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https://www.readbyqxmd.com/read/28794531/a-randomised-comparative-evaluation-of-supraclavicular-and-infraclavicular-approaches-to-brachial-plexus-block-for-upper-limb-surgeries-using-both-ultrasound-and-nerve-stimulator
#1
Ranganathan Jothi Abhinaya, Rajagopalan Venkatraman, Palanisamy Matheswaran, Govindarajan Sivarajan
BACKGROUND AND AIMS: The supraclavicular and infraclavicular brachial plexus blocks have a similar distribution of anaesthesia, and both can be used effectively for surgeries of the upper limb. This study aimed to compare the supraclavicular and infraclavicular approaches of brachial plexus blocks, guided by ultrasound and neurostimulation. METHODS: Sixty adult patients scheduled for elective upper limb surgery of the elbow and/or below were randomly divided into two groups: infraclavicular Group (I) and supraclavicular Group (S)...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28776638/a-novel-combination-of-peripheral-nerve-blocks-for-arthroscopic-shoulder-surgery
#2
D Musso, S Flohr-Madsen, K Meknas, T Wilsgaard, L M Ytrebø, Ø Klaastad
BACKGROUND: Interscalene brachial plexus block is currently the gold standard for intra- and post-operative pain management for patients undergoing arthroscopic shoulder surgery. However, it is associated with block related complications, of which effect on the phrenic nerve have been of most interest. Side effects caused by general anesthesia, when this is required, are also a concern. We hypothesized that the combination of superficial cervical plexus block, suprascapular nerve block, and infraclavicular brachial plexus block would provide a good alternative to interscalene block and general anesthesia...
August 4, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28775084/small-cell-lung-cancer-presenting-as-unilateral-rhinorrhoea
#3
Adam Haymes, Sridhayan Mahalingam, Natasha Choudhury
The metastatic spread of infraclavicular malignancies to the nasal cavity is rare. We describe the case of a 58-year-old man who presented with a 4-month history of right-sided rhinorrhoea, maxillary hypoesthesia, hyposmia and hypogeusia. Clinical examination revealed an irregular mass within the right nasal cavity. Immunohistochemical analyses of biopsies were consistent with small cell carcinoma of indeterminate origin. A positron emission tomography scan demonstrated extensive mediastinal lymphadenopathy with collapse-consolidation of the right lung's middle lobe and no other sites of metastasis...
August 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28732521/retroclavicular-approach-vs-infraclavicular-approach-for-plexic-bloc-anesthesia-of-the-upper-limb-study-protocol-randomized-controlled-trial
#4
P L Langlois, A F Gil-Blanco, D Jessop, Y Sansoucy, F D'Aragon, N Albert, P Echave
BACKGROUND: The coracoid approach is recognized as the simplest approach to perform brachial plexus anaesthesia, but needle visualization needs to be improved. With a different needle entry point, the retroclavicular approach confers a perpendicular angle between the ultrasound and the needle, which theoretically enhances needle visualization. This trial compares these two techniques. The leading hypothesis is that the retroclavicular approach is comparable to the infraclavicular coracoid approach in general aspects, but needle visualization is better with this novel approach...
July 21, 2017: Trials
https://www.readbyqxmd.com/read/28725962/optimal-positioning-of-the-nipple-areola-complex-in-men-using-the-mohrenheim-estimated-tangential-tracking-line-mett-line-an-intuitive-approach
#5
Tobias R Mett, Nicco Krezdorn, Rosalia Luketina, Maria K Boyce, Helga Henseler, Ramin Ipaktchi, Peter M Vogt
INTRODUCTION: The reconstruction of the body shape after post-bariatric surgery or high-grade gynecomastia involves, besides skin tightening, the repositioning of anatomical, apparent landmarks. The surgeon usually defines these during the preoperative planning. In particular, the positions of the nipple-areola complexes (NAC) should contribute to the gender-appropriate appearance. While in the female breast numerous methods have been developed to determine the optimal position of the NACs, there are only a few, metric and often impractical algorithms for positioning the nipples and areoles in the male...
July 19, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28680779/first-case-of-the-cervical-lymph-node-as-the-only-site-of-metastasis-from-anal-cancer
#6
Bo Wang, Sunny Jaiswal, Muhammad W Saif
Anal squamous cell carcinoma was a previously uncommon malignancy that has steadily increased in incidence with the increased prevalence of human papillomavirus (HPV) and human immunodeficiency virus (HIV). Anal squamous cell carcinoma is typically characterized by local and regional involvement and distant metastases are far less common. Here, we report a case of a 36-year-old female initially diagnosed with anal squamous cell carcinoma manifesting as an anal mass along with an enlarged inguinal lymph node...
May 30, 2017: Curēus
https://www.readbyqxmd.com/read/28656387/spontaneous-recovery-of-non-operated-traumatic-brachial-plexus-injury
#7
S H Lim, J S Lee, Y H Kim, T W Kim, K M Kwon
PURPOSE: We investigated the spontaneous recovery of non-operated traumatic brachial plexus injury (BPI). METHODS: A total of 25 cases of non-operated traumatic BPI were analysed by retrospective review of medical records; in all cases, consecutive electrodiagnostic studies (ES) were conducted from 1 to 4 months and 18 to 24 months post-trauma. Injury severity was assessed using a modified version of Dumitru and Wilbourn's scale (DWS) based on ES. Spontaneous recovery of brachial plexus components per subject was analysed using Wilcoxon's signed-rank test...
June 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28651954/case-report-ultrasound-guided-infraclavicular-brachial-plexus-block-for-a-case-with-posterior-elbow-dislocation
#8
Sinan Akay, Sami Eksert, Murtaza Kaya, Kenan Keklikci, Ali Kantemir
BACKGROUND: The interest in regional anesthesia procedures for the management of upper-extremity emergencies has increased. Toward that end, supraclavicular, interscalene, or infraclavicular approaches, with or without ultrasound guidance, are used for brachial plexus nerve blocks. Although many studies have reported on the use of ultrasound-guided supraclavicular and interscalene brachial plexus blocks for upper-extremity dislocations, very few studies have reported on the use of ultrasound-guided infraclavicular brachial plexus blocks...
June 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28624567/results-of-operative-treatment-of-brachial-plexus-injury-resulting-from-shoulder-dislocation-a-study-with-a-long-term-follow-up
#9
Olga Gutkowska, Jacek Martynkiewicz, Sylwia Mizia, Michał Bąk, Jerzy Gosk
BACKGROUND: Injury to the infraclavicular brachial plexus is an uncommon but serious complication of shoulder dislocation. This work aims to determine the effectiveness of operative treatment in patients with this type of injury. METHODS: Thirty-three patients (26 males,7 females; mean age 45 years 3 months) treated operatively for brachial plexus injury resulting from shoulder dislocation between the years 2000-2013 were included in this retrospective case series...
June 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28603868/pre-operative-brachial-plexus-block-compared-with-an-identical-block-performed-at-the-end-of-surgery-a-prospective-double-blind-randomised-clinical-trial
#10
A Holmberg, A R Sauter, Ø Klaastad, T Draegni, J C Raeder
We evaluated whether pre-emptive analgesia with a pre-operative ultrasound-guided infraclavicular brachial plexus block resulted in better postoperative analgesia than an identical block performed postoperatively. Fifty-two patients undergoing fixation of a fractured radius were included. All patients received general anaesthesia with remifentanil and propofol. Patients were randomly allocated into two groups: a pre-operative block or a postoperative block with 0.5 ml.kg(-1) ropivacaine 0.75%. After surgery, all patients received regular paracetamol plus opioids for breakthrough pain...
June 12, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28586961/long-term-results-of-a-highly-performing-conformal-electron-therapy-technique-for-chest-wall-irradiation-after-mastectomy
#11
Noemie Grellier Adedjouma, Marion Chevrier, Alain Fourquet, Emilie Costa, Haoping Xu, Frederique Berger, Francois Campana, Fatima Laki, Philippe Beuzeboc, Delphine Lefeuvre, Nathalie Fournier-Bidoz, Youlia M Kirova
PURPOSE: To evaluate locoregional control and survival after mastectomy, as well as toxicity, in patients irradiated by a previously described postmastectomy highly conformal electron beam radiation therapy technique (PMERT). METHODS AND MATERIALS: We included all women irradiated by postmastectomy electron beam radiation therapy for nonmetastatic breast cancer between 2007 and 2011 in our department. Acute and late toxicities were retrospectively assessed using Common Terminology Criteria for Adverse Events version 3...
May 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28553851/morphometric-parameters-of-cardiac-implantable-electronic-device-cied-pocket-walls-observed-on-device-replacement
#12
Roman Steckiewicz, Elżbieta Barbara Świętoń, Agnieszka Kołodzińska, Magdalena Bogdańska, Łukasz Fus, Przemysław Solarz
BACKGROUND: The final stage of a conventional de-novo cardiac implantable electronic device (CIED) implantation procedure with transvenous lead insertion involves the formation of a pocket by tissue separation superficial to the pectoralis major muscle in the right or left infraclavicular region, where the device is subsequently placed. Over time, a scar "capsule" forms around the CIED as a result of normal biological remodeling. MATERIALS AND METHODS: The purpose of this study was to analyze the structure and present the variations of CIED capsules observed during device replacement...
May 29, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28518084/subcutaneous-trigeminal-nerve-field-stimulation-for-refractory-facial-pain
#13
Martin Jakobs, Sigrid Schuh-Hofer, Andreas Unterberg, Rezvan Ahmadi
Chronic or neuropathic trigeminal facial pain can be challenging to treat. Neurosurgical procedures should be applied when conservative treatment fails. Neuromodulation techniques for chronic facial pain include deep brain stimulation and motor cortex stimulation, which are complex to perform. Subcutaneous nerve field stimulation is certified for chronic back pain and is the least invasive form of neuromodulation. We applied this technique to treat chronic and neuropathic trigeminal pain as an individual therapy concept...
May 10, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28479443/postoperative-pain-management-following-thoracic-outlet-decompression
#14
Mathew Wooster, Dana Reed, Adam Tanious, Karl Illig
BACKGROUND: Thoracic outlet decompression (TOD) is associated with significant postoperative pain often leading to hospital length of stay out of proportion to the risk profile of the operation. We seek to describe the improvement in hospital length of stay and patient pain control with an improved multiagent pain management regimen. METHODS: We retrospectively reviewed the hospital length of stay, medication regimen/usage, operative details, and operative indications for all patients undergoing TOD from January 2012 through June 2015...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28458119/tnm-classification-and-the-need-for-revision-of-pn3a-breast-cancer
#15
T J A van Nijnatten, M Moossdorff, L de Munck, B Goorts, M L G Vane, K B M I Keymeulen, R G H Beets-Tan, M B I Lobbes, M L Smidt
BACKGROUND: According to the seventh edition of tumour-node-metastasis (TNM) classification, pN3a status in breast cancer patients consists of presence of an infraclavicular lymph node metastasis (LNM) and/or presence of ≥10 axillary LNMs. The aim of this study was to determine whether prognosis of pN3a based on at least an infraclavicular LNM differs from ≥10 axillary LNMs. METHODS: Data were obtained from the Netherlands Cancer Registry. All patients were diagnosed between 2005 and 2008 with primary invasive epithelial breast cancer and pN2a or pN3a status as pathologic result...
April 26, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28421316/comparison-of-the-coracoid-and-retroclavicular-approaches-for-ultrasound-guided-infraclavicular-brachial-plexus-block
#16
Nilgun Kavrut Ozturk, Ali Sait Kavakli
PURPOSE: This prospective randomized study compared the coracoid and retroclavicular approaches to ultrasound-guided infraclavicular brachial plexus block (IBPB) in terms of needle tip and shaft visibility and quality of block. We hypothesized that the retroclavicular approach would increase needle tip and shaft visibility and decrease the number of needle passes compared to the coracoid approach. METHODS: A total of 100 adult patients who received IBPB block for upper limb surgery were randomized into two groups: a coracoid approach group (group C) and a retroclavicular approach group (group R)...
August 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28412188/patterns-of-brachial-plexus-stretch-palsy-in-a-prospective-series-of-565-surgically-treated-patients
#17
Jayme A Bertelli, Marcos F Ghizoni, Francisco Soldado
PURPOSE: To report the distribution of the different patterns of stretch brachial plexus injuries (BPIs) in a retrospective cohort of patients operated at our institution during an 11-year period. METHODS: From September 2002 to June 2012, we evaluated and operated on 565 patients with traction injuries of the brachial plexus. Average age was 26.8 years (SD ±9.3 years); the interval between the injury and surgery was 5.4 months (SD ±2.8 months). The pattern of injury was defined based on data obtained from a standardized clinical examination, preoperative helical computed tomography myelography after intradural contrast injection, surgical findings, and intraoperative electric stimulation...
June 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28348896/effect-of-arm-positioning-on-entrapment-of-infraclavicular-nerve-block-catheter
#18
Eric Kamenetsky, Rahul Reddy, Mark C Kendall, Antoun Nader, Jessica J Weeks
Continuous brachial plexus nerve block catheters are commonly inserted for postoperative analgesia after upper extremity surgery. Modifications of the insertion technique have been described to improve the safety of placing an infraclavicular brachial plexus catheter. Rarely, these catheters may become damaged or entrapped, complicating their removal. We describe a case of infraclavicular brachial plexus catheter entrapment related to differences in arm positioning during catheter placement and removal. Written authorization to obtain, use, and disclose information and images was obtained from the patient...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28346651/breast-cancer-metastases-to-the-head-and-neck-case-series-and-literature-review
#19
Jeremiah C Tracy, Nicholas R Mildenhall, Richard O Wein, Miriam A O'Leary
Breast cancer is the most common cancer in women and is the second most common cause of cancer-related death. Despite the relatively high prevalence of this disease, breast cancer manifestations in the head and neck are relatively rare. Supraclavicular lymphadenopathy and bony metastases to the mandible and maxilla are the most common manifestation of breast cancer in the head and neck. Head and neck metastases are the first presentation of distant disease in approximately one-third of cases. The prognosis of breast cancer with distant metastases to the head and neck is generally poor, and the management of these lesions is controversial...
March 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28344184/arteriovenous-hybrid-graft-with-outflow-in-the-proximal-axillary-vein
#20
Allen G Murga, Jason Chiriano, Sharon C Kiang, Sheela Patel, Christian Bianchi, Ahmed M Abou-Zamzam, Theodore H Teruya
BACKGROUND: The patency of long-term hemodialysis access in end-stage renal disease patients remains a significant challenge. Often these patients are affected with limited venous outflow options, requiring limb abandonment, and creation of new access in the contralateral arm. Vascular surgeons are familiar with the exposure of the proximal axillary artery via an infraclavicular incision. The axillary vein is easily exposed through this technique. The use of the hybrid Gore graft can make the venous anastomosis easier...
March 24, 2017: Annals of Vascular Surgery
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