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https://www.readbyqxmd.com/read/29664130/time-to-redefine-the-intramammary-lymph-node-as-a-separate-entity
#1
M Green, H Tafazal, B Swati, R Vidya
The lymphatic drainage for the majority of primary breast tumours is to the axillary lymph nodes (ALNs). Some, however drain to the so-called extra-axillary basins, namely the internal mammary, supra- and infraclavicular regions. Another potential drainage route includes the intramammary lymph nodes (IMLNs). Current guidance suggests IMLNs should be considered as part of the axillary group, potentially affecting axillary management. However, due to evolution in imaging and advancement in technology, IMLNs may now be distinguished more accurately pre-operatively...
April 17, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29628564/comparison-of-magnesium-sulfate-and-dexmedetomidine-as-an-adjuvant-to-0-5-ropivacaine-in-infraclavicular-brachial-plexus-block
#2
Mohamed M Abu Elyazed, Mona M Mogahed
Background: Magnesium sulfate and dexmedetomidine were used as adjuvants to local anesthesia to improve the quality of regional anesthesia. Aims: The aim of this study is to evaluate and compare the effects of magnesium sulfate and dexmedetomidine when added to ropivacaine on the quality of infraclavicular brachial plexus block (BPB). Settings and Design: This was a prospective randomized double-blinded controlled study. Patients and Methods: A total of 105 adult patients undergoing surgery in hands, wrist, and forearm using infraclavicular BPB were randomly assigned into three groups...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29620988/a-simple-guide-to-regional-anaesthesia
#3
E M Valsamis, S Wade, C Thornhill, C Carey, D Ricketts
Regional anaesthesia is widely used in modern anaesthetic practice for perioperative and postoperative analgesia. In the operating theatre, regional anaesthesia is used both on its own and in combination with other techniques (general anaesthesia and sedation). Regional anaesthesia is now a core skill set in anaesthetic training. This article provides a basic outline of regional anaesthesia for surgeons and other non-anaesthetic staff working with anaesthetists, reviewing preparation, consent, basic and specialist equipment, central neuraxial blocks (spinal, epidural and caudal), trunk blocks, upper limb blocks (interscalene, supraclavicular, infraclavicular and axillary) and lower limb blocks (femoral, fascia iliaca, sciatic, popliteal and ankle)...
April 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29619928/studies-of-upper-limb-pain-in-occupational-medicine-in-general-practice-and-among-computer-operators
#4
Jørgen Riis Jepsen
Diagnostic consensus criteria cannot be applied in a major proportion of patients with upper limb complaints, many of which are regarded as "non-specific". The three empirical studies in this thesis aimed to address this diagnostic challenge by incorporating representative neurological qualities in the physical examination.
Patterns of muscle weakness, sensory abnormalities and nerve trunk allodynia based on the nerves' topography and their motor and cutaneous innervation were defined to reflect peripheral nerve afflictions and their locations...
April 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29594207/patterns-of-loco-regional-failure-in-women-with-breast-cancer-treated-by-postmastectomy-conformal-electron-beam-radiation-therapy-pmert-large-scale-single-center-experience
#5
Gokoulakrichenane Loganadane, Zhen Xi, Hao Ping Xu, Noemie Grellier Adedjouma, Louis Bazire, Alain Fourquet, Youlia M Kirova
Purpose: To evaluate loco regional control and describe the patterns of loco regional failure in women with breast cancer irradiated by a previously described post-mastectomy highly conformal electron beam radiotherapy technique. Materials and methods: We included all women irradiated by PMERT for non-metastatic breast cancer (BC) between 2007 and 2011 in our department. All cases of bilateral BC were excluded. All patients who experienced loco regional recurrence have been studied...
June 2017: Clinical and Translational Radiation Oncology
https://www.readbyqxmd.com/read/29583101/safety-of-percutaneous-axillary-artery-access-with-a-suture-mediated-closing-device-for-parallel-endograft-aortic-procedures-a-retrospective-pilot-study
#6
Gilbert Dominique Puippe, Adrian Kobe, Zoran Rancic, Roger Pfiffner, Mario Lachat, Thomas Pfammatter
BACKGROUND: The aim of this study was to evaluate the technical success of percutaneous ultrasound-guided access to the infraclavicular axillary artery with a suture-mediated closing device for patients requiring large-sized upper extremity access. PATIENTS AND METHODS: In 18 consecutive patients (17 male, one female, mean age 73.5 ± 9.6 years, range 52-88 years), artery accesses with the preclosing modification for chimney endografts was gained with 20 ultrasound-guided infraclavicular axillary...
March 27, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29554324/a-novel-approach-for-responsive-neural-stimulator-implantation-with-infraclavicular-placement-of-the-internal-pulse-generator
#7
Lucas R Philipp, Mark R Witcher, Robert E Gross
INTRODUCTION: The Responsive Neurostimulation System (RNS, Neuropace, Mountain View, California) has been proven to be effective at reducing seizures in patients with partial-onset epilepsy. The system incorporates a skull-mounted neurostimulator that requires a cranial incision for replacement. Although integral to the functioning of the system, in some circumstances, such as in the setting of infection, this can be disadvantageous. At present, there are no alternatives to cranial implantation of the RNS System...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29501016/management-of-extensive-surgical-emphysema-with-subcutaneous-drain-a-case-report
#8
Quoc Tran, Ryo Mizumoto, Daniel Mehanna
INTRODUCTION: Subcutaneous emphysema (SE) is a frequent and often self-limiting complication of tube thoracostomy or other cardiothoracic procedures. On rare occasions, severe and extensive surgical emphysema marked by palpable cutaneous tension, dysphagia, dysphonia, palpebral closure or associated with pneumoperitoneum, airway compromise, "tension phenomenon" and respiratory failure require treatment. PRESENTATION OF CASE: A 67 year old lady presented with a large spontaneous pneumothorax on the background of end-stage chronic obstructive pulmonary disease (COPD) and newly diagnosed lung cancer, developed extensive surgical emphysema following insertion of a chest drain...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29477681/surgical-missteps-in-the-management-of-venous-thoracic-outlet-syndrome-which-lead-to-reoperation
#9
Meena M Archie, Johnathon C Rollo, Hugh A Gelabert
INTRODUCTION: Surgical management of spontaneous subclavian thrombosis due to venous thoracic outlet syndrome (vTOS) results in durable relief of symptoms. The need to re-operate is rare. We report our experience with re-operation for vTOS. METHODS: Patients evaluated for vTOS between 1996 and 2016 were identified in a prospective database. Data recorded included demographics, initial presentation, initial surgery, recurrent presentation, re-operation, and final outcomes...
February 22, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29457395/-effects-of-patient-controlled-infraclavicular-brachial-plexus-block-for-postoperative-pain-and-surgical-efficacy-in-patients-with-terrible-tyriad-of-the-elbow
#10
Wang Xiu-Zhen, Ye-Ying Ge, Guang-Yao Ye, Jing-Wei Zhang, Wei-Hu Ma
OBJECTIVE: To study the effects of ultrasound guided inter-scalene brachial plexus block and patient-controlled infraclavicular brachial plexus block for postoperative pain and surgical efficacy in patients with terrible tyriad of the elbow. METHODS: From March 2015 to August 2016, 60 patients with terrible tyriad of the elbows were treated in Ningbo No.6 Hospital with ASA I to II internal fixation. There were 32 males and 28 females, ranging in age from 16 to 70 years old, with a mean age of (55...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29444598/venous-outlet-syndrome-caused-by-capillary-hemangioma-of-the-subclavian-vein
#11
Stefano Bongiolatti, Daniela Massi, Vincenza Maio, Alessandro Gonfiotti, Domenico Viggiano, Luca Voltolini
We report a case of intravenous lobular capillary hemangioma in the subclavian vein, causing venous thoracic outlet syndrome. A 32-year-old woman was referred to our unit with facial and left arm oedema. Ultrasound evaluation, computed tomography and magnetic resonance imaging showed a hypervascular mass in the middle portion of the subclavian vein, with arrest of venous flow. Through an infraclavicular approach, we excised the venous axis with the endovascular palpable tumour that extended from the axillary-subclavian junction to the jugular-subclavian junction, without reconstruction...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29414627/infraclavicular-versus-axillary-nerve-catheters-a-retrospective-comparison-of-early-catheter-failure-rate
#12
Michaela B Quast, Hans P Sviggum, Andrew C Hanson, David E Stoike, David P Martin, Adam D Niesen
STUDY OBJECTIVES: Continuous brachial plexus catheters are often used to decrease pain following elbow surgery. This investigation aimed to assess the rate of early failure of infraclavicular (IC) and axillary (AX) nerve catheters following elbow surgery. DESIGN: Retrospective study. SETTING: Postoperative recovery unit and inpatient hospital floor. PATIENTS: 328 patients who received IC or AX nerve catheters and underwent elbow surgery were identified by retrospective query of our institution's database...
February 3, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29388461/the-infraclavicular-approach-for-paget-schroetter-syndrome
#13
REVIEW
G Samoila, C P Twine, I M Williams
Introduction Paget-Schroetter syndrome is a rare effort thrombosis of the axillary-subclavian vein, mainly occurring in young male patients. Current management involves immediate catheter directed thrombolysis, followed by surgical decompression of the subclavian vein. This has been invariably performed using a transaxillary or supraclavicular approach. However, the subclavian vein crosses the first rib anteriorly just behind the manubrium and can also be accessed via an infraclavicular incision. Methods MEDLINE® and Embase™ were searched for all studies on outcomes in patients undergoing infraclavicular first rib resection for treatment of Paget-Schroetter syndrome...
February 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29382370/supraclavicular-subclavian-access-for-sapien-transcatheter-aortic-valve-replacement-a-novel-approach
#14
Thom G Dahle, Nathaniel J Castro, Brian M Stegman, Jacob R Dutcher, John M Teskey, Wade T Schmidt, Daren S Danielson, Sara J Dezell, Virginia B Daniels, Daniel J Tiede
BACKGROUND: Within the trans-subclavian approach, procedural techniques can vary widely, and reported access generally refers to an infraclavicular axillary approach. We describe and report the use of a novel supraclavicular true subclavian approach for transcatheter aortic valve replacement (TAVR) exclusively for implantation of Sapien 3 valves. CASE PRESENTATION: We report our first five consecutive patients undergoing TAVR with a Sapien 3 valve using a standardized subclavian approach at a single center...
January 30, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29356780/the-effect-of-infraclavicular-brachial-plexus-blocks-on-the-axillary-nerve
#15
LETTER
Dario Musso, Sandra Flohr-Madsen, Lars Marius Ytrebø, Øivind Klaastad
No abstract text is available yet for this article.
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29343900/direct-electrical-injury-to-brachial-plexus
#16
Maksud Mubarak Devale, Gaurav Jatin Kadakia, Vicky Ghewarchand Jain, Rohit Prakash Munot
Electrical current can cause neurological damage directly or by conversion to thermal energy. However, electrical injury causing isolated brachial plexus injury without cutaneous burns is extremely rare. We present a case of a 17-year-old boy who sustained accidental electrical injury to left upper extremity with no associated entry or exit wounds. Complete motor and sensory loss in upper limb were noted immediately after injury. Subsequently, the patient showed partial recovery in muscles around the shoulder and in ulnar nerve distribution at 6 months...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29338149/injection-pressure-mapping-of-intraneural-vs-perineural-injections-further-lessons-from-cadaveric-studies
#17
Andrzej Krol, Arber Vala, Leonidas Phylactides, Matthew Szarko, Miguel A Reina, Jose de Andrés
BACKGROUND: The aim of the study was to investigate the difference between intraneural and perineural injection pressures in human cadavers. Targeted nerves included the cervical roots, the supraclavicular and infraclavicular brachial plexus, the sciatic-subgluteal nerve and the common peroneal and tibial nerves. METHODS: Ten readings were obtained for each nerve location. 1mL of 0.9% NaCl was injected over ten seconds - deliberately slower than in clinical practice to eliminate the risk of aberrant readings relating to the speed of injection...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29319604/the-european-society-of-regional-anaesthesia-and-pain-therapy-american-society-of-regional-anesthesia-and-pain-medicine-recommendations-on-local-anesthetics-and-adjuvants-dosage-in-pediatric-regional-anesthesia
#18
Santhanam Suresh, Claude Ecoffey, Adrian Bosenberg, Per-Anne Lonnqvist, Gildasio S de Oliveira, Oscar de Leon Casasola, José de Andrés, Giorgio Ivani
BACKGROUND AND OBJECTIVES: Dosage of local anesthetics (LAs) used for regional anesthesia in children is not well determined. In order to evaluate and come to a consensus regarding some of these controversial topics, The European Society of Regional Anaesthesia and Pain Therapy (ESRA) and the American Society of Regional Anesthesia and Pain Medicine (ASRA) developed a Joint Committee Practice Advisory on Local Anesthetics and Adjuvants Dosage in Pediatric Regional Anesthesia. METHODS: Representatives from both ASRA and ESRA composed the joint committee practice advisory...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29301465/outcomes-following-operative-management-of-thoracic-outlet-syndrome-in-the-pediatric-patients
#19
Jesus M Matos, Lorena Gonzalez, Elias Kfoury, Angela Echeverria, Carlos F Bechara, Peter H Lin
Objectives Thoracic outlet syndrome, a condition commonly reported in adults, occurs infrequently in the pediatric population. The objective of this study was to assess the outcome of surgical interventions of thoracic outlet syndrome in pediatric patients. Methods Clinical records of all pediatric patients with thoracic outlet syndrome who underwent operative repair from 2002 to 2015 in a tertiary pediatric hospital were reviewed. Pertinent clinical variables and treatment outcomes were analyzed. Results Sixty-eight patients underwent a total of 72 thoracic outlet syndrome operations (mean age 15...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29290323/-dendritic-infraclavicular-fibromyxolipoma-at-the-boundary-between-spindle-cell-lipoma-and-solitary-fibrous-tumour
#20
Inmaculada Ruiz Molina, Eduardo Solís García, Vicente Cívico Amat
Dendritic fibromyxolipoma (DFML) is a rare soft tissue tumor recently described with only 27 cases reported in the literature. None of them have shown recurrence or metastasis after excision. Histologically it is composed of small stellate or spindle cells in a myxoid stroma with abundant collagen bundles mixed with mature adipose tissue. The proliferating cells typically show immunoexpression positive for CD34 and bcl-2. A cytogenetic analysis reveals deletion involving 13q14.3 region. We describe the first reported case to date located in the infraclavicular region...
January 2018: Revista Española de Patología
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