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https://www.readbyqxmd.com/read/29781232/predictors-of-outcomes-in-managing-breast-abscesses-a-large-retrospective-single-center-analysis
#1
Miriam David, Priyanka Handa, Maria Castaldi
We have retrospectively examined a wide range of clinical characteristics, sonographic features, microbiology, and antibiotic regimens in patients with breast abscesses to seek predictive features related to outcome. Because consensus for optimal treatment of breast abscesses has moved toward minimally invasive management using single or repeated needle aspiration (ASP) coupled with adjuvant antibiotics, we assessed whether any factors correlate with the need for repeat procedures by analyzing the number of ASPs and/or surgical incision and drainage (I&D) per abscess...
May 20, 2018: Breast Journal
https://www.readbyqxmd.com/read/29780241/patient-and-physician-preferences-for-attributes-of-coronary-revascularization
#2
Carlos Alberto da Silva Magliano, Andrea Liborio Monteiro, Bernardo Rangel Tura, Claudia Silvia Rocha Oliveira, Amanda Rebeca de Oliveira Rebelo, Claudia Cristina de Aguiar Pereira
Background: Patients with a diagnosis of coronary artery disease (CAD) may face important decisions regarding treatment options, with the "right choice" depending on the relative weights of risks and benefits. Studies performed as discrete choice experiments are used to estimate these weights, and attribute selection is an essential step in the design of these studies. Attributes not included in the design cannot be analyzed. In this study, we aimed to elicit, rank, and rate attributes that may be considered important to patients and physicians who must choose between angioplasty and surgery for coronary revascularization...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29716640/tranexamic-acid-versus-placebo-to-prevent-blood-transfusion-during-radical-cystectomy-for-bladder-cancer-tact-study-protocol-for-a-randomized-controlled-trial
#3
Rodney H Breau, Luke T Lavallée, Sonya Cnossen, Kelsey Witiuk, Ilias Cagiannos, Franco Momoli, Gregory Bryson, Salmaan Kanji, Christopher Morash, Alexis Turgeon, Ryan Zarychanski, Ranjeeta Mallick, Greg Knoll, Dean A Fergusson
BACKGROUND: Radical cystectomy for bladder cancer is associated with a high risk of needing red blood cell transfusion. Tranexamic acid reduces blood loss during cardiac and orthopedic surgery, but no study has yet evaluated tranexamic acid use during cystectomy. METHODS: A randomized, double-blind (surgeon-, anesthesiologist-, patient-, data-monitor-blinded), placebo-controlled trial of tranexamic acid during cystectomy was initiated in June 2013. Prior to incision, the intervention arm participants receive a 10 mg/kg loading dose of intravenously administered tranexamic acid, followed by a 5 mg/kg/h maintenance infusion...
May 2, 2018: Trials
https://www.readbyqxmd.com/read/29660154/local-mepivacaine-before-castration-of-horses-under-medetomidine-isoflurane-balanced-anaesthesia-is-effective-to-reduce-perioperative-nociception-and-cytokine-release
#4
M Abass, S Picek, J F Glaus Carzòn, C Kühnle, A Zaghlou, R Bettschart-Wolfensberger
BACKGROUND: In horses castration with primary intention healing is usually performed under balanced inhalation anaesthesia. To optimise analgesia, the use of local anaesthesia was tested. OBJECTIVES: To investigate the effect of local mepivacaine before castration with first intention healing under balanced medetomidine-isoflurane anaesthesia and flunixin meglumine, morphine analgesia on perioperative cytokine levels and pain in horses. STUDY DESIGN: Prospective blinded clinical study...
April 16, 2018: Equine Veterinary Journal
https://www.readbyqxmd.com/read/29606040/decision-making-algorithm-for-minimally-invasive-approaches-to-anterior-skull-base-meningiomas
#5
Malte Ottenhausen, Kavelin Rumalla, Andrew F Alalade, Prakash Nair, Emanuele La Corte, Iyan Younus, Jonathan A Forbes, Atef Ben Nsir, Matei A Banu, Apostolos John Tsiouris, Theodore H Schwartz
OBJECTIVE Anterior skull base meningiomas are benign lesions that cause neurological symptoms through mass effect on adjacent neurovascular structures. While traditional transcranial approaches have proven to be effective at removing these tumors, minimally invasive approaches that involve using an endoscope offer the possibility of reducing brain and nerve retraction, minimizing incision size, and speeding patient recovery; however, appropriate case selection and results in large series are lacking. METHODS The authors developed an algorithm for selecting a supraorbital keyhole minicraniotomy (SKM) for olfactory groove meningiomas or an expanded endoscopic endonasal approach (EEA) for tuberculum sella (TS) or planum sphenoidale (PS) meningiomas based on the presence or absence of olfaction and the anatomical extent of the tumor...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29605791/use-of-postmortem-computed-tomography-to-retrieve-small-metal-fragments-derived-from-a-weapon-in-the-bodies-of-victims-in-two-homicide-cases
#6
Rie Sano, Yoichiro Takahashi, Akira Hayakawa, Masayuki Murayama, Rieko Kubo, Satoshi Hirasawa, Hiroyuki Tokue, Takehiro Shimada, Sachiko Awata, Hiroyuki Takei, Masahiro Yuasa, Shinji Uetake, Hisashi Akuzawa, Yoshihiko Kominato
Postmortem computed tomography (PMCT) is becoming a commonly used modality in routine forensic investigation. Mechanical injuries including lacerations, incisions, stab wounds and gunshot wounds frequently contain foreign bodies that may have significant value as clues in criminal investigations. CT is a sensitive modality for detection of metal foreign bodies that may be associated with injuries to the victim in cases of homicide or traffic accidents. Here we report two cases in which PMCT was able to act as a guide to forensic pathologists for retrieval of metal fragments in the corpses of the victims, the retrieved fragments then being used to validate the confessions of the assailants through comparison with the knife and the crowbar, respectively, that had been used in the crimes...
March 23, 2018: Legal Medicine
https://www.readbyqxmd.com/read/29551010/decision-support-system-for-the-planning-of-minimally-invasive-aortic-valve-replacement-surgery
#7
Hui Li, Miguel Castro, Pascal Haigron, Jean-Philippe Verhoye, Vito Giovanni Ruggieri
PURPOSE: Minimally invasive aortic valve replacement (MIAVR) procedures remain more complex and technically challenging compared to conventional full sternotomy surgery. This technique involves a restricted surgical field and a limited workspace, which is, at present, strictly reserved for the most experienced surgeons. The MIAVR clinical outcomes are strongly dependent on the appropriate choice of the thoracic incision. This work presents a decision support system to optimize, through an interactive visualization interface, the exposure of the target structure in a limited field of view...
March 17, 2018: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29549678/higher-cost-of-single-incision-laparoscopic-cholecystectomy-due-to-longer-operating-time-a-study-of-opportunity-cost-based-on-meta-analysis
#8
F Fuertes-Guirò, M Girabent-Farrés
BACKGROUND: We aimed to calculate the opportunity cost of the operating time to demonstrate that single incision laparoscopic cholecystectomy (SILC) is more expensive than classic laparoscopic cholecystectomy (CLC). METHODS: We identified studies comparing use of both techniques during the period 2008-2016, and to calculate the opportunity cost, we performed another search in the same period of time with an economic evaluation of classic laparoscopy. We performed a meta-analysis of the items selected in the first review considering the cost of surgery and surgical time, and we analyzed their differences...
January 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29444116/field-evaluation-of-the-safety-acceptability-and-feasibility-of-early-infant-male-circumcision-using-the-accucirc-device
#9
Robert C Bailey, Irene Nyaboke, Mary Ellen Mackesy-Amiti, Erick Okello, Valentine Pengo, Betha Ochomo, Mary Emmaculate Auma, Simon Were, Stella Ojuok, Evelyne Adoyo, Mildred Adhiambo, Marisa R Young, Rebeca M Plank, Fredrick O Otieno
BACKGROUND: As countries scale up adult voluntary medical male circumcision (VMMC) for HIV prevention, they are looking ahead to long term sustainable strategies, including introduction of early infant male circumcision (EIMC). Although a number of devices for EIMC are prequalified by the World Health Organization, evaluation of additional devices can provide policy-makers and clinicians the information required to make informed decisions. We undertook a field evaluation of the safety and acceptability of the AccuCirc device in Kisumu County, Kenya...
2018: PloS One
https://www.readbyqxmd.com/read/29429283/-advantages-and-disadvantages-of-femtosecond-laser-assisted-lasik-and-smile
#10
F J Zhang, M S Sun
With the development of excimer laser and femtosecond laser equipment, application of diversified and customized surgical decision in modern corneal refractive surgery has been an inevitable trend. However, how to make a personalized decision with an accurate surgical design to achieve better visual quality becomes the main focus in clinical applications. Small-incision lenticule extraction (SMILE) and femtosecond assisted laser in situ keratomileusis (FS-LASIK) have been commonly acknowledged as the mainstream of corneal refractive surgery for ametropia correction nowadays...
January 11, 2018: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/29405194/-the-significance-of-student-competitions-for-the-development-of-motivation-for-education-and-the-acquisition-of-professional-competences-in-the-students-the-department-of-forensic-medical-expertise-of-the-sechenovsky-university
#11
Yu I Pigolkin, Yu V Lomakin, E N Leonova
Russia joined the Bologna process in 2003 and since that time has become integrated into the unified European educational space. The key element of the new form of the higher education process is the self-guided unsupervised work of the students. Motivation is needed to promote the involvement of the students in the educational process which implies the necessity of the goal-oriented initiative for the acquisition of professional knowledge and practical experience in the field of forensic medicine. To achieve this goal, the Department of Forensic Medicine of I...
2018: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/29392436/prothrombin-complex-concentrate-reversal-of-coagulopathy-in-emergency-general-surgery-patients
#12
Moustafa Younis, Mohamed Ray-Zack, Nadeem N Haddad, Asad Choudhry, Matthew C Hernandez, Kevin Wise, Martin D Zielinski
BACKGROUND: Coagulopathy can delay or complicate surgical diseases that require emergent surgical treatment. Prothrombin complex concentrates (PCC) provide concentrated coagulation factors which may reverse coagulopathy more quickly than plasma (FFP) alone. We aimed to determine the time to operative intervention in coagulopathic emergency general surgery patients receiving either PCC or FFP. We hypothesize that PCC administration more rapidly normalizes coagulopathy and that the time to operation is diminished compared to FFP alone...
February 1, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29372149/decision-to-delivery-interval-in-emergency-cesarean-delivery-in-tertiary-care-hospital-in-thailand
#13
Khemanat Khemworapong, Nalat Sompagdee, Dittakarn Boriboonhirunsarn
Objective: To determine the decision-to-delivery interval (DDI) in emergency cesarean delivery and associated factors. Methods: A total of 431 pregnant women who were indicated for emergency cesarean delivery were included. Clinical information and timing of process after decision until delivery and pregnancy outcomes were evaluated. Results: Mean age was 30 years, and 59.4% were nulliparous. Mean gestational age at delivery was 37.9 weeks...
January 2018: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29354655/guidelines-vs-actual-management-of-skin-and-soft-tissue-infections-in-the-emergency-department
#14
Rahul S Kamath, Deepthi Sudhakar, Julianna G Gardner, Vagish Hemmige, Hossam Safar, Daniel M Musher
Background: Infections of skin and soft tissue (SSTI) commonly cause visits to hospital emergency departments (EDs). The Infectious Diseases Society of America (IDSA) has published guidelines for the management of SSTI, but it is unclear how closely these guidelines are followed in practice. Methods: We reviewed records of patients seen in the ED at a large tertiary care hospital to determine guidelines adherence in 4 important areas: the decision to hospitalize, choice of antibiotics, incision and drainage (I&D) of abscesses, and submission of specimens for culture...
January 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29336477/intraoperative-adverse-events-associated-with-extremely-preterm-cesarean-deliveries
#15
Charline Bertholdt, Sophie Menard, Pierre Delorme, Marie-Charlotte Lamau, François Goffinet, Camille Le Ray
INTRODUCTION: At the same time as survival is increasing among premature babies born before 26 weeks of gestation, the rates of cesarean deliveries before 26 weeks is also rising. Our purpose was to compare the frequency of intraoperative adverse events during cesarean deliveries in two gestational age groups: 24-25 weeks and 26-27 weeks. MATERIAL AND METHODS: This single-center retrospective cohort study included all women with cesarean deliveries performed before 28+0 weeks from 2007 through 2015...
May 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29302294/severe-tetracycline-dental-discoloration-restoration-with-conventional-feldspathic-ceramic-veneers-a-clinical-report
#16
Vicente Faus-Matoses, Ignacio Faus-Matoses, Esther Ruiz-Bell, Vicente J Faus-Llácer
The treatment of severe tetracycline discoloration is a challenge for the dentist. There are several treatment options and one of the most effective is the use of feldspathic veneers. The aim of this clinical case was to carry out the replacement with conventional feldspathic ceramic veneers on a patient with highly stained teeth (grade IV tetracycline) by a minimally invasive approach. Clinical examination revealed gingival retraction, color change of the veneers, ceramic cracked of 1.1 and 1.3 and incisal wear in lower anterior teeth...
November 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/29274151/preliminary-evaluation-of-near-infrared-vein-visualization-technology-in-the-screening-of-palatal-blood-vessels
#17
E Yaprak, S Kayaalti-Yuksek
BACKGROUND: Avoidance from palatal blood vessel rupture is a major concern during the palatal soft tissue graft surgery. There is no defined chair-side and case-specific palatal blood vessel detection approach to facilitate the harvesting process. The objective of this pilot study is to assess the feasibility of a near-infrared vein visualization system in the screening process of palatal blood vessels. MATERIAL AND METHODS: An extraoral vein visualization device (AccuVein AV400) was applied to a total of 304 hemi-maxilla of 152 individuals by two blind examiners...
January 1, 2018: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/29242798/anterior-elbow-pain-caused-by-compression-of-the-lateral-antebrachial-cutaneous-nerve
#18
Sean M Booth, Abdulbaset Abosala, Chris Peach
Introduction: The complex anatomy and biomechanics of the elbow joint can lead to diagnostic uncertainty when a clinician is determining the cause of a patient's anterior elbow pain. We present a case of anterior elbow pain with an uncommon and often overlooked etiology. Elbow pain due to compression of the lateral antebrachial nerve (LACN) has an unknown incidence or prevalence. Case Report: A 27-year-old left-hand dominant male presented to our orthopedic elbow clinic complaining of bilateral elbow clicking and discomfort which had been present for several years...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29225780/the-decision-to-delivery-interval-in-emergency-caesarean-sections-impact-of-anaesthetic-technique-and-work-shift
#19
Anette Hein, David Thalen, Ylva Eriksson, Jan G Jakobsson
Background: One important task of the emergency anaesthesia service is to provide rapid, safe and effective anaesthesia for emergency caesarean sections (ECS). A Decision to Delivery Interval (DDI) <30 minutes for ECS is a quality indicator for this service. The aim of this study was to assess the DDI and the impact of chosen anaesthetic technique (general anaesthesia (GA), spinal anaesthesia (SPA) with opioid supplementation, or "top-up" of labour epidural analgesia (tEDA) with local anaesthesia and fentanyl mixture) and work shift for ECS at Danderyds Hospital, Sweden...
2017: F1000Research
https://www.readbyqxmd.com/read/29181352/a-case-report-of-dual-incision-technique-for-total-femur-arthroplasty-as-a-salvage-procedure-in-infected-non-unions
#20
Aniruddh Agrawal, Vinod Agrawal, Sandeepkumar Yadav, Shushil K Soni, Sawan Kumar Pawar
Introduction: Total femur arthroplasty (TFA) is a rare salvage limb procedure which serves as an effective alternative to limb amputation. Most commonly, it is indicated for oncologic orthopedic cases, and very few cases of a purely traumatic history for TFA have been documented. The decision to perform this complex procedure involves paying careful attention to reconstructive needs and functional expectations of the patient. Alternatives to this procedure are quite detrimental and include hip disarticulation and above-the-knee amputation...
July 2017: Journal of Orthopaedic Case Reports
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