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https://www.readbyqxmd.com/read/29331874/thyroid-hormone-resuscitation-after-brain-death-in-potential-organ-donors-a-primer-for-neurocritical-care-providers-and-narrative-review-of-the-literature
#1
REVIEW
Ian A Buchanan, Vivek A Mehta
Solid organ transplantation has become a mainstay in the contemporary management of end-stage organ failures fueled by advances in immunosuppression, intensive care and surgical technology. Every year, a vast number of transplantable organs is lost on account of hemodynamic instability in potential brain-dead organ donors. Because of a growing organ shortage, measures that increase total donor supply pools are desperately needed. Thyroid hormone has been identified as an adjunctive therapy in donor management due to its potential for increasing organ supply and is currently endorsed by transplant organizations such as United Network for Organ Sharing (UNOS)...
January 8, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29326834/ablation-of-atrial-fibrillation-in-patients-with-congenital-heart-disease
#2
Marwan M Refaat, Jad Ballout, Moussa Mansour
With improved surgical techniques and medical management for patients with congenital heart diseases, more patients are living longer and well into adulthood. This improved survival comes with a price of increased morbidity, mainly secondary to increased risk of tachyarrhythmias. One of the major arrhythmias commonly encountered in this subset of cardiac patients is AF. Similar to the general population, the risk of AF increases with advancing age, and is mainly secondary to the abnormal anatomy, abnormal pressure and volume parameters in the hearts of these patients and to the increased scarring and inflammation seen in the left atrium following multiple surgical procedures...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29321843/esophagocoloplasty-fistula-successfully-treated-with-vacuum-assisted-closure
#3
Santiago A Endara, Fernando J Terán, Armando J Serrano, Manuela J Castillo, Gabriel A Molina
Esophageal fistulas in the cervical region are usually difficult to manage and carry a high morbidity. We report a case of an esophago-colonic fistula after colonic interposition, successfully managed with vacuum-assisted closure 'V.A.C. system', (Kinetic Concepts Inc., San Antonio, TX, USA). The patient initially presented with purulent fluid from the cervical wound 13 days after surgery. Esophagogram confirmed a leak. Since the patient had a history of anastomotic leaks, a surgical intervention was not the treatment of choice...
January 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29319639/mild-complications-or-unusual-persistence-of-porcine-collagen-and-hyaluronic-acid-gel-following-periocular-filler-injections
#4
Natalie Wolkow, Frederick A Jakobiec, Thaddeus P Dryja, Daniel R Lefebvre
The purpose of this study was to describe the histopathologic appearance of dermal eyelid fillers that were unexpectedly encountered in ophthalmic plastic surgery samples from patients with mild eyelid disfigurements, and to review eyelid cases with complications that had previously been described in the literature. A retrospective histopathologic study with Alcian blue, elastic, and Masson trichrome stains of 2 cases that were submitted to the Ocular Pathology Department was conducted, and a critical review of previously published cases of the histopathologic characteristics of dermal filler material in the periocular region was also conducted...
January 9, 2018: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29319598/corneal-collagen-cross-linking-with-riboflavin-and-ultraviolet-a-light-for-pediatric-keratoconus-ten-year-results
#5
Cosimo Mazzotta, Claudio Traversi, Stefano Baiocchi, Simone Bagaglia, Orsola Caporossi, Antonio Villano, Aldo Caporossi
PURPOSE: To assess the 10-year follow-up efficacy and safety of riboflavin ultraviolet A-induced cross-linking (CXL) in a population of pediatric patients aged 18 years and younger with progressive keratoconus (KC). METHODS: The prospective longitudinal cohort study included 62 eyes of 47 keratoconic patients undergoing epithelium-off CXL who completed 10-year follow-up. The surgical procedure was performed in all patients according to the Siena (Dresden modified) protocol...
January 9, 2018: Cornea
https://www.readbyqxmd.com/read/29316189/acute-lumbar-paraspinal-compartment-syndrome-a-systematic-review
#6
REVIEW
William Alexander, Nelson Low, George Pratt
While still a rare entity, acute lumbar paraspinal compartment syndrome has an increasing incidence. Similar to other compartment syndromes, acute lumbar paraspinal compartment syndrome is defined by raised pressure within a closed fibro-osseous space, limiting tissue perfusion within that space. The resultant tissue ischaemia presents as acute pain, and if left untreated, it may result in permanent tissue damage. A literature search of 'paraspinal compartment syndrome' revealed 21 articles. The details from a case encountered by the authors are also included...
January 8, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29314096/formats-of-responsibility-elective-surgery-in-the-era-of-evidence-based-medicine
#7
Ariel Ducey, Shoghi Nikoo
This article illustrates what pragmatic sociology refers to as investments in form, by examining the formats created and used by a group of surgeons to determine when elective surgery for pelvic floor disorders could be responsibly undertaken. Drawing upon ethnographic observations of surgical consultations at an academic medical centre in Canada, we show how two specific formats - that the patient is sufficiently bothered and the patient accepts the risks of surgery - allow for justifiable action in conditions of uncertainty and contingency and in light of the demands of dominant imperatives in medicine and health care, especially evidence-based medicine (EBM)...
January 3, 2018: Sociology of Health & Illness
https://www.readbyqxmd.com/read/29313987/variable-role-of-carotid-bodies-in-cardiovascular-responses-to-exercise-hypoxia-and-hypercapnia-in-spontaneously-hypertensive-rats
#8
Wioletta Pijacka, Pedro L Katayama, Helio C Salgado, Gisele S Lincevicius, Ruy R Campos, Fiona D McBryde, Julian F R Paton
The carotid body has recently emerged as a promising therapeutic target for treating cardiovascular disease, however the potential impact of carotid bodies removal on the dynamic cardiovascular responses to acute stressors such as exercise, hypoxia and hypercapnia in hypertension is an important safety consideration that has not been studied. We first validated a novel surgical approach to selectively resect the carotid bodies bilaterally (CBR) sparing the carotid sinus baroreflex. Second, we evaluated the impact of CBR on the cardiovascular responses to exercise, hypoxia and hypercapnia in the conscious, chronically instrumented spontaneously hypertensive (SH) rats...
January 5, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29311491/visual-evoked-potential-in-rabbits-eyes-with-subretinal-implantation-by-vitrectomy-of-okayama-university-type-retinal-prosthesis-oureptm
#9
Toshihiko Matsuo, Tetsuya Uchida, Koichiro Yamashita, Shigiko Takei, Daisuke Ido, Mamoru Tanaka, Masao Oguchi, Toshinori Furukawa
Okayama University-type retinal prosthesis (OURePTM) is a photoelectric dye-coupled polyethylene film which generates electric potential in response to light and stimulates nearby neurons. This study aims to test surgical feasibility for subretinal film implantation and to examine functional durability of films in subretinal space. Dye-coupled films were implanted subretinally by vitrectomy in the right eye of normal white rabbits: 8 rabbits for 1 month and 8 rabbits for 6 months. The implanted films were removed by vitrectomy in 4 of these 8 rabbits in 1-month or 6-month implantation group...
January 1, 2018: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/29306854/successful-management-of-a-24-year-old-pregnant-woman-with-necrotising-fasciitis-of-the-forearm
#10
Sam Nahas, Anne McKirdy, Arjuna Imbuldeniya
A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×109/L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics...
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29305390/blind-alleys-and-dead-ends-researching-innovation-in-late-20th-century-surgery
#11
Harriet Palfreyman, Roger L Kneebone
This article examines the fortunes of one particular surgical innovation in the treatment of gallstones in the late 20th century; the percutaneous cholecystolithotomy (PCCL). This was an experimental procedure which was trialled and developed in the early days of minimally invasive surgery and one which fairly rapidly fell out of favour. Using diverse research methods from textual analysis to oral history to re-enactment, the authors explore the rise and fall of the PCCL demonstrating that such apparent failures are as crucial a part of innovation histories as the triumphs and have much light to shed on the development of surgery more generally...
January 5, 2018: Medical Humanities
https://www.readbyqxmd.com/read/29303386/visual-prognosis-in-compressive-optic-neuropathy-secondary-to-sphenoid-sinus-mucocele-a-systematic-review
#12
Emily Li, Martha A Howard, Eugenia M Vining, Richard D Becker, Jonathan Silbert, Robert L Lesser
Sphenoid sinus mucoceles (SSMs) are rare, benign lesions that can expand, often presenting with ocular symptoms-decreased vision, diplopia, visual field defects, proptosis, and external ophthalmoplegia. Reported cases are few, visual compromise varies, and factors affecting visual prognosis are poorly characterized. We investigate whether prompt surgical intervention (within 2 weeks of visual symptom onset) affects best-corrected visual acuity (BCVA) regained in patients with vision loss secondary to compressive SSM...
January 5, 2018: Orbit
https://www.readbyqxmd.com/read/29301804/recurrent-hospitalisations-in-a-rare-case-of-hemicorporectomy-a-challenging-case-for-medical-management
#13
Ajit Thakur, Brittney Elliott, Rohan Naik, Nabeel Khan, Shayna McQuaid, Camelia Arsene
Hemicorporectomy, or translumbar amputation, is a radical surgery involving the dissection of the body at the waist and is usually reserved for complex medical conditions including locally invasive malignancy and terminal pelvic osteomyelitis. Only 71 cases have previously been reported. We present a rare case of hemicorporectomy in a 53-year-old patient with terminal pelvic osteomyelitis which occurred after he suffered a gunshot wound at T6 causing paraplegia at the age of 31. Unfortunately, this patient continued to suffer recurrent hospitalisations and sepsis events secondary to chronic, non-healing advanced pressure ulcers and complicated urinary tract infections despite repeated courses of broad-spectrum intravenous antibiotics and surgical debridements...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29300223/osteotomies-in-patello-femoral-instabilities
#14
David Dejour, Bertrand Le Coultre
Patellar instability is defined by clinical and radiologic criteria. The surgical treatment is aimed at restoring the congruence of the patellofemoral articulation and correcting extensor mechanism malalignment, to prevent recurrence of dislocation. The standard soft-tissue procedures are lateral release and vastus medialis advancement and medial patello femoral ligament plasty. Bony procedures are frequently performed in addition to soft-tissue surgery, to realign the extensor mechanism by means of tibial tubercle medialization, or to correct the patellar index in patella alta...
March 2018: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/29299742/functional-and-anatomical-outcomes-following-surgical-management-of-persistent-fetal-vasculature-a-single-center-experience-of-44-cases
#15
Murat Karacorlu, Mumin Hocaoglu, Isil Sayman Muslubas, Serra Arf, Mehmet Giray Ersoz, Omer Uysal
PURPOSE: To investigate the functional and anatomical outcomes following surgical management of persistent fetal vasculature (PFV). METHODS: Single-center, retrospective, interventional consecutive case series of 41 patients (44 eyes) who underwent vitrectomy with or without lensectomy through a limbal or pars plana/plicata approach with diagnosis of anterior, posterior, or combined anterior and posterior segment PFV were included. RESULTS: The median age at the time of surgery was 3 months (range, 1-36 months), and the mean follow-up period was 37...
January 3, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29299649/surgical-management-of-intrahepatic-cholangiocarcinoma-in-patients-with-cirrhosis-impact-of-lymphadenectomy-on-peri-operative-outcomes
#16
Fabio Bagante, Gaya Spolverato, Matthew Weiss, Sorin Alexandrescu, Hugo P Marques, Luca Aldrighetti, Shishir K Maithel, Carlo Pulitano, Todd W Bauer, Feng Shen, George A Poultsides, Olivier Soubrane, Guillaume Martel, B Groot Koerkamp, Alfredo Guglielmi, Endo Itaru, Andrea Ruzzenente, Timothy M Pawlik
BACKGROUND: The consequences of lymphadenectomy (LND) on cirrhotic patients undergoing hepatectomy for intrahepatic cholangiocarcinoma (ICC) have not been investigated. We sought to analyze the impact of LND on morbidity among patients undergoing resection for ICC. METHODS: A total of 1005 patients who underwent hepatectomy for ICC at one of the 14 participating institutions between 1990 and 2015 were identified. A propensity score match analysis was performed to reduce confounding biases between cirrhosis and non-cirrhosis groups...
January 3, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29289460/risk-management-for-surgical-energy-driven-devices-used-in-the-operating-room
#17
F Borie, M Mathonnet, A Deleuze, B Millat, J-F Gravié, H Johanet, J-P Lesage, J Gugenheim
Complications related to energy sources in the operating room are not well-recognized or published, despite occasionally dramatic consequences for the patient and the responsible surgeon. The goal of this study was to evaluate the risks and consequences related to use of energy sources in the operating room. PATIENTS AND METHODS: Between 2009 and 2015, 876 adverse events related to health care (AERHC) linked to energy sources in the operating room were declared in the French experience feedback data base "REX"...
December 27, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29283950/evaluating-resident-perspectives-on-international-humanitarian-missions
#18
Matthew D Chetta, Afaaf Shakir, Laurence S Paek, Gordon K Lee
BACKGROUND: Opportunities for international missions are highly sought after by medical students, residents, and attending plastic surgeons. The educational benefits and ethical considerations of trainees participating in these ventures have been extensively debated. At the time of this writing, many surgical training programs lack the necessary infrastructure or funds to support missions of this sort. Despite the increasing interest, the perceived benefit of international work has not yet been well studied...
December 27, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29283318/surgical-smoke-control-with-local-exhaust-ventilation-experimental-study
#19
Taekhee Lee, Jhy-Charm Soo, Ryan F LeBouf, Dru Burns, Diane Schwegler-Berry, Michael Kashon, Jay Bowers, Martin Harper
This experimental study aimed to evaluate airborne particulates and volatile organic compounds (VOCs) from surgical smoke when a local exhaust ventilation (LEV) system is in place. Surgical smoke was generated from human tissue in an unoccupied operating room using an electrocautery surgical device for 15 minutes with three different test settings; 1) without LEV control, 2) control with a wall irrigation suction unit with an in-line ultra-low penetration air filter and 3) control with a smoke evacuation system...
December 28, 2017: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/29283126/comparison-of-surgical-outcomes-between-canaloplasty-and-trabeculectomy-with-mitomycin-c-at-2-year-follow-up-a-longitudinal-cohort-study
#20
Winston J Garris, Crystal Le, David Zurakowski, Ramesh S Ayyala
PURPOSE: To compare operative outcomes of patients after canaloplasty and trabeculectomy with mitomycin C (MMC) through 2-year follow-up. METHODS: We included 31 eyes of 31 patients with primary open-angle glaucoma (POAG) who underwent canaloplasty and 37 eyes of 37 patients with POAG who underwent trabeculectomy with MMC with 24 months of postoperative follow-up. All surgeries were performed by a single surgeon between January 2005 and May 2011. Failure was defined as intraocular pressure (IOP> 18 or <4 mmHg at 2 years), second operative procedure, or loss of light perception...
January 2018: Indian Journal of Ophthalmology
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