Luis Martínez-Ordaz
Appendicitis represents a common disease for the surgeon with a relative risk between 7-8%. It was thought that if more time passed between diagnosis and treatment, the risk for complications, such as perforation or abscess formation, was higher; nevertheless; the evolution is variable, making necessary the development of different strategies such as antibiotic use only, interval surgery or endoscopic treatment. The purpose of this study is to make a revision in the management of appendicitis comparing conservative and surgical treatment...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28091771/localization-of-parathyroid-adenomas-using-11-c-methionine-pet-after-prior-inconclusive-imaging
#11
Milou E Noltes, Annemieke M Coester, Anouk N A van der Horst-Schrivers, Bart Dorgelo, Liesbeth Jansen, Walter Noordzij, Clara Lemstra, Adrienne H Brouwers, Schelto Kruijff
PURPOSE: Minimally invasive parathyroidectomy (MIP) is the recommended treatment in primary hyperparathyroidism (pHPT) for which accurate preoperative localization is essential. The current imaging standard consists of cervical ultrasonography (cUS) and MIBI-SPECT/CT. (11)C-MET PET/CT has a higher resolution than MIBI-SPECT/CT. The aim of this study was to determine the diagnostic performance of (11)C-MET PET/CT after initial inconclusive or negative localization. METHODS: We performed a retrospective single center cohort study of patients with pHPT undergoing parathyroid surgery after prior negative imaging and later localization by means of (11)C-MET PET/CT between 2006 and 2014...
January 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28089421/microbiology-and-treatment-of-brain-abscess
#12
REVIEW
Itzhak Brook
Brain abscess is a focal pyogenic infection of the brain's parenchyma. The most frequent intracranial locations (in descending order of frequency) are: frontal-temporal, frontal-parietal, partial, cerebellar, and occipital lobes. The major predisposing factors are: an associated contiguous focus of infection, trauma, and hematogenous spread from a distant focus. The microbial etiology depends on the site of the primary infection; the patient's age, underlying condition, and immune status; and the geographic location...
January 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28087488/cathepsin-k-targeted-sub-micron-particles-for-regenerative-repair-of-vascular-elastic-matrix
#13
Brenton Jennewine, Jonathan Fox, Anand Ramamurthi
: Abdominal Aortic Aneurysms (AAA) involve slow dilation and weakening of the aortic wall due to breakdown of structural matrix components, such as elastic fibers by chronically overexpressed matrix metalloproteinases (MMPs), primarily, MMPs-2 and -9. Auto-regenerative repair of disrupted elastic fibers by smooth muscle cells (SMCs) at the AAA site is intrinsically poor and together with chronic proteolysis prevents restoration of elastin homeostasis, necessary to enable AAA growth arrest or regression to a healthy state...
January 10, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28079049/lateralization-index-but-not-contralateral-suppression-at-adrenal-vein-sampling-predicts-improvement-in-blood-pressure-after-adrenalectomy-for-primary-aldosteronism
#14
M Tagawa, M Ghosn, H Wachtel, D Fraker, R R Townsend, S Trerotola, D L Cohen
Adrenal vein sampling (AVS) is essential in differentiating unilateral from bilateral sources of aldosterone excess in primary aldosteronism (PA). However, its ability to predict blood pressure (BP) improvement after adrenalectomy has not been well studied. This is a retrospective observational study of 119 patients who underwent AVS by sequential technique followed by adrenalectomy for PA at the Hospital of the University of Pennsylvania from 1997 to 2015. Median age was 52 years (interquartile range 44-59), 67% were male and median duration of hypertension was 10 (interquartile range 6-20) years...
January 12, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28076489/robotic-surgery-bioethical-aspects
#15
Rodrigo Siqueira-Batista, Camila Ribeiro Souza, Polyana Mendes Maia, Sávio Lana Siqueira
Introduction: The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. Objective: To present review of the ethical aspects of robot use in surgery. Method: Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Results: Of the citations obtained, were selected 17 articles, which were used for the preparation of the article...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28074820/airway-management-of-the-cardiac-surgical-patients-current-perspective
#16
REVIEW
Arindam Choudhury, Nishkarsh Gupta, Rohan Magoon, Poonam Malhotra Kapoor
The difficult airway (DA) is a common problem encountered in patients undergoing cardiac surgery. However, the challenge is not only just establishment of airway but also maintaining a definitive airway for the safe conduct of cardiopulmonary bypass from initiation to weaning after surgical correction or palliation, de-airing of cardiac chambers. This review describes the management of the DA in a cardiac theater environment. The primary aims are recognition of DA both anatomical and physiological, necessary preparations for (and management of) difficult intubation and extubation...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074234/-biological-downsizing-acetabular-defect-reconstruction-in-revision-total-hip-arthroplasty
#17
S Koob, S Scheidt, T M Randau, M Gathen, M D Wimmer, D C Wirtz, S Gravius
BACKGROUND: Periacetabular bony defects remain a great challenge in revision total hip arthroplasty. After assessment and classification of the defect and selection of a suitable implant the primary stable fixation and sufficient biological reconstitution of a sustainable bone stock are essential for long term success in acetabular revision surgery. Biological defect reconstruction aims for the down-sizing of periacetabular defects for later revision surgeries. TECHNIQUE: In the field of biological augmentation several methods are currently available...
January 10, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28070552/long-term-survival-after-anterior-pelvic-exenteration-and-total-vaginectomy-for-recurrent-endometrial-carcinoma-with-metastatic-inguinal-nodes-at-the-time-of-surgery
#18
Benjamin Margolis, Sun Woo Kim, Dennis S Chi
•Pelvic exenteration can be used in patients with multifocal recurrence.•Ability to achieve negative margins remains a necessity for pelvic exenteration.•Individualized treatments are essential for those with recurrent malignancy.
February 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28070232/abdominosacral-resection-for-locally-recurring-rectal-cancer
#19
Filiberto Belli, Alessandro Gronchi, Carlo Corbellini, Massimo Milione, Ermanno Leo
AIM: To investigate feasibility and outcome of abdominal-sacral resection for treatment of locally recurrent rectal adenocarcinoma. METHODS: A population of patients who underwent an abdominal-sacral resection for posterior recurrent adenocarcinoma of the rectum at the National Cancer Institute of Milano, between 2005 and 2013, is considered. Retrospectively collected data includes patient characteristics, treatment and pathology details regarding the primary and the recurrent rectal tumor surgical resection...
December 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28069072/pansaid-paracetamol-and-nsaid-in-combination-study-protocol-for-a-randomised-trial
#20
Kasper Højgaard Thybo, Daniel Hägi-Pedersen, Jørn Wetterslev, Jørgen Berg Dahl, Henrik Morville Schrøder, Hans Henrik Bülow, Jan Gottfrid Bjørck, Ole Mathiesen
BACKGROUND: Effective postoperative pain management is essential for the rehabilitation of the surgical patient. No 'gold standard' exists after total hip arthroplasty (THA) and combinations of different nonopioid medications are used with virtually no evidence for additional analgesic efficacy compared to monotherapy. The objective of this trial is to investigate the analgesic effects and safety of paracetamol and ibuprofen alone and in combination in different dosages after THA. METHODS: PANSAID is a placebo-controlled, parallel four-group, multicentre trial with centralised computer-generated allocation sequence and allocation concealment and with varying block size and stratification by site...
January 10, 2017: Trials
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