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https://www.readbyqxmd.com/read/29433986/surgical-and-oncological-outcomes-in-patients-after-vascularised-flap-reconstruction-for-locoregionally-advanced-penile-cancer
#1
Sarah R Ottenhof, Andrew Leone, Rosa S Djajadiningrat, Mounsif Azizi, Kamran Zargar, Laura C Kidd, Gregory Diorio, Gerard Mosiello, Niels M Graafland, Philippe E Spiess, Simon Horenblas
BACKGROUND: Treatment of locoregionally advanced penile squamous cell carcinoma (LAPSCC) is challenging. The exact role (in terms of oncological benefit) of extensive surgery is not well established. Moreover, surgery invariably leads to large defects requiring reconstructive surgery. Rectus abdominis myocutaneous (RAM) and abdominal advancement flaps have an independent and constant blood supply, are easily harvested, and provide substantial skin coverage and soft tissue. OBJECTIVE: To determine the surgical and oncological outcomes in patients with LAPSCC undergoing surgical resection with RAM flaps...
February 9, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29430981/the-diabetic-foot-attack-tis-too-late-to-retreat
#2
Prashanth R J Vas, Michael Edmonds, Venu Kavarthapu, Hisham Rashid, Raju Ahluwalia, Christian Pankhurst, Nikolaos Papanas
The "diabetic foot attack" is one of the most devastating presentations of diabetic foot disease, typically presenting as an acutely inflamed foot with rapidly progressive skin and tissue necrosis, at times associated with significant systemic symptoms. Without intervention, it may escalate over hours to limb-threatening proportions and poses a high amputation risk. There are only best practice approaches but no international protocols to guide management. Immediate recognition of a typical infected diabetic foot attack, predominated by severe infection, with prompt surgical intervention to debride all infected tissue alongside broad-spectrum antibiotic therapy is vital to ensure both limb and patient survival...
February 1, 2018: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29406827/pyoderma-gangrenosum-a-review-of-pathogenesis-and-treatment
#3
Christine Ahn, Deborah Negus, William Huang
Pyoderma gangrenosum (PG) is a complex neutrophilic dermatosis that can occur as an idiopathic disease, in association with systemic conditions such as inflammatory bowel disease, as part of an inherited inflammatory syndrome. It can be challenging to treat, as it occurs in a wide variety of clinical settings and there is a lack of a standardized treatment approach. The main limitations to treatment have been an incomplete understanding of the pathogenesis. However, recent advances have been made in understanding the pathogenesis of this condition, and PG is now considered an autoinflammatory disease process...
February 6, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29392094/review-of-the-current-management-of-pressure-ulcers
#4
REVIEW
Tatiana V Boyko, Michael T Longaker, George P Yang
Significance: The incidence of pressure ulcers is increasing due to our aging population and the increase in the elderly living with disability. Learning how to manage pressure ulcers appropriately is increasingly important for all professionals in wound care. Recent Advances: Many new dressings and treatment modalities have been developed over the recent years and the goal of this review is to highlight their benefits and drawbacks to help providers choose their tools appropriately. Critical Issues: Despite an increased number of therapies available on the market, none has demonstrated any clear benefit over the others and pressure ulcer treatment remains frustrating and time-consuming...
February 1, 2018: Advances in Wound Care
https://www.readbyqxmd.com/read/29369117/does-goal-directed-haemodynamic-and-fluid-therapy-improve-peri-operative-outcomes-a-systematic-review-and-meta-analysis
#5
Matthew A Chong, Yongjun Wang, Nicolas M Berbenetz, Ian McConachie
BACKGROUND: Much uncertainty exists as to whether peri-operative goal-directed therapy is of benefit. OBJECTIVES: To discover if peri-operative goal-directed therapy decreases mortality and morbidity in adult surgical patients. DESIGN: An updated systematic review and random effects meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Embase and the Cochrane Library were searched up to 31 December 2016...
January 23, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29368671/no-3-canadian-general-hospital-mcgill-in-the-great-war-service-and-sacrifice
#6
Andrew Beckett, Edward J Harvey
During the Great War, McGill University fielded a full general hospital to care for the wounded and sick among the Allied forces fighting in France and Belgium. The unit was designated No. 3 Canadian General Hospital (McGill) and included some of the best medical minds in Canada. Because the unit had a relationship with Sir William Osler, who was a professor at McGill from 1874 to 1885, the unit received special attention throughout the war, and legendary Canadian medical figures, such as John McCrae, Edward Archibald and Francis Scrimger, VC, served on its staff...
February 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29357133/pathophysiologic-mechanisms-and-current-treatments-for-cutaneous-sequelae-of-burn-wounds
#7
Caroline Hall, Carolyn Hardin, Christopher J Corkins, Alisha Z Jiwani, John Fletcher, Anders Carlsson, Rodney Chan
Burn injuries are a pervasive clinical problem. Extensive thermal trauma can be life-threatening or result in long-lasting complications, generating a significant impact on quality of life for patients as well as a cost burden to the healthcare system. The importance of addressing global or systemic issues such as resuscitation and management of inhalation injuries is not disputed but is beyond the scope of this review, which focuses on cutaneous pathophysiologic mechanisms for current treatments, both in the acute and long-term settings...
December 12, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/29346145/diagnostic-and-therapeutic-ultrasound-on-venous-and-arterial-ulcers-a-focused-review
#8
Steven J Kavros, Robert Coronado
GENERAL PURPOSE: To provide information about the use of ultrasound for diagnostic and therapeutic treatment of venous and arterial ulcers. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to: ABSTRACT: To review the diagnostic and therapeutic use of ultrasound on venous and arterial ulcers...
February 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29328528/evaluation-of-the-use-of-recombinant-human-basic-fibroblast-growth-factor-in-combination-with-negative-pressure-wound-therapy-with-instillation-and-dwell-time-in-porcine-full-thickness-wound-model
#9
Hiroto Saijo, Deepak V Kilpadi, Sadanori Akita
NPWT with instillation and dwell time (NPWTi-d), which combines NPWT with wound irrigation, has been clinically applied as a more effective treatment than conventional NPWT. Commercially available recombinant human basic fibroblast growth factor (rh-bFGF) has been demonstrated to be beneficial for use over the wound beds. The objective of this study was to evaluate the effectiveness of combined treatment with NPWTi-d and rh-bFGF. Six pigs received 12 full-thickness excisional skin wounds and were treated with 6 different treatment groups for each pair...
January 12, 2018: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29322847/tissue-expanders-with-a-focus-on-extremity-reconstruction
#10
Abdul R Arain, Keegan Cole, Christopher Sullivan, Samik Banerjee, Jillian Kazley, Richard L Uhl
Acute traumatic or surgical wounds that cannot be primarily closed often cause substantial morbidity and mortality. This often leads to increased costs from higher material expenses, more involved nursing care, and longer hospital stays. Advancements in soft tissue expansion has made it a popular alternative to facilitate early closure without the need for more complicated plastic surgical procedures. Areas Covered: In this review, we briefly elaborate on the history and biomechanics of tissue expansion and provide comprehensive descriptions of traditional internal tissue expanders and a variety of contemporary external tissue expanders...
January 11, 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29288184/leak-study-design-of-a-nationwide-randomised-controlled-trial-to-find-the-best-way-to-treat-wound-leakage-after-primary-hip-and-knee-arthroplasty
#11
Claudia A M Löwik, Frank-Christiaan Wagenaar, Walter van der Weegen, Rudolf W Poolman, Rob G H H Nelissen, Sjoerd K Bulstra, Yvette Pronk, Karin M Vermeulen, Marjan Wouthuyzen-Bakker, Inge van den Akker-Scheek, Martin Stevens, Paul C Jutte
INTRODUCTION: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are highly successful treatment modalities for advanced osteoarthritis. However, prolonged wound leakage after arthroplasty is linked to prosthetic joint infection (PJI), which is a potentially devastating complication. On the one hand, wound leakage is reported as a risk factor for PJI with a leaking wound acting as a porte d'entrée for micro-organisms. On the other hand, prolonged wound leakage can be a symptom of PJI...
December 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29286452/esophageal-heat-transfer-for-patient-temperature-control-and-targeted-temperature-management
#12
Melissa I Naiman, Maria Gray, Joseph Haymore, Ahmed F Hegazy, Andrej Markota, Neeraj Badjatia, Erik B Kulstad
Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time...
November 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29275802/the-lauramann-howe-russell-papers-a-window-into-critical-care-medicine-during-the-american-civil-war
#13
Benjamin Gorbaty
The Civil War influenced all aspects of American society and culture, including the field of medicine and critical care. Union physician Lauramann Howe Russell's letter to his daughter, Ellen Howe, written on October 19, 1862, illustrates the changes in hospital construction, gender roles in healthcare and medical treatments which revolutionized healthcare during the Civil War. This letter offers a glimpse of the medical care of wounded soldiers during the early years of the Civil War. In describing his conversion hospital, he reveals the precursor to the new hospital construction which would greatly influence hospital design for decades to come...
October 2017: Journal of Anesthesia History
https://www.readbyqxmd.com/read/29274639/the-changing-roles-of-community-nurses-the-case-of-health-plan-nurses-in-israel
#14
Rachel Nissanholtz-Gannot, Bruce Rosen, Miriam Hirschfeld
BACKGROUND: In Israel, approximately one-third of the country's nurses work in community settings - primarily as salaried employees in Israel's four non-profit health plans. Many health system leaders believe that the roles of health plan nurses have changed significantly in recent years due to a mix of universal developments (such as population aging and academization of the profession) and Israel-specific changes (such as the introduction of extensive quality monitoring in primary care)...
December 23, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29248237/the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-correlates-with-cost-of-care-for-diabetic-foot-ulcers-treated-in-a-multidisciplinary-setting
#15
Caitlin W Hicks, Joseph K Canner, Hikmet Karagozlu, Nestoras Mathioudakis, Ronald L Sherman, James H Black, Christopher J Abularrage
OBJECTIVE: We have previously demonstrated that the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification correlates with wound healing time in patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. Our aim was to assess whether the charges and costs associated with DFU care increase with higher WIfI stages. METHODS: All patients presenting to our multidisciplinary diabetic limb preservation service from June 2012 to June 2016 were enrolled in a prospective database...
December 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29245303/viable-placental-allograft-as-a-biological-dressing-in-the-clinical-management-of-full-thickness-thermal-occupational-burns-two-case-reports
#16
Eric L Johnson, Elisabet K Tassis, Georgina M Michael, Susan G Whittinghill
RATIONALE: Occupational burn injuries can be detrimental and difficult to manage. The majority of complex cases are referred and managed at regional burn centers where access to specialized care is available. As an alternative to hospitalization with staged surgical procedures, placental products may be used for outpatient medical management of these common burn injuries, especially if access to a regional burn center is limited or restricted.Fresh amnion has been a treatment of choice in burns for more than 100 years...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29238756/outcomes-of-internal-hemipelvectomy-for-pelvic-tumors-a-developing-country-s-prospective
#17
REVIEW
Masood Umer, Moiz Ali, Rizwan H Rashid, Yasir Mohib, Haroon U Rashid
Introduction: Previously, external hemipelvectomy was the mainstay of treatment for pelvic tumors. However, with technological advancements, limb salvage procedures such as internal hemipelvectomy have emerged as a viable alternative. However, there is limited literature available on long-term outcomes and complications of internal hemipelvectomy, especially from developing countries. Therefore, the objective of this study was to share our experience of internal hemipelvectomy at a tertiary care center in a developing country...
May 2017: International Journal of Surgery. Oncology
https://www.readbyqxmd.com/read/29213192/advances-of-stem-cell-therapeutics-in-cutaneous-wound-healing-and-regeneration
#18
REVIEW
Suman Kanji, Hiranmoy Das
Cutaneous wound healing is a complex multiple phase process, which overlaps each other, where several growth factors, cytokines, chemokines, and various cells interact in a well-orchestrated manner. However, an imbalance in any of these phases and factors may lead to disruption in harmony of normal wound healing process, resulting in transformation towards chronic nonhealing wounds and abnormal scar formation. Although various therapeutic interventions are available to treat chronic wounds, current wound-care has met with limited success...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/29196241/scleroderma-skin-ulcers-definition-classification-and-treatment-strategies-our-experience-and-review-of-the-literature
#19
REVIEW
Dilia Giuggioli, Andreina Manfredi, Lumetti Federica, Colaci Michele, Clodoveo Ferri
BACKGROUND: Skin ulcers (SU) are one of the most frequent manifestations of systemic sclerosis (SSc). SSc-SU are very painful, often persistent and recurrent; they may lead to marked impairment of patient's activities and quality of life. Despite their severe impact on the whole SSc patient's management, the proposed definition, classification criteria, and therapeutic strategies of SSc-SU are still controversial. OBJECTIVE: The present study aimed to elaborate a comprehensive proposal of definition, classification, and therapeutic strategy of SSc-SU on the basis of our long-term single center experience along with a careful revision of the world literature on the same topic...
November 28, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29180895/postoperative-pain-management-in-the-postanesthesia-care-unit-an-update
#20
REVIEW
Jie Luo, Su Min
Acute postoperative pain remains a major problem, resulting in multiple undesirable outcomes if inadequately controlled. Most surgical patients spend their immediate postoperative period in the postanesthesia care unit (PACU), where pain management, being unsatisfactory and requiring improvements, affects further recovery. Recent studies on postoperative pain management in the PACU were reviewed for the advances in assessments and treatments. More objective assessments of pain being independent of patients' participation may be potentially appropriate in the PACU, including photoplethysmography-derived parameters, analgesia nociception index, skin conductance, and pupillometry, although further studies are needed to confirm their utilities...
2017: Journal of Pain Research
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