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essential surgical knowledge

Alyssa R Golas, Jamie P Levine, Justin Ream, Eduardo D Rodriguez
An accurate and comprehensive understanding of lower extremity arterial anatomy is essential for the successful harvest and transfer of a free fibula osteoseptocutaneous flap (FFF). Minimum preoperative evaluation includes detailed history and physical including lower extremity pulse examination. Controversy exists regarding whether preoperative angiographic imaging should be performed for all patients. Elevation of an FFF necessitates division of the peroneal artery in the proximal lower leg and eradicates its downstream flow...
October 14, 2016: Journal of Craniofacial Surgery
B Krishnan, G Arun Prasad, B Madhan
AIM: Proper and adequate documentation in operation notes is a basic tool of clinical practice with medical and legal implications. An audit was done to ascertain if oral and maxillofacial surgery operative notes in an Indian public sector hospital adhered to the guidelines published by the Royal College of Surgeons England. METHODS: Fifty randomly selected operative notes were evaluated against the guidelines by RCS England with regards to the essential generic components of an operation note...
September 2016: Journal of Maxillofacial and Oral Surgery
Frédéric Chamberland, Tristan Maurina, Séverine Degano-Valmary, Thierry Spicarolen, Loïc Chaigneau
Angiosarcomas are one of the rarest subtypes of sarcomas; those are malignant vascular tumors arising from vascular endothelial cells. Occurrence of intra-oral angiosarcoma is extremely rare (0.0077% of all cancers in Europe). We present here, to our knowledge, the first case of a 83-year-old man with gingival and both palatine tonsils localization of a grade-two angiosarcoma discovered after a two months history of a painful lesion followed by hematoma and spontaneous bleeding. Chemotherapy with paclitaxel and hemostatic radiotherapy were inefficient and he died seven months after the first symptoms...
September 5, 2016: Rare Tumors
M Bricout, J Rezzouk
When implanting the Maia(®) trapeziometacarpal prosthesis, surgeons will be faced with a variety of complications they must be able to recognize and anticipate. Their ability to deal with these complications and possibly even failures is governed by their knowledge of the right steps to take. The aim of this retrospective study was to assess the incidence of complications reported during implantation of the Maia(®) prosthesis, to describe their nature and potential predisposing factors, and to study failures and their outcomes...
June 2016: Hand Surgery and Rehabilitation
M T Letsch, M Kreulen, H A Rakhorst
Infections of the hand can result in significant limitation of the function of the hand, and may even require partial amputation of a digit. A felon is an abscess of the distal pulp of the fingertip, which can spread rapidly through the flexor tendon sheath when not treated appropriately. Knowledge of the anatomy and the correct method of physical examination are essential when assessing a patient suspected of having a felon or flexor tendon sheath infection. Here we present two patients with a complicated felon resulting in palmar necrosis of the distal phalanx of the thumb, in which a groin flap was used to reconstruct the thumb...
2016: Nederlands Tijdschrift Voor Geneeskunde
Naveen Sharma, Avinash Mandloi, Ashish Agrawal, Shailendra Singh
INTRODUCTION: The clavicle, humerus and acromioclavicular (AC) joint separately are very commonly involved in traumatic injuries around the shoulder. Acromioclavicular joint dislocation with distal clavicle fracture is a well recognized entity in clinical practice. AC joint dislocation with mid shaft clavicle fracture is uncommon and only few cases have been reported in literature. However, to the best of our knowledge, this is the first case report to describe an acromioclavicular dislocation with ipsilateral mid shaft clavicle, mid shaft humerus and coracoid process fracture...
April 2016: Journal of Orthopaedic Case Reports
Maria Grazia Spurio
For a long time, terms like "mind" and "emotion" have rarely been taken into account, not even mentioned in the medical texts. The latest scientific researches, including the studies of Candace Pert, on the contrary, have emphasized that the entire body thinks, because every single cell hears, and feels emotions. The international researcher has discovered the endocrines and a vast number of neuropeptides, that work as an "information network" that interconnects the entire body, the "psychic" molecules are transmitted and travel, communicating information as in a circular and recursive body - mind mechanism...
September 2016: Psychiatria Danubina
Scott M Tintle, Christopher LeBrun, James R Ficke, Benjamin K Potter
Traumatic and trauma-related amputations represent unfortunate sequelae of severe injury, but should not be viewed as a treatment failure and may represent the best reconstructive option for some patients. Lessons from recent military conflicts have guided the evolution of modern surgical techniques and rehabilitation management of this challenging patient population, and treatment at a specialty center may improve patient outcomes. Despite appropriate management, however, surgical complications remain common and revision surgery is often necessary...
October 2016: Journal of Orthopaedic Trauma
Kohei Ogawa, Kenya Kamimura, Ken-Ichi Mizuno, Yoko Shinagawa, Yuji Kobayashi, Hiroyuki Abe, Yukari Watanabe, Shunsaku Takahashi, Kazunao Hayashi, Junji Yokoyama, Manabu Takeuchi, Masaaki Kobayashi, Satoshi Yamagiwa, Yuichi Sato, Shuji Terai
Bezoars are relatively rare foreign bodies of gastrointestinal tract and often cause ileus and ulcerative lesions in the stomach and subsequent bleeding and perforation due to their size and stiffness. Therefore, the removal of bezoars is essential and recent development of devices, the endoscopic removal procedure, is often applied. However, due to their stiffness, simple endoscopic removal failed in not a few cases, and surgical removal has also been used. Recently, the efficacy of a combination therapy of endoscopic procedure and dissolution using carbonated liquid has been reported...
2016: Gastroenterology Research and Practice
David Dreizin, Arthur J Nam, Nikki Tirada, Martin D Levin, Deborah M Stein, Uttam K Bodanapally, Stuart E Mirvis, Felipe Munera
After the nasal bones, the mandible is the second most common site of facial fractures, and mandibular fractures frequently require open reduction. In the trauma injury setting, multidetector computed tomography (CT) has become the cornerstone imaging modality for determining the most appropriate treatment management, fixation method, and surgical approach. Multidetector CT is also used to assess the adequacy of the reduction and evaluate potential complications in the postoperative period. For successful restoration of the mandible's form and function, as well as management of posttraumatic and postoperative complications, reconstructive surgeons are required to have a detailed understanding of mandibular biomechanics, occlusion, and anatomy...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Giulia Colzani, Pierluigi Tos, Bruno Battiston, Giovanni Merolla, Giuseppe Porcellini, Stefano Artiaco
The extensor apparatus is a complex muscle-tendon system that requires integrity or optimal reconstruction to preserve hand function. Anatomical knowledge and the understanding of physiopathology of extensor tendons are essential for an accurate diagnosis of extensor tendon injuries (ETIs) of the hand and wrist, because these lesions are complex and commonly observed in clinical practice. A careful clinical history and assessment still remain the first step for the diagnosis, followed by US and MR to confirm the suspect of ETI or to investigate some doubtful conditions and rule out associate lesions...
April 2016: Journal of Hand and Microsurgery
Francesco Soria, Shahrokh F Shariat, Seth P Lerner, Hans-Martin Fritsche, Michael Rink, Wassim Kassouf, Philippe E Spiess, Yair Lotan, Dingwei Ye, Mario I Fernández, Eiji Kikuchi, Daher C Chade, Marko Babjuk, Arthur P Grollman, George N Thalmann
PURPOSE: Upper-tract urothelial carcinoma (UTUC) is a relatively uncommon disease with limited available evidence on specific topics. The purpose of this article was to review the previous literature to summarize the current knowledge about UTUC epidemiology, diagnosis, preoperative evaluation and prognostic assessment. METHODS: Using MEDLINE, a non-systematic review was performed including articles between January 2000 and February 2016. English language original articles, reviews and editorials were selected based on their clinical relevance...
September 7, 2016: World Journal of Urology
Vin-Cent Wu, Shuo-Meng Wang, Chia-Hui Chang, Ya-Hui Hu, Lian-Yu Lin, Yen-Hung Lin, Shih-Chieh Jeff Chueh, Likwang Chen, Kwan-Dun Wu
There exists a great knowledge gap in terms of long-term effects of various surgical and pharmacological treatments on outcomes among primary aldosteronism (PA) patients. Using a validated algorithm, we extracted longitudinal data for all PA patients diagnosed in 1997-2010 and treated in the Taiwan National Health Insurance. We identified 3362 PA patients for whom the mean length of follow-up was 5.75 years. PA has higher major cardiovascular events (MACE) than essential hypertension (23.3% vs 19.3%, p = 0...
2016: Scientific Reports
Jonathon M Brown, Jaydev B Mistry, Jeffrey J Cherian, Randa K Elmallah, Morad Chughtai, Steven F Harwin, Michael A Mont
Modern primary total hip arthroplasty (THA) is among the most successful operations in medicine. It has been a consistently effective treatment for end-stage osteoarthritis of the hip. With the increasing number of primary THA procedures being performed and the decreasing age of patients undergoing the procedure, there is an inevitable associated increase in revision burden for arthroplasty surgeons. Revision THA is most often indicated for instability, aseptic loosening, osteolysis, infection, periprosthetic fracture, component malposition, and catastrophic implant failure...
August 30, 2016: Orthopedics
Marcelo Garcia Toneto, Shandi Prill, Leticia Manoel Debon, Fernando Zucuni Furlan, Nedio Steffen
The authors conducted a review of the major aspects of progression of knowledge about the surgical treatment of hyperparathyroidism. Through literature review, we analyzed articles on the history of the evolution of anatomical, physiological, pathological and surgical knowledge of the parathyroid glands. Because of their unique anatomical features, the parathyroid glands were the last of the endocrine glands to be discovered, which greatly hindered proper treatment until the first decades of the twentieth century...
May 2016: Revista do Colégio Brasileiro de Cirurgiões
Adam Sipe, Sebastian R McWilliams, Lauren Saling, Constantine Raptis, Vincent Mellnick, Sanjeev Bhalla
Fistulae between the aorta and adjacent structures are a rare, emergent, and potentially life-threatening process. Most commonly, aortic fistulae arise secondarily as a complication of prior aortic surgery with fistulization to adjacent structures. Rarely, a primary fistula may arise from the aorta in the setting of a pre-existing aneurysm or from a mass, inflammation, or infection. Although the incidence of aortic fistulae remains low, the frequency continues to increase as aortic surgical interventions and post-surgical follow-up with imaging become more common...
August 24, 2016: Emergency Radiology
Concepció Fuentes-Pumarola, David Ballester-Ferrando, Sandra Gelabert-Vilella, Cristina Bosch-Farré, M Carme Malagón-Aguilera, Carolina Rascón-Hernán, Anna Bonmatí-Tomàs, Rosario Fernandez-Peña
Within the context of the European Higher Education Area's requirement of competency-based assessments, the objective of the present study was to evaluate the Nursing Degree Practicum experience at the University of Girona (Spain) and ascertain student and faculty perceptions of the degree of competency achieved as a result of the practicum. This cross-sectional, descriptive, study combined quantitative analysis of a questionnaire and qualitative analysis of focus group comments. In the quantitative part of the study, 163 fourth-year nursing students completed the questionnaire; the qualitative analysis was derived from a focus group of 5 students and 5 professors...
October 2016: Nurse Education Today
L Pescatori, M Niutta, M P Tropeano, G Santoro, A Santoro
Despite the recent progress in surgical technology in the last decades, the surgical treatment of skull base lesions still remains a challenge. The purpose of this study was to assess the anatomy of the tentorial and cavernous segment of the fourth cranial nerve as it appears in two different surgical approaches to the skull base: subtemporal transtentorial approach and pretemporal fronto-orbito-zygomatic approach. Four human cadaveric fixed heads were used for the dissection. Using both sides of each cadaveric head, we made 16 dissections: 8 with subtemporal transtentorial technique and 8 with pretemporal fronto-orbito-zygomatic approach...
August 22, 2016: Neurosurgical Review
C Strasilla, V Sychra
Magnetic resonance imaging (MRI) is the imaging method of choice for patients with vestibular schwannoma, with almost 100 % sensitivity and specificity. The role of computed tomography (CT) is limited to preoperative planning and the postoperative phase. High-resolution sequences and the application of gadolinium-based i.v. contrast medium are crucial for MRI-based diagnosis. Description of the size and location of the tumor, as well as its relationship to adjacent structures and anatomic features, is essential, since these factors, in addition to clinical findings, influence the type of treatment, surgical options, and associated risks...
August 17, 2016: HNO
A Depeyre, A Brygo, X Leroy, R Gryselein, J Ferri
INTRODUCTION: Osteoid osteoma is a benign osseous tumor affecting mainly young men. Although it develops essentially in long bones, some cases occurring in face, mainly in mandible, were related. To our knowledge, only one single case was described in zygomatic bone. OBSERVATION: A 71-year-old man consulted for a right periorbital pain evolving since months with night recrudescence. The pain was not relieved by standard analgesics. Clinical examination was strictly normal...
August 9, 2016: Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
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