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High Risk Surgery

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https://www.readbyqxmd.com/read/29475110/pathological-fracture-risk-assessment-in-patients-with-femoral-metastases-using-ct-based-finite-element-methods-a-retrospective-clinical-study
#1
Amir Sternheim, Ornit Giladi, Yair Gortzak, MIchael Drexler, Moshe Salai, Nir Trabelsi, Charles Milgrom, Zohar Yosibash
Physician recommendation for prophylactic surgical fixation of a femur with metastatic bone disease (MBD) is usually based on Mirels' criteria and clinical experience, both of which suffer from poor specificity. This may result in a significant number of these health compromised patients undergoing unnecessary surgery. CT-based finite element analyses (CTFEA) have been shown to accurately predict strength in femurs with metastatic tumors in an ex-vivo study. In order to assess the utility of CTFEA as a clinical tool to determine the need for fixation of patients with MBD of the femur, an ad hoc CTFEA was performed on a retrospective cohort of fifty patients...
February 20, 2018: Bone
https://www.readbyqxmd.com/read/29474946/functional-results-and-patient-satisfaction-after-long-fusion-for-spinal-deformity-in-parkinson-s-disease
#2
C Scemama, G Mangone, R Bonaccorsi, H Pascal-Moussellard
BACKGROUND: Patients with Parkinson's disease often present abnormal posture or severe sagittal malalignment, causing significant disability. Surgical fusion is these cases shows high rates of complications, but may nevertheless provide functional benefit; however, this remains to be assessed. HYPOTHESIS: Long fusion for patients with Parkinson's disease and postural disorder could alleviate disability despite the high risk of complications. METHODS: We retrospectively reviewed 18 Parkinson patients treated by long fusion for spinal deformity...
February 20, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29474848/urology-consultation-and-emergency-department-revisits-for-children-with-urinary-stone-disease
#3
Jane Kurtzman, Lihai Song, Michelle E Ross, Charles D Scales, David I Chu, Gregory E Tasian
PURPOSE: To determine the association between urology consultation and emergency department (ED) revisits for children with urinary stones. MATERIALS AND METHODS: This retrospective cohort study included patients ≤18 years-old who presented to an ED in South Carolina with a urinary stone from 1997-2015. The primary exposure was urology consultation during the index ED visit. The primary outcome was a stone-related ED revisit occurring within 180 days of discharge from an index ED visit...
February 20, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29474555/health-related-quality-of-life-of-patients-after-surgery-for-acute-type-a-aortic-dissection
#4
Uyanga Adam, Helmut Habazettl, Katharina Graefe, Hermann Kuppe, Maximilian Wundram, Stephan Dominik Kurz
OBJECTIVES: Acute Type A aortic dissection (ATAAD) and the ensuing surgical therapy may be experienced as a traumatic event by patients. This study aimed at analysing the prevalence of post-traumatic stress disorder (PTSD) and the physical and mental well-being of survivors of surgically treated ATAAD. METHODS: A total of 393 survivors were contacted and asked to fill in various health questionnaires. RESULTS: Two hundred and ten (53%) patients returned the questionnaires...
February 20, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29474271/de-escalation-treatment-of-human-papillomavirus-positive-oropharyngeal-squamous-cell-carcinoma-an-evidence-based-review-for-the-locally-advanced-disease
#5
Gustavo T Stock, Renata R C Colombo Bonadio, Gilberto de Castro
PURPOSE OF REVIEW: Oropharyngeal cancer (OPC) incidence is increasing worldwide, especially in developed countries where it seems to be etiologically related to the elevating rates of high-risk human papillomavirus (HPV) infection. Considered a distinct disease because of its weak correlation with the traditional risk factors (tobacco use and alcohol), it has different patterns of survival outcomes, locoregional and distant failure, generally with better prognosis independently of the treatment...
February 22, 2018: Current Opinion in Oncology
https://www.readbyqxmd.com/read/29474234/simple-hysterectomy-for-residual-cervical-intraepithelial-neoplasm
#6
Liat Binyamin, Meirav Segev, Yoav Peled, Haim Krissi, Gad Sabah, Oded Raban, Ariella Jakobson-Setton, Avi Ben-Haroush, Ram Eitan
OBJECTIVE: Many patients undergo hysterectomy for the treatment of cervical dysplasia. Factors that correlate with residual high-grade squamous intraepithelial lesions (HGSIL) at hysterectomy are not clear. We set out to determine preoperative features that may predict residual disease for patients treated for cervical dysplasia. MATERIALS AND METHODS: A retrospective database was reviewed for women who underwent simple hysterectomy for HGSIL between 1990 and 2013...
February 23, 2018: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/29474216/anesthesia-and-analgesia-for-gynecological-surgery
#7
Allana Munro, Ana Sjaus, Ronald B George
PURPOSE OF REVIEW: High-quality analgesia has been linked to improved patient satisfaction as well as improved short-term and long-term postoperative outcomes. Acute surgical pain is a modifiable risk factor for development of chronic postoperative pain, which is reported by up to 26% of gynecologic surgical patients. In other surgical populations, multimodal analgesia has shown improved pain control and decreased reliance on opioids. This review examines recent evidence for various analgesic modalities applied specifically to the gynecologic surgical population...
February 22, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29473789/ligament-augmentation-for-prevention-of-proximal-junctional-kyphosis-and-proximal-junctional-failure-in-adult-spinal-deformity
#8
Michael M Safaee, Vedat Deviren, Cecilia Dalle Ore, Justin K Scheer, Darryl Lau, Joseph A Osorio, Fred Nicholls, Christopher P Ames
OBJECTIVE Proximal junctional kyphosis (PJK) is a well-recognized, yet incompletely defined, complication of adult spinal deformity surgery. There is no standardized definition for PJK, but most studies describe PJK as an increase in the proximal junctional angle (PJA) of greater than 10°-20°. Ligament augmentation is a novel strategy for PJK reduction that provides strength to the upper instrumented vertebra (UIV) and adjacent segments while also reducing junctional stress at those levels. METHODS In this study, ligament augmentation was used in a consecutive series of adult spinal deformity patients at a single institution...
February 23, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29473376/can-re-cturbt-be-useful-in-pt1hg-disease-as-a-risk-indicator-of-recurrence-and-progression-a-single-centre-experience
#9
Roberto Giulianelli, Barbara Cristina Gentile, Gabriella Mirabile, Luca Albanesi, Paola Tariciotti, Giorgio Rizzo, Maurizio Buscarini, Mauro Vermiglio
INTRODUCTION: Understaging after initial transurethral resection is common in patients with high-risk non muscle infiltrating bladder cancer (NMIBC) and can delay accurate diagnosis and definitive treatment. The rate of upstaging from T1 to T2 disease after repeated transurethral resection ranges from 0 to 28%, although the rate of upstaging may be even higher up to 49% when muscularis propria is absent in the first specimen. A restaging classic transurethral resection of bladder tumour (re-cTURBT) is the better predictor of early stage progression...
December 31, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/29472105/identification-of-patients-at-high-risk-for-post-discharge-venous-thromboembolism-after-hepato-pancreato-biliary-surgery-which-patients-benefit-from-extended-thromboprophylaxis
#10
Eliza W Beal, Dmitry Tumin, Jeffery Chakedis, Erica Porter, Dimitrios Moris, Xu-Feng Zhang, Sherif Abdel-Misih, Mary Dillhoff, Andrei Manilchuk, Jordan Cloyd, Carl R Schmidt, Timothy M Pawlik
BACKGROUND: The objective of the current study was to define risk factors associated with the 30-day post-operative risk of VTE after HPB surgery and create a model to identify patients at highest risk of post-discharge VTE. METHODS: Patients who underwent hepatectomy or pancreatectomy in the ACS-NSQIP Participant Use Files 2011-2015 were identified. Logistic regression modeling was used; a model to predict post-discharge VTE was developed. Model discrimination was tested using area under the curve (AUC)...
February 19, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29471555/-pregnancy-after-obesity-and-metabolic-surgery-risks-and-complications
#11
Christine Stroh, Tanja Groten, Eckehardt Schleussner, Thomas Manger
The increasing prevalence of morbid obesity in Germany is associated with an increasing number of metabolic surgical interventions. Short-term surgical and long-term metabolic complications - such as nutrient deficiencies - are the main risks of metabolic surgery and the resulting malabsorption. Obesity, especially morbid obesity, is associated with a high incidence of female infertility. One important cause of female infertility in obese women is the polycystic ovary syndrome, with 6 - 10%. Metabolic surgery significantly increases the fertility of obese women...
February 22, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29471554/-day-surgery-for-endoscopic-inguinal-hernia-repair
#12
Ulrich Steger, Markus Bisping, Jennifer Urban, Thorsten Vowinkel, Aloys Wiesmann, Jonathan Ryll
BACKGROUND: Whereas international guidelines recommend day surgery for endoscopic inguinal hernia repair, this approach is still controversial in Germany. In the light of international guidelines and at the request of patients, we have established total extraperitoneal patch plastic (TEP) surgery in the outpatient setting in our hospital. METHODS: A retrospective analysis of all unilateral TEP procedures carried out between January 2013 and December 2015 in our outpatient surgery, focused on postoperative complications, conversion to admission and rate of recurrence...
February 22, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29470819/adequate-local-control-in-high-risk-soft-tissue-sarcoma-of-the-extremity-treated-with-surgery-alone-at-a-reference-centre-should-radiotherapy-still-be-a-standard
#13
Marco Fiore, Samuel Ford, Dario Callegaro, Claudia Sangalli, Chiara Colombo, Stefano Radaelli, Anna Maria Frezza, Salvatore L Renne, Paolo G Casali, Alessandro Gronchi
BACKGROUND: Established practice for the management of soft tissue sarcoma (STS) of the extremity and trunk wall combines perioperative radiotherapy (RT) with limb-preserving surgery. OBJECTIVE: The aim of this study was to explore whether high-quality surgery at high-volume centers may offer equivalent local control in selected cases, when RT needs to be avoided. METHODS: All consecutive adult cases of primary, high-risk STSs treated in a high-volume reference center over a 12-year timeframe were included, and, on retrospective analysis, were divided into two groups...
February 22, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29470800/landiolol-a-review-in-tachyarrhythmias
#14
Yahiya Y Syed
Intravenous landiolol [Rapibloc® (EU)], an ultra short-acting highly cardioselective β1 -blocker, is approved in the EU for the rapid short-term control of tachyarrhythmias in the perioperative and intensive care settings. It has long been used in Japan to treat perioperative tachyarrhythmias. The efficacy of landiolol has been demonstrated in a large number of randomized controlled clinical trials. Landiolol significantly reduced heart rate in patients with postoperative or intraoperative supraventricular tachycardia relative to placebo and in those with atrial fibrillation/flutter and left ventricular dysfunction relative to digoxin...
February 22, 2018: Drugs
https://www.readbyqxmd.com/read/29470698/permanent-hypoparathyroidism-after-total-thyroidectomy-in-children-results-from-a-national-registry
#15
Erik Nordenström, Anders Bergenfelz, Martin Almquist
INTRODUCTION: Hypoparathyroidism is the most common complication following thyroidectomy. There are few population-based reports on the rate of hypoparathyroidism in children. The incidence of medical treatment of permanent hypoparathyroidism in children is reported using a national registry. METHODS: The study population included patients below 18 years of age undergoing total thyroidectomy reported to the Scandinavian Quality Registry for Thyroid, Parathyroid and Adrenal Surgery 2004-2014...
February 22, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29470687/surgical-management-of-extensive-dissecting-thoracic-aortic-aneurysm-via-the-semi-clamshell-approach
#16
Hiroshi Furukawa, Takeshi Honda, Takahiko Yamasawa, Hisao Masaki, Kazuo Tanemoto
BACKGROUND: We retrospectively evaluated the initial clinical experience of the surgical management of extensive dissecting thoracic aortic aneurysm (TAA) via the semi-clamshell approach. METHODS: Thirteen patients (3 women and 10 men, mean age 67 ± 15 years) who underwent elective surgical intervention for extensive dissecting TAA via semi-clamshell approach in our institute between May 2007 and April 2017 participated in this study. Regarding surgical techniques, left thoracotomy with transverse sternotomy was initially performed via the third or fourth intercostal space following an incision from the right sternal borderline to the anterior axillary line on the left sternal borderline...
February 22, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29470234/incidence-of-neuraxial-abnormalities-is-approximately-8-among-patients-with-adolescent-idiopathic-scoliosis-a-meta-analysis
#17
Michael Faloon, Nikhil Sahai, Todd P Pierce, Conor J Dunn, Kumar Sinha, Ki Soo Hwang, Arash Emami
BACKGROUND: Several studies have sought to address the role of routine preoperative MRI in patients with adolescent idiopathic scoliosis (AIS) undergoing deformity correction. Despite similar results regarding the prevalence of neuraxial anomalies detected on MRI, published conclusions conflict and give opposing recommendations. Lack of consensus has led to important variations in use of MRI before spinal surgery for patients with AIS. QUESTIONS/PURPOSES: This systematic review and meta-analysis of studies about patients with AIS evaluated (1) the overall proportion of neuraxial abnormalities; (2) the patient factors and curve characteristics that may be associated with abnormalities; and (3) the proportion of patients who underwent neurosurgical intervention before scoliosis surgery and the kinds of neuraxial lesions that were identified...
February 21, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29469984/coil-embolization-to-successfully-treat-annular-rupture-during-transcatheter-aortic-valve-replacement
#18
Ryan Azarrafiy, Felipe N Albuquerque, Roger G Carrillo, Mauricio G Cohen
Aortic annular rupture is one of the most feared complications of transcatheter aortic valve replacement (TAVR). This complication often presents as sudden cardiac tamponade with hypotension and requires urgent intervention. The traditional rescue strategy for such cases is emergency surgical intervention, yet the mortality remains high considering most patients who undergo TAVR are not candidates for open heart surgery. As such, there is a need for percutaneous alternatives to treat this critical complication...
February 22, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29469804/early-results-of-total-hip-arthroplasty-using-dual-mobility-cup-in-patients-with-osteonecrosis-of-the-femoral-head
#19
Chahine Assi, Nadim Kheir, Camille Samaha, Pascal Kouyoumjian, Kaissar Yammine
INTRODUCTION: Osteonecrosis of the femoral head (ONFH) remains a therapeutic challenge for patients undergoing total hip arthroplasty (THA). The majority of these patients are young with high functional demand, and show an increased risk of dislocation following surgery than patients with osteoarthritis. The use of double mobility cup (DMC) has been linked with lower rates of complications when compared to conservative cups; however, the literature is scarce over DMC results in patients with ONFH...
2018: SICOT-J
https://www.readbyqxmd.com/read/29468855/major-clinical-research-advances-in-gynecologic-cancer-in-2017
#20
REVIEW
Dong Hoon Suh, Miseon Kim, Kyung Hun Lee, Keun Yong Eom, Maj Kamille Kjeldsen, Mansoor Raza Mirza, Jae Weon Kim
In 2017, 10 topics were selected as major clinical research advances in gynecologic oncology. For cervical cancer, efficacy and safety analysis results of a 9-valent human papillomavirus (HPV) vaccine and long-term impact of reduced dose of quadrivalent vaccine were updated. Brief introduction of KEYNOTE trials of pembrolizumab, a monoclonal antibody that blocks the interaction between programmed death (PD)-1 and its ligands, PD-L1 and PD-L2, followed. Tailored surveillance programs for gynecologic cancer related with Lynch syndrome and update on sentinel lymph node mapping were reviewed for uterine corpus cancer...
March 2018: Journal of Gynecologic Oncology
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