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https://www.readbyqxmd.com/read/29455293/variations-of-transverse-foramina-in-cervical-vertebrae-what-happens-to-the-vertebral-artery
#1
Aristeidis Zibis, Vasileios Mitrousias, Nikolaos Galanakis, Nikoletta Chalampalaki, Dimitrios Arvanitis, Apostolos Karantanas
PURPOSE: The purpose of this study is to examine variations of the foramen transversarium and the vertebral artery in computed tomography angiographies (CTa) of the cervical spine, investigate their coexistence, and present possible considerations regarding such variations in spine surgical procedures. METHODS: Fifty CTa of the neck were retrospectively reviewed. Transverse and anteroposterior diameter of the foramen and diameter of the vertebral artery were measured...
February 17, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29439780/evolving-imaging-techniques-for-staging-axillary-lymph-nodes-in-breast-cancer
#2
REVIEW
S Lowes, A Leaver, K Cox, K Satchithananda, D Cosgrove, A Lim
The presence and extent of axillary nodal metastases at the time of breast cancer diagnosis is a critical factor in disease prognosis and plays a central role in deciding the best treatment for patients. Accurate assessment of the axilla is therefore an essential component in staging breast cancer. Over the years, axillary staging has evolved from surgical axillary lymph node dissection (ALND), with its numerous associated long-term complications, to the much less-radical surgical sentinel lymph node excision biopsy (SLNB), the current reference standard...
February 10, 2018: Clinical Radiology
https://www.readbyqxmd.com/read/29433887/a-cadaveric-procedural-anatomy-simulation-course-improves-video-based-assessment-of-operative-performance
#3
Gaurav Sharma, Mario A Aycart, Lynne O'Mara, Joaquim Havens, Matthew Nehs, Naomi Shimizu, Douglas S Smink, Edwin Gravereaux, Jonathan D Gates, Reza Askari
BACKGROUND: Inadequate anatomic knowledge has been cited as a major contributor to declining surgical resident operative competence. We analyzed the impact of a comprehensive, procedurally oriented cadaveric procedural anatomy dissection laboratory on the operative performance of surgery residents, hypothesizing that trainees' performance of surgical procedures would improve after such a dissection course. MATERIALS AND METHODS: Midlevel general surgery residents (n = 9) participated in an 8 wk, 16-h surgery faculty-led procedurally oriented cadaver simulation course...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29402122/detailed-analysis-of-research-and-practice-in-the-life-of-a-pediatric-surgeon-in-east-central-europe-in-the-20th-century-an-example-of-prof-zofia-umiastowska-sawicka
#4
REVIEW
Przemyslaw Wolak, Andrzej Wincewicz, Anna Porębska, Stanislaw Sulkowski, Agnieszka Wincewicz-Price, Jonathan Price
Professor Zofia Umiastowska Sawicka laid the foundations for modern pediatric surgery in Poland, first in Bialystok, and subsequently in Kielce. She was a student of Prof. Jan Kossakowski from Warsaw Medical University to be counted among his most talented and skilled disciples. Professor Umiastowska became the head of the first Department of Pediatric Surgery in Bialystok, which was later incorporated into the Medical Academy of Bialystok. In 1977 she moved to Kielce to run the Department of Pediatric Surgery until her retirement in 1991...
December 2017: Acta Medico-historica Adriatica: AMHA
https://www.readbyqxmd.com/read/29393040/perioperative-treatment-of-patients-undergoing-acute-high-risk-abdominal-surgery%C3%A2
#5
Line Toft Tengberg
Critically ill acute high-risk abdominal surgery patients represent a major challenge to health care providers, with the typical patient being elderly and frail, and with severe and multiple comorbidities. The mortality rate in this population is high, and the postoperative course is characterized by complications, prolonged hospitalisation and considerable risk of permanent disability. With an ageing population, the number of elderly patients, as well as challenges concerning treatment will arise, calling for a coordinated effort both nationally and internationally to enhance treatment in this vulnerable patient group...
February 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29382857/neuroprotective-drug-for-nerve-trauma-revealed-using-artificial-intelligence
#6
David Romeo-Guitart, Joaquim Forés, Mireia Herrando-Grabulosa, Raquel Valls, Tatiana Leiva-Rodríguez, Elena Galea, Francisco González-Pérez, Xavier Navarro, Valerie Petegnief, Assumpció Bosch, Mireia Coma, José Manuel Mas, Caty Casas
Here we used a systems biology approach and artificial intelligence to identify a neuroprotective agent for the treatment of peripheral nerve root avulsion. Based on accumulated knowledge of the neurodegenerative and neuroprotective processes that occur in motoneurons after root avulsion, we built up protein networks and converted them into mathematical models. Unbiased proteomic data from our preclinical models were used for machine learning algorithms and for restrictions to be imposed on mathematical solutions...
January 30, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29378389/limits-of-endoscopic-endonasal-surgery-for-craniopharyngioma
#7
Douglas A Hardesty, Alaa S Montaser, André Beer-Furlan, Ricardo L Carrau, Daniel M Prevedello
Craniopharyngiomas represent one of the most challenging brain tumors for the neurosurgeon. For most of the 20th century, these parasellar lesions have been approached via the classic open approaches of neurosurgery such as pterional, frontobasal, interhemispheric, and transpetrosal craniotomies. The endoscopic endonasal approach to these tumors, rather than craniotomy, has risen in popularity over the last two decades. Regardless of approach, a detailed knowledge of surgical anatomy and careful preoperative surgical planning are essential to achieve good clinical results; iatrogenic morbidity can potentially be severe due to hypothalamus, optic apparatus, and/or vascular injuries...
January 26, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29368903/-anesthesic-management-during-total-organic-separation-of-pygopagus-conjoined-twins
#8
Mayra Lizeth Nava-Martínez, Enriqueta Macias-Miranda, Karla Guadalupe Lozada-Rosete, Juan José Dosta-Herrera
BACKGROUND: Conjoined twins are among the most rare and challenging congenital malformations. The incidence varies from 1:30 000 to 1:200 000 live births. Pygopagus twins account for about 10 to 18% of all conjoined twins. CLINICAL CASE: We report the case of male conjoined pygopagus twins. They shared medullary canal, anal canal and sacrococcygeal region, without any degree of cross circulation. At the moment of the surgery, twin 1 had congenital heart disease without medical treatment...
January 2018: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29348993/delayed-presentation-of-cerebral-air-embolism-from-a-left-atrial-esophageal-fistula-a-case-report-and-review-of-the-literature
#9
Catherine Peterson, Clay Elswick, Vicki Diaz, R Shane Tubbs, Marc Moisi
Air embolism developing from an atrial-esophageal fistula that was created as a complication from an atrial ablation procedure is a rare, yet usually fatal diagnosis. Neurologic manifestations such as meningitis, altered mental status, seizures, strokes, transient ischemic attacks (TIAs), psychiatric changes, and coma can ensue. Imaging of the brain might reveal infarcts, cerebral edema, as well as signs of pneumocephalus. This case describes a 42-year-old male with recent cardiac ablation procedure at an outside hospital for refractory atrial fibrillation (A-fib) who presented with altered mental status, dyspnea and diaphoresis...
November 15, 2017: Curēus
https://www.readbyqxmd.com/read/29344523/clinical-skills-temporal-degradation-assessment-in-undergraduate-medical-education
#10
Joseph Fisher, Rebecca Viscusi, Adam Ratesic, Cameron Johnstone, Ross Kelley, Angela M Tegethoff, Jessica Bates, Elaine H Situ-Lacasse, William J Adamas-Rappaport, Richard Amini
Introduction: Medical students' ability to learn clinical procedures and competently apply these skills is an essential component of medical education. Complex skills with limited opportunity for practice have been shown to degrade without continued refresher training. To our knowledge there is no evidence that objectively evaluates temporal degradation of clinical skills in undergraduate medical education. The purpose of this study was to evaluate temporal retention of clinical skills among third year medical students...
January 2018: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/29334232/stereotactic-body-radiation-therapy-sbrt-for-hepatocellular-carcinoma-imaging-evaluation-post-treatment
#11
Trenton Kellock, Teresa Liang, Alison Harris, Devin Schellenberg, Roy Ma, Stephen Ho, Wan Wan Yap
Surgical resection, when feasible, is the standard of care for hepatocellular carcinoma (HCC). However, many tumors are not resectable at the time of diagnosis. Recently, stereotactic body radiation therapy (SBRT) has emerged as a non-invasive local therapy for both non-resectable primary hepatic malignancies as well as hepatic metastases. Knowledge of the expected hepatic parenchymal appearance post treatment, as well as potential pitfalls and complications, is essential for accurate evaluation of treatment response...
January 15, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29313293/management-of-care-transition-and-hospital-discharge
#12
Amedeo Zurlo, Giovanni Zuliani
Current demographic and epidemiological trends highlight a growing task in surgical departments by elderly patients, characterized by high prevalence of comorbidity, complexity, and functional disability. Of consequence, discharge of an elderly patient must be considered in a new cultural perspective and should be imagined as a well-structured process starting from admission to surgical department and finishing with the patient discharge in a setting able to support her/him in the best possible way. The lack of a suitable discharge planning and of a proper transition program in the elderly subjects increases the risk of quick re-admission and may negatively affect the functional and the status quality of life of patients and caregivers...
January 8, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29298133/epidemiology-and-risk-factors-for-isolation-of-multi-drug-resistant-organisms-in-patients-with-complicated-intra-abdominal-infections
#13
Francesco M Labricciosa, Massimo Sartelli, Lilian M Abbo, Pamela Barbadoro, Luca Ansaloni, Federico Coccolini, Fausto Catena
BACKGROUND: Patients with complicated intra-abdominal infections (cIAIs) caused by multi-drug-resistant organisms (MDROs) have been identified as being at increased risk for adverse outcomes. Prompt identification and stratification of these patients is essential in the clinical management, allowing the physician timely optimization of empiric antimicrobial therapy while awaiting results of intra-operative cultures to streamline antibiotic treatment. METHODS: The study is a secondary analysis from two prospective multi-center color surveillance studies...
January 3, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29295546/zinc-in-wound-healing-modulation
#14
REVIEW
Pei-Hui Lin, Matthew Sermersheim, Haichang Li, Peter H U Lee, Steven M Steinberg, Jianjie Ma
Wound care is a major healthcare expenditure. Treatment of burns, surgical and trauma wounds, diabetic lower limb ulcers and skin wounds is a major medical challenge with current therapies largely focused on supportive care measures. Successful wound repair requires a series of tightly coordinated steps including coagulation, inflammation, angiogenesis, new tissue formation and extracellular matrix remodelling. Zinc is an essential trace element (micronutrient) which plays important roles in human physiology...
December 24, 2017: Nutrients
https://www.readbyqxmd.com/read/29291178/a-competency-based-simulation-curriculum-for-surgical-resident-trauma-resuscitation-skills
#15
Matthew L Moorman, Tony R Capizzani, Michelle A Feliciano, Judith C French
Background: Evidence-based curricula for nonprocedural simulation training in general surgery are lacking. Residency programs are required to implement simulation training despite this shortcoming. The goal of this project was the development of a simulation curriculum that measurably improves milestone performance and replaces traditional experienced-based training with a competency-based model. Materials and Methods: SimMan 3G® (Laerdal Medical, Wappingers Falls, NY, USA) was utilized for simulation...
October 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29233583/diagnostic-approach-to-the-acute-abdomen
#16
REVIEW
Gilles Fecteau, André Desrochers, David Francoz, Sylvain Nichols
The acute abdomen is a term used to characterize an animal presented as an emergency, in a more or less severe critical state, and for which medical and possibly surgical treatment will be necessary. To succeed, the clinician should use a systematic approach, have an excellent knowledge of the bovine abdominal anatomy, and have a good understanding of the pathophysiology of abdominal pain. Good clinical judgment, critical analysis, and good client communication skills are also essential. This article presents and discusses those necessary skills in the context of field practice...
December 9, 2017: Veterinary Clinics of North America. Food Animal Practice
https://www.readbyqxmd.com/read/29221836/efficacy-versus-complications-in-arterial-thrombolysis
#17
H P Ebben, M V van Burink, V Jongkind, D E Mouwen, J Udding, W Wisselink, J K Kievit, A M Wiersema, K K Yeung
BACKGROUND: Acute peripheral arterial occlusions threaten life and limb. Thrombolysis is an established, minimally invasive alternative treatment for surgical thromboembolectomy. Yet, there is no consensus regarding an optimal thrombolysis protocol and current knowledge is largely based on studies from the 1990's. This study reviews a contemporary cohort of patients treated with thrombolysis and aims to evaluate the treatment results and to identify possible predictors for outcome and (bleeding) complications...
December 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29208310/equivalent-mortality-and-complication-rates-following-periprosthetic-distal-femur-fractures-managed-with-either-lateral-locked-plating-or-a-distal-femoral-replacement
#18
Jason S Hoellwarth, Mitchell S Fourman, Lawrence Crossett, Mark Goodman, Peter Siska, Gele B Moloney, Ivan S Tarkin
INTRODUCTION: Management of distal femur fractures above total knee arthroplasty (TKA) remains challenging. Two common surgical options are locked lateral plating (LLP) and distal femoral arthroplasty (DFR). Unfortunately, approximately 30-50% of patients may die within one year of injury, require further surgery, or not regain prior mobility performance. We compared 87 LLP to 53 DFR patients - to our knowledge the largest comparative study - focusing on 90- and 365-day mortality, mobility maintenance, and further surgery...
December 1, 2017: Injury
https://www.readbyqxmd.com/read/29188307/-criteria-for-resectability-of-pancreatic-cancer-and-postoperative-imaging
#19
L Grenacher, M Juchems
By improving the techniques of pancreatic surgery, the mortality and morbidity for pancreatic carcinoma could be significantly reduced. For radiologists a profound knowledge of the surgical techniques is of decisive importance. Based on this knowledge postoperative complications can be reliably uncovered and local recurrences can be detected at an early stage. The complications resulting from pancreatic surgery can be severe and often necessitate a radiological intervention. As pancreatic cancer itself is a severe disease with a poor 5‑year survival, which can only be improved by an R0 resection, it is crucial to identify using imaging those patients who are primarily operable or who can potentially achieve an operable condition through neoadjuvant chemotherapy (borderline) and inoperable patients to avoid postoperative complications which would additionally weaken them and result in unnecessary delays in initiating palliative therapy...
November 29, 2017: Der Radiologe
https://www.readbyqxmd.com/read/29185018/evaluation-of-resources-necessary-for-provision-of-trauma-care-in-botswana-an-initiative-for-a-local-system
#20
Michael B Mwandri, Timothy C Hardcastle
BACKGROUND: Developing countries face the highest incidence of trauma, and on the other hand, they do not have resources for mitigating the scourge of these injuries. The World Health Organization through the Essential Trauma Care (ETC) project provides recommendations for improving management of the injured and building up of systems that are effective in low-middle-income countries (LMICs). This study uses ETC project recommendations and other trauma-care guidelines to evaluate the current status of the resources and organizational structures necessary for optimal trauma care in Botswana; an African country with relatively good health facilities network, subsidized public hospital care and a functioning Motor Vehicle Accident fund covering road traffic collision victims...
November 28, 2017: World Journal of Surgery
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