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https://www.readbyqxmd.com/read/28538044/mycobacterium-chimaera-infections-associated-with-heater-cooler-units-in-cardiac-surgery
#1
Peter W Schreiber, Hugo Sax
PURPOSE OF REVIEW: Mycobacterium chimaera infections following cardiac surgery have been reported from an increasing number of countries. These infections are characterized by a poor prognosis with a case fatality rate around 50% despite treatment. Since the first description in 2013, our understanding has grown steadily. Several outbreak investigations, case series, and experiments with heater-cooler units (HCUs) have been published. This review summarizes the current knowledge. RECENT FINDINGS: M...
May 19, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28534215/-acute-haematogenous-osteomyelitis-in-children-diagnostic-algorithm-and-treatment-strategies
#2
M Willegger, A Kolb, R Windhager, C Chiari
Acute haematogenous osteomyelitis (AHO) in children is a severe condition. A delay in diagnosis and insufficient treatment may result in deformities, chronicity and sepsis. Therefore a structured diagnostic workup has to be followed in order to diagnose or rule out osteomyelitis. To identify the causative agent for targeted antibiotic treatment, a bone biopsy or puncture should be performed. However, approximately 25% of cases are culture-negative even after biopsy. The knowledge of the typical age-dependent bacterial spectrum is essential for empirical antibiotic therapy...
May 22, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28523415/pictorial-review-of-vascular-involvement-and-complex-vascular-reconstructions-in-borderline-to-minimally-advanced-pancreatic-malignancies
#3
REVIEW
Donald L Ly, Seng Thipphavong, Boraiah Sreeharsha
PURPOSE: To review borderline resectability criteria for pancreatic malignancies, show examples of few surgically treated minimally advanced pancreatic malignancies, discuss various complex vascular reconstructions, and highlight the imaging appearances. BACKGROUND: Often aggressive surgical approaches are used to treat borderline to minimally advanced pancreatic malignancies in specialist centers. As abdominal radiologists it is essential to have up-to-date knowledge to distinguish such tumors with accuracy and also be well versed with the various vascular reconstructions used in such surgeries...
May 18, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28521354/surgical-microanatomy-of-the-posterior-condylar-emissary-vein-and-its-anatomical-variations-for-the-transcondylar-fossa-approach
#4
Nakao Ota, Rokuya Tanikawa, Tsutomu Yoshikane, Masataka Miyama, Takanori Miyazaki, Yu Kinoshita, Hidetoshi Matsukawa, Takeshi Yanagisawa, Fumihiro Sakakibara, Go Suzuki, Norihiro Saito, Shiro Miyata, Kosumo Noda, Toshiyuki Tsuboi, Rihei Takeda, Hiroyasu Kamiyama, Sadahisa Tokuda, Kyousuke Kamada
BACKGROUND: It is essential to identify and be aware of the anatomy of the posterior condylar emissary vein (PCEV) for achieving an adequate operative field for the transcondylar fossa approach (TCFA). OBJECTIVE: To describe the variations in the drainage patterns of PCEVs and the technical issues encountered in such cases. METHODS: This was a retrospective analysis of the anatomy of PCEVs in 104 sides in 52 cases treated by the TCFA. Preoperative findings of multidetector-row computed tomography (CT) and CT venography (CTV) were compared with the intraoperative findings...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28516202/-plastic-reconstruction-of-radiation-injuries
#5
P M Vogt, T R Mett, C Henkenberens, C Radtke, R Ipaktchi
In addition to surgical and drug therapy, radiotherapy (or radiation therapy) is one of the three mainstays of modern oncological therapy regimes. It uses ionizing radiation to control tumors by damaging the DNA of cancerous tissue leading to cellular death. Although advances have been made in recent years resulting in a reduced dosage to the surrounding tissues, radiation injuries and tissue-related side effects cannot be completely avoided. Knowledge of the pathophysiology, treatment modalities and interdisciplinary treatment approaches are essential for effective therapy whilst limiting side effects...
May 17, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28509331/anatomic-landmarks-in-lacrimal-surgery-from-an-ophthalmologist-s-point-of-view
#6
REVIEW
Jens Heichel, Hans-Gert Struck, Anja Viestenz, Thomas Hammer, Arne Viestenz, Miltiadis Fiorentzis
Epiphora is a common clinical symptom of nasolacrimal duct obstruction. However, it is present in several pathologies and can lead to decreased quality of life for patients. A careful clinical examination including a detailed patient's history and diagnostic tests such as the fluorescein dye disappearance test and diagnostic syringing of the lacrimal duct are essential. Depending on the time of presentation (congenital, primary or secondary acquired), grade (subtotal or total) and location of the stenosis, different surgical approaches can be considered...
May 16, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28501114/evaluation-of-palliative-care-training-and-skills-retention-by-medical-students
#7
Priti P Parikh, Mary T White, Lynne Buckingham, Kathryn M Tchorz
BACKGROUND: Training in palliative and end-of-life care has been introduced in medical education; however, the impact of such training and the retention of skills and knowledge have not been studied in detail. This survey study examines long-term follow-up on end-of-life communication skills training, evaluation, and skills retention in medical students. MATERIALS AND METHODS: During the surgical clerkship, all third-year medical students received communication skills training in palliative care using simulated patients...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28477319/transition-of-care-in-congenital-heart-disease-ensuring-the-proper-handoff
#8
REVIEW
Angela Lee, Barbara Bailey, Geraldine Cullen-Dean, Sandra Aiello, Joanne Morin, Erwin Oechslin
BACKGROUND: With great advances in medical and surgical care, most congenital heart disease patients are living in to adulthood and require lifelong surveillance and expert care for adult onset complications. Care lapse and lack of successful transfer from pediatric to adult care put young adults at risk for increased morbidity and premature death. Hence, transition and transfer from pediatric to adult care is a crucial and critical process to provide access to specialized care and lifelong surveillance...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28469459/cardiac-evaluation-and-monitoring-of-patients-undergoing-noncardiac-surgery
#9
REVIEW
Arsalan Rafiq, Eduard Sklyar, Jonathan N Bella
Surgical management of disease has a tremendous impact on our health system. Millions of people worldwide undergo surgeries every year. Cardiovascular complications in the perioperative period are one of the most common events leading to increased morbidity and mortality. Although such events are very small in number, they are associated with a high mortality rate making it essential for physicians to understand the importance of perioperative cardiovascular risk assessment and evaluation. Its involves a detailed process of history taking, patient's medical profile, medications being used, functional status of the patient, and knowledge about the surgical procedure and its inherent risks...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28451716/-interventional-radiology-in-the-head-and-neck-region
#10
C Mayer, E Hattingen, H Schild, F Bootz, A Schröck
In interventional neuroradiology, endovascular embolization represents an important and helpful tool in the treatment of multiple head and neck diseases. These interventional procedures may be performed with curative intent, to reduce the surgical risk within a multimodal treatment concept, or to improve or at least maintain a good quality of life within a palliative therapy concept. In addition to a good understanding of disease pathology, knowledge of vascular anatomy, including collateral vessels and dangerous extracranial-intracranial anastomoses, is essential for successful treatment, as is implementation of an established technique using appropriate material...
April 27, 2017: HNO
https://www.readbyqxmd.com/read/28418784/a-fresh-cadaver-model-for-the-instruction-of-ultrasound-guided-fine-needle-aspiration-of-thyroid-nodules
#11
Hilary C McCrary, Erynne A Faucett, Audriana N Hurbon, Tijana Milinic, Jose A Cervantes, Sean L Kent, William J Adamas-Rappaport
Objective The aim of our study is to determine if a fresh cadaver model (FCM) for the instruction of ultrasound (US)-guided fine-needle aspiration (FNA) of thyroid nodules is a practical method for instruction. Study Design Pre- and postinstruction assessment of medical students' ability to perform US-guided FNA of artificially created thyroid nodules placed adjacent to the thyroid gland of a fresh cadaver. Setting University-based fresh cadaver laboratory. Subjects and Methods Study participants included a total of 17 first- and second-year medical students with minimal US training...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28405904/endocrine-tumors-causing-arterial-hypertension-pathophysiological-mechanisms-and-clinical-implications
#12
REVIEW
Agata Buonacera, Benedetta Stancanelli, Lorenzo Malatino
Some tumors are a relatively rare and amendable cause of hypertension, often associated with a higher cardiovascular morbidity and mortality, as compared with that of both general population and patients with essential hypertension. This worse prognosis is not entirely related to blood pressure increase, because the release of substances from the tumor can directly influence blood pressure behavior. Diagnostic approach is challenging and needs a deep knowledge of the different neuro-hormonal and genetic mechanisms determining blood pressure increase...
April 12, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28403403/objective-model-using-only-gender-age-and-medication-list-predicts-in-hospital-morbidity-after-elective-surgery
#13
J D Blitz, K S Mackersey, J C Miller, S M Kendale
Background.: Most current surgical risk models contain many variables: some of which may be esoteric, require a physician's assessment or must be obtained intraoperatively. Early preoperative risk stratification is essential to identify high risk, elective surgical patients for medical optimization and care coordination across the perioperative period. We sought to create a simple, patient-driven scoring system using: gender, age and list of medications to predict in-hospital postoperative morbidity...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28386927/microsurgical-techniques-in-temporal-lobe-epilepsy
#14
Mario A Alonso Vanegas, Sean M Lew, Michiharu Morino, Stenio A Sarmento
Temporal lobe resection is the most prevalent epilepsy surgery procedure. However, there is no consensus on the best surgical approach to treat temporal lobe epilepsy. Complication rates are low and efficacy is very high regarding seizures after such procedures. However, there is still ample controversy regarding the best surgical approach to warrant maximum seizure control with minimal functional deficits. We describe the most frequently used microsurgical techniques for removal of both the lateral and mesial temporal lobe structures in the treatment of medically intractable temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (corticoamygdalohippocampectomy and selective amygdalohippocampectomy)...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28384848/surgical-implications-of-portal-vein-variations-and-liver-segmentations-a-recent-update
#15
REVIEW
Showkathali Iqbal, Raiz Iqbal, Faiz Iqbal
The Couinaud's liver segmentation is based on the identification of portal vein bifurcation and origin of hepatic veins. It is widely used clinically, because it is better suited for surgery and is more accurate in localizing and monitoring various intra parenchymal lesions. According to standard anatomy, the portal vein bifurcates into right and left branches; the left vein drains segment II, III and IV and the right vein divides into two secondary branches - the anterior portal vein drains segments V and VIII, and the posterior drains segments VI and VII...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28341505/secondary-aortoenteric-erosion-followed-by-recurrent-lower-extremity-abscesses
#16
Shigeshi Ono, Yoshitomo Samejima, Susumu Watada, Toshihiro Kakefuda
A secondary aortoenteric fistula (SAEF) is a relatively rare complication of aortoiliac reconstructive surgery, often involving relatively fixed duodenal 3(rd) portion and a vascular anastomosis. We observed a 52-year-old man with a recurrent right lower leg abscess following the erosion between ipsilateral bifurcated prosthetic graft limb and non-fixed jejunum. In situ graft-sparing surgical treatment with aggressive debridement was successfully performed. A SAEF may occur even at a non-vascular anastomosis site, or in non-fixed small bowel, and may become a source of a septic embolus...
March 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28337730/current-concepts-of-shared-decision-making-in-orthopedic-surgery
#17
REVIEW
Kevin Klifto, Christopher Klifto, James Slover
PURPOSE OF REVIEW: The Shared Decision Making (SDM) model, a collaborative decision making process between the physician and patient to make an informed clinical decision that enhances the chance of treatment success as defined by each patient's preferences and values, has become a new and promising tool in the healthcare process; however, minimal data exists on its application in the orthopedic surgical specialty. Increasing evidence has demonstrated that this once novel idea can be implemented successfully in the orthopedic setting to improve patient outcomes...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28333609/fundamental-use-of-surgical-energy-fuse-an-essential-educational-program-for-operating-room-safety
#18
Stephanie B Jones, Malcolm G Munro, Liane S Feldman, Thomas N Robinson, L Michael Brunt, Steven D Schwaitzberg, Daniel B Jones, Pascal R Fuchshuber
Operating room (OR) safety has become a major concern in patient safety since the 1990s. Improvement of team communication and behavior is a popular target for safety programming at the institutional level. Despite these efforts, essential safety gaps remain in the OR and procedure rooms. A prime example is the use of energy-based devices in ORs and procedural areas. The lack of fundamental understanding of energy device function, design, and application contributes to avoidable injury and harm at a rate of approximately 1 to 2 per 1000 patients in the US...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28318605/achilles-tendon-moment-arm-length-is-smaller-in-children-with-cerebral-palsy-than-in-typically-developing-children
#19
Barbara M Kalkman, Lynn Bar-On, Francesco Cenni, Constantinos N Maganaris, Alfie Bass, Gill Holmes, Kaat Desloovere, Gabor J Barton, Thomas D O'Brien
When studying muscle and whole-body function in children with cerebral palsy (CP), knowledge about both internal and external moment arms is essential since they determine the mechanical advantage of a muscle over an external force. Here we asked if Achilles tendon moment arm (MAAT) length is different in children with CP and age-matched typically developing (TD) children, and if MAAT can be predicted from anthropometric measurements. Sixteen children with CP (age: 10y 7m±3y, 7 hemiplegia, 12 diplegia, GMFCS level: I (11) and II (8)) and twenty TD children (age: 10y 6m±3y) participated in this case-control study...
March 3, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28276942/probiotic-use-in-an-infectious-disease-setting
#20
Gregor Reid
The lethality of infectious diseases and deep concern over growing antimicrobial resistance make it essential that alternative or adjunct therapies be developed. Areas covered: Using papers published in PubMed, a case is presented to consider beneficial microbes as a means to improve management of infectious diseases. Clinical evidence is mounting that certain probiotic microbes can contribute to this armamentarium. These could have an immediate effect against necrotizing enterocolitis, pre- and post-surgical procedures, antibiotic-associated infections, urogenital infections in women and for reducing the severity and duration of respiratory infections...
March 1, 2017: Expert Review of Anti-infective Therapy
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