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Surgical outcomes

Chao Xiong, Zhiquan Zhang, Gurpreet S Baht, Niccolo Terrando
Surgery is commonly used to improve and maintain quality of life. Unfortunately, in vulnerable patients such as the elderly, complications may occur and significantly diminish the outcome. Indeed, after routine orthopedic surgery to repair a fracture, as many as 50% of elderly patients suffer from neurologic complications like delirium. Also, the capacity to heal and regenerate tissue after surgery decreases with age, and can impact the quality of fracture repair and even osseous integration of implants. Thus, a better understanding of mechanisms that drive these age-dependent changes could provide strategic targets to minimize risk for such complications and optimize outcomes...
February 27, 2018: Journal of Visualized Experiments: JoVE
Rami Musallam, Nabeel Salem, Ramez Al Halol, Hammam Al Deeb, Bettina Bottcher, Hanaa AlHamaida
BACKGROUND: Early pregnancy loss occurs in 10% of all clinically recognised pregnancies. 80% of pregnancy losses occur in the first trimester. Offering choice and participation in the management decisions is essential to patient-centred care. The aim of this study was to assess the management of first trimester pregnancy loss at the Emirati Hospital in Rafah, Gaza Strip. METHODS: In this retrospective audit, we compared the management of first trimester pregnancy loss at Emirati Hospital using the American College of Obstetricians and Gynecologists guidelines (ACOG, No...
February 21, 2018: Lancet
Musallam Abukhalil, Osama Mehjez, Mohammed Aladdam, Bettina Bottcher, Sobhi Skaik, Mohammed Matter
BACKGROUND: In 2013, al-Shifa Hospital, the largest hospital in the Gaza Strip, introduced an assessment programme for potential kidney donors on the basis of medical and radiological evaluation. The aims of this study and an associated clinical audit were to examine the final outcome of the potential live kidney donors assessment programme, to review the findings and determine the level of accuracy of the radiological evaluations, to assess the completeness and standard of radiological record keeping, and to evaluate adherence to guidelines...
February 21, 2018: Lancet
Dennis D Spencer, Jason L Gerrard, Hitten P Zaveri
Intracranial electrophysiological recording in patients with refractory focal epilepsy is the gold standard for defining epileptogenic tissue. Although the concordance of intracranial electrophysiology, structural MRI, and pathology can identify brain regions for resection, complete seizure control after surgery is not achieved in all patients with focal epilepsy. Repetitive identical behavioural seizures suggest one onset area, but epileptogenesis might be distributed and connected by functional and structural brain networks outside the seizure onset area, which could explain poor postsurgical outcomes in some patients...
April 2018: Lancet Neurology
Mini Kamboj, Teresa Childers, Jessica Sugalski, Donna Antonelli, Juliane Bingener-Casey, Jamie Cannon, Karie Cluff, Kimberly A Davis, E Patchen Dellinger, Sean C Dowdy, Kim Duncan, Julie Fedderson, Robert Glasgow, Bruce Hall, Marilyn Hirsch, Matthew Hutter, Lisa Kimbro, Boris Kuvshinoff, Martin Makary, Melanie Morris, Sharon Nehring, Sonia Ramamoorthy, Rebekah Scott, Mindy Sovel, Vivian Strong, Ashley Webster, Elizabeth Wick, Julio Garcia Aguilar, Robert Carlson, Kent Sepkowitz
BACKGROUND Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement. OBJECTIVE To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRS DESIGN American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined...
March 19, 2018: Infection Control and Hospital Epidemiology
Guangyuan Sun, Jun Xue, Yue Zhang, Xiaobin Gao, Fei Guo
PURPOSE: This study aimed to use propensity score matching (PSM) to compare the short- and long-term outcomes of laparoscopic surgery for the treatment of rectal cancer in elderly and middle-aged patients. METHODS: Data were retrospectively obtained from 588 patients aged ≥60 years when they underwent laparoscopic surgery for rectal cancer in our hospital between January 2009 and December 2016. The patients were divided into an elderly group (≥70 years) or a middle-aged group (60-69 years), and were subsequently matched 1:1 using PSM for sex, body mass index, Charlson comorbidity index (CCI), tumor location, clinical stage, and American Society of Anesthesiologists (ASA) score...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Aleksandar Stepanovic, Marina Nikitovic
Glioblastoma is the most frequent primary malignant brain tumor in adults. With the number of symptoms and signs, it belongs to diseases where a lot of treatment modalities are often applied. A standard treatment for patients with glioblastoma includes surgical resection followed by radiotherapy with concomitant and adjuvant temozolomide. Each type of treatment has its own toxicity. Temozolomide is an oral alkylating cytotoxic drug and like any other alkylating agent can induce side effects. Although temozolomide is generally a well tolerated drug, with rare severe toxic effects, sometimes certain toxicities can overcome the life risk of the underlying malignancy...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Karla Soares-Weiser, John Rathbone, Yusuke Ogawa, Kiyomi Shinohara, Hanna Bergman
BACKGROUND: Antipsychotic (neuroleptic) medication is used extensively to treat people with chronic mental illnesses. Its use, however, is associated with adverse effects, including movement disorders such as tardive dyskinesia (TD) - a problem often seen as repetitive involuntary movements around the mouth and face. This review, one in a series examining the treatment of TD, covers miscellaneous treatments not covered elsewhere. OBJECTIVES: To determine whether drugs, hormone-, dietary-, or herb-supplements not covered in other Cochrane reviews on TD treatments, surgical interventions, electroconvulsive therapy, and mind-body therapies were effective and safe for people with antipsychotic-induced TD...
March 19, 2018: Cochrane Database of Systematic Reviews
Hitoshi Kameyama, Tatsuo Kanda, Yosuke Tajima, Yoshifumi Shimada, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa, Toshifumi Wakai
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. However, rectal GIST is rare, the incident rate of it is approximately 5% of all GISTs. Rectal GIST symptoms generally include bleeding and/or pain and occasionally, urinary symptoms. Immunohistochemical evaluation finds that most rectal GIST tumors are CD117 (KIT) positive, and are sometimes CD34, platelet-derived growth factor receptor alpha (PDGFRA), smooth muscle actin, S-100, or vimentin positive...
2018: Translational Gastroenterology and Hepatology
Brian R Waterman, William Arroyo, Eric J Cotter, Michael A Zacchilli, E'Stephan J Garcia, Brett D Owens
Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013...
March 2018: Orthopaedic Journal of Sports Medicine
Marco Taurchini, Carlo Del Naja, Antonio Tancredi
The Enhanced Recovery After Surgery (ERAS) is a model of care introduced in 1997 by a group of general surgeons from Northern Europe led by Henrik Kehlet. The core of this approach is to produce improvements in surgical patient outcomes, especially in the reduction of hospital stay, complications rate, early recovery and reduction of economic burdens. Simply elaborating and establishing a protocol is not enough and much more efforts and changes are needed to achieve the aim to offer a sustainable improvement in the overall quality of patient care, therefore, ERAS is not a single and rigid protocol but is a method, a "modus operandi", a new way of multidisciplinary teamwork with readiness to make changes as knowledge evolves, i...
2018: Journal of Visualized Surgery
Ramón Cugat, Eduard Alentorn-Geli, Xavier Cuscó, Jordi Navarro, Gilbert Steinbacher, Pedro Álvarez-Díaz, Roberto Seijas, David Barastegui, Montse García-Balletbó
Posterior cruciate ligament reconstruction using the transtibial technique provides successful clinical outcomes. However, a bone-patellar tendon-bone (BTB) autograft with the transtibial technique has not been used by some surgeons because of concerns with graft passage from the tibial to the femoral tunnels (sharp turn) that can damage graft fibers. In the present surgical technique, an arthroscopic, transtibial, single-bundle technique for posterior cruciate ligament reconstruction using the BTB autograft with an easy and effective technical tip to facilitate graft passage is presented...
February 2018: Arthroscopy Techniques
Borong Chen, Disheng Xiong, Zirong Pan, Mingyuan Chen, Gang Liu, Shengjie Wang, Yongzhi Ye, Rui Xiao, Junjie Zeng, Jiayi Li, Zhengjie Huang
Totally laparoscopic distal gastrostomy (TLDG) and laparoscopic- assisted distal gastrostomy (LADG) are the minimally invasive surgical technology for gastric cancer. This study aimed to compare the surgical outcomes of these two methods. Relevant studies were selected through electronic searches of EMBASE, PubMed and Web of Science. In total, 21 non-randomized controlled studies containing 2475 patients in the totally laparoscopic distal gastrostomy and 1889 patients in the laparoscopic-assisted distal gastrostomy were included in this study...
February 23, 2018: Oncotarget
Waseem Mehmood Nizamani
Ligamentum flavum cyst is considered as a category of juxtafacet cyst and is recognized to be rare cause of cord compression and radiculopathy. The pathogenesis of these cysts is not yet fully understood, but it has been proposed that continuous stress to this ligament due to minor repetitive trauma, such as in spondylolisthesis and degenerative disc disease, may lead to the development of cyst. Intraspinal cyst can encroach and displace neural structures that can lead to neurologic symptoms. Although a rare entity, intraspinal cyst should be included in the causative factors of neurogenic claudication or lumbar radiculopathy based on typical magnetic resonance imaging appearance...
February 2018: Radiology case reports
Tao Yang, Fei Wang, Chaoshi Niu
The majority of spinal cavernous angiomas (CAs) originate from the vertebral bodies with or without epidural space extension. Solitary epidural CAs are rare. In the present study, we retrospectively reviewed the records of 12 patients who underwent microsurgery for solitary spinal epidural CAs. All patients had performed pre- and postoperative magnetic resonance imaging. The patients were 7 females and 5 males with the mean age of 52.1 years. Two tumors were located in the cervicothoracic spine, nine in the thoracic spine and one in the lumbar spine, respectively...
April 2018: Oncology Letters
Melissa Rochon, Julian We Jarman, Joseph Gabriel, Lisa Butcher, Carlos Morais, Martin Still, Ishtiaq Ahmed, Mario Petrou, Richard Trimlett, Anthony DeSouza, Rashmi Yadav, Shahzad G Raja
Background: Previously, we reported that the Brompton Harefield Infection Score (BHIS) accurately predicts surgical site infection (SSI) after coronary artery bypass grafting (CABG). The BHIS was developed using two-centre data and stratifies SSI risk into three groups based on female gender, diabetes or HbA1c > 7.5%, body mass index ≥ 35, left ventricular ejection fraction < 45% and emergency surgery. The purpose of this study was to prospectively evaluate BHIS internally as well as externally...
March 2018: Journal of Infection Prevention
Sarah Ivy Gallagher, Debora Candace Matthews
Background: The aim of this systematic review was to evaluate whether patients with gingival recession would benefit from an acellular dermal matrix graft (ADMG) in ways that are comparable to the gold standard of the subepithelial connective tissue graft (SCTG). Materials and Methods: A systematic review and meta-analysis comparing ADMG to SCTG for the treatment of Miller Class I and II recession defects was conducted according to PRISMA guidelines. PubMed, Excerpta Medica Database, and Cochrane Central Register of Controlled Trials databases were searched up to March 2016 for controlled trials with minimum 6 months duration...
November 2017: Journal of Indian Society of Periodontology
Hongchuan Guo, Xu Wang, Chunyu Song, Zihao Song, Jiantao Liang, Gang Song, Yuhai Bao
OBJECTIVE: To retrospectively analyze the clinical data of 4 patients with trigeminal neuralgia (TN) secondary to osteoid osteoma (OO) of petrous bone and discuss the treatment experiences for this rare disease. METHOD: Between January 2008 and December 2016, 4 patients diagnosed as TN secondary to OO of petrous bone received surgical treatment in Xuan Wu Hospital of Capital Medical University. We summarized the characteristics and treatment experiences of this rare disease through retrospective review of the clinical information, imaging features, surgical details and follow up outcomes of all those 4 patients...
March 15, 2018: World Neurosurgery
A-G Hue, R Gauthé, A-C Tobenas-Dujardin, A Vallée, J Mouton, F Dujardin
INTRODUCTION: Among the various options for internal fixation of acetabular fractures, the enlarged iliofemoral approach is less often used, being more invasive, although providing greater exposure enabling control of all components in complex fractures. Even so, the impact of its invasiveness has not been confirmed, and long-term results are not known. We therefore performed a retrospective study, aiming 1) to assess long-term functional outcome, and 2) to assess associated morbidity...
March 15, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Toscane C Noordhoff, Jan Groen, Jeroen R Scheepe, Bertil F M Blok
CONTEXT: Surgical treatment of anatomic bladder outlet obstruction (BOO) may be indicated in males with neurogenic bladder dysfunction. A bothersome complication after surgery is urinary incontinence. OBJECTIVE: To identify the optimal practice in the surgical treatment of anatomic BOO in males with neurogenic bladder dysfunction, due to multiple sclerosis, Parkinson disease, spinal cord injury (SCI), spina bifida, or cerebrovascular accident (CVA). EVIDENCE ACQUISITION: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement...
March 15, 2018: European Urology Focus
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