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decision to incision

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
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
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
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
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
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
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 at 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...
January 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
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
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...
December 23, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
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
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
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
Matthew R Naunheim, Margaret L Naunheim, Vinay K Rathi, Ramon A Franco, Mark G Shrime, Phillip C Song
Objectives Subglottic stenosis can be addressed with several different surgical techniques, but patient preferences for these treatment modalities are poorly understood. Economic methods are increasingly being used to understand how patients make decisions. The objective of this pilot study was to assess preferences in subglottic stenosis treatment using patient-centric stated preference techniques. Study Design Discrete choice experiment (DCE). Setting Academic research facility. Subjects and Methods A computer-based DCE was administered in a monitored setting to volunteers from the general population...
November 1, 2017: Otolaryngology—Head and Neck Surgery
Alex Aulakh, Patrick Idoko, Suzanne T Anderson, Wendy Graham
Ours is the first published study to examine post-Caesarean section (CS) wound infections in The Gambia. We explored risk factors and clinical management retrospectively at a large referral hospital over a 12-month period. A total of 777 cases were identified and records for 682 (88%) were retrieved. The CS rate was 21.8% and the wound infection rate 13.2%. Risk factors included: length of labour; decision-to-incision time and stillbirth. Only 7.4% of women received preoperative antibiotic prophylaxis, but all women received multiple-dose, postoperative antibiotics...
January 1, 2017: Tropical Doctor
Z Beriashvili, M Gurgenidze
A 28-year-old male patient came to Surgical Department 15.07.2003 after a gunshot wound. An emergency operation was performed. Among the other damages of different part of intestinum damage of the anterior wall of the second anatomical part of the duodenum was diagnosed intraoperatively. The size of the damaged area was 3×1 sm. The doudenal wound was sutured with two layers after updating the edges. On the fifth postoperative day the wound leakage was detected. Later the giant sizes of duodenal fistula was formed...
October 2017: Georgian Medical News
Sunil V Patel, David D Paskar, Richard L Nelson, Satyanarayana S Vedula, Scott R Steele
BACKGROUND: Surgeons who perform laparotomy have a number of decisions to make regarding abdominal closure. Material and size of potential suture types varies widely. In addition, surgeons can choose to close the incision in anatomic layers or mass ('en masse'), as well as using either a continuous or interrupted suturing technique, of which there are different styles of each. There is ongoing debate as to which suturing techniques and suture materials are best for achieving definitive wound closure while minimising the risk of short- and long-term complications...
November 3, 2017: Cochrane Database of Systematic Reviews
Sudhir Khichy, Baldev Singh, Manpreet Singh, Sukha Singh
BACKGROUND: Surgical site infections are the most common postoperative complications and frequently cause morbidity and mortality. Different antibiotic regimens were evaluated as prophylaxis in wound infection following elective surgical procedures. Prophylactic antibiotics should be given to cover the "decisive period" which is a period after incision to mobilization of host defenses thus preventing an infection from developing. OBJECTIVES: The aim is to study the effectiveness of short-term antibiotic coverage during decisive period in the prevention of postoperative wound sepsis in clean surgical cases...
July 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
Fernando M Safdie, Manuel Villa Sanchez, Inderpal S Sarkaria
Video assisted thoracic surgery (VATS) has become a routinely utilized approach to complex procedures of the chest, such as pulmonary resection. It has been associated with decreased postoperative pain, shorter length of stay and lower incidence of complications such as pneumonia. Limitations to this modality may include limited exposure, lack of tactile feedback, and a two-dimensional view of the surgical field. Furthermore, the lack of an open incision may incur technical challenges in preventing and controlling operative misadventures leading to major hemorrhage or other intraoperative emergencies...
2017: Journal of Visualized Surgery
Jessica Goodwin, Pepper Womack, Billy Moore, J Laureano Phillips, Therese Duane
BACKGROUND: It is unclear whether surgical residents understand how to classify incisions, which may impact how closure is handled in the operating room. We hypothesized that surgical residents define incision class (IC) accurately compared with an attending NSQIP surgeon champion (SC). METHODS: We evaluated our NSQIP database from April 1, 2015, to December 31, 2016, including cases in which a resident was present and IC was documented. Cases in which the resident, circulator, or surgical clinical rater disagreed on the IC were then reviewed by a blinded SC...
November 2017: Surgical Infections
Alkinoos Athanasiou, Ioannis Balogiannis, Ioannis Magras
BACKGROUND: Lasting bilateral mydriasis and absence of pupillary light reflex following severe traumatic brain injury (TBI) are considered signs of irreversible brainstem damage and have been strongly associated with poor outcome. CASE DESCRIPTION: A young female patient presented with severe TBI, contusions, and diffuse brain edema. She was initially treated medically, but developed delayed secondary refractory intracranial hypertension and bilaterally dilated, non-reactive pupils for 12 h...
2017: Surgical Neurology International
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