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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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)...
April 18, 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
#9
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...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28348896/effect-of-arm-positioning-on-entrapment-of-infraclavicular-nerve-block-catheter
#10
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
#11
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
#12
Allen G Murga, Jason Chiriano, Sharon C Kiang, Sheela Patel, Christian Bianchi, Ahmed M Abou-Zamzam, Theodore H Teruya
INTRODUCTION: The patency of long-term hemodialysis access in end-stage renal disease (ESRD) 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 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28331739/a-rare-tumor-that-mimicked-metastasis-in-a-patient-with-breast-cancer-epithelioid-hemangioendothelioma
#13
Fatmagül Kuşku Çabuk, Fatma Aktepe, Ahmet Serkan İlgün, Dauren Sarsenov, Filiz Elbüken, Vahit Özmen
A woman aged 50 years was diagnosed as having an invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast and underwent bilateral mastectomy eight years ago. A mass was identified during follow-up in positron-emission tomography (PET) image in the left infraclavicular region, indicating metastasis. Histopathologic examination showed a mass of 1.9 × 1 × 0.7 cm in dimensions characterized by spindle or round nuclei cells that formed island or cords in hyaline and myxoid ground and intracytoplasmic vacuoles containing erythrocytes...
April 2016: Journal of Breast Health (2013)
https://www.readbyqxmd.com/read/28298044/a-novel-method-of-lengthening-the-accessory-nerve-for-direct-coaptation-during-nerve-repair-and-nerve-transfer-procedures
#14
R Shane Tubbs, Andrés A Maldonado, Yolanda Stoves, Fabian N Fries, Rong Li, Marios Loukas, Rod J Oskouian, Robert J Spinner
OBJECTIVE The accessory nerve is frequently repaired or used for nerve transfer. The length of accessory nerve available is often insufficient or marginal (under tension) for allowing direct coaptation during nerve repair or nerve transfer (neurotization), necessitating an interpositional graft. An attractive maneuver would facilitate lengthening of the accessory nerve for direct coaptation. The aim of the present study was to identify an anatomical method for such lengthening. METHODS In 20 adult cadavers, the C-2 or C-3 connections to the accessory nerve were identified medial to the sternocleidomastoid (SCM) muscle and the anatomy of the accessory nerve/cervical nerve fibers within the SCM was documented...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28259825/soft-tissue-neoplasms-causing-apparent-venous-thoracic-outlet-syndrome
#15
Aleem K Mirza, Ian J Barrett, Animesh Rathore, Bassem T Elhassan, Peter S Rose, Thomas Shives, Thomas C Bower
Venous thoracic outlet syndrome (vTOS) usually results from compression of the subclavian vein classically as a result of narrowing of the costoclavicular space. We report 2 rare cases of soft tissue neoplasms resulting in apparent vTOS. The first case is a 46-year-old female with a 2-year history of intermittent unilateral shoulder pain, who was initially diagnosed with intervertebral disk herniation. Cervical fusion was performed; however, her symptoms progressed and she additionally developed paresthesias and venous congestion...
March 1, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28259569/utility-and-safety-of-axillary-conduits-during-endovascular-repair-of-thoracoabdominal-aneurysms
#16
Jordan R Stern, Sharif H Ellozy, Peter H Connolly, Andrew J Meltzer, Darren B Schneider
OBJECTIVE: Endovascular treatment of thoracoabdominal aortic aneurysms (TAAAs) with branched and fenestrated stent grafts often requires upper extremity arterial access for antegrade delivery of bridging covered stents into the visceral arteries. Axillary, brachial, and radial artery approaches have been described, but data on the safety and utility of the different approaches remain limited. We have preferentially used axillary artery conduits for upper extremity arterial access during endovascular repair of TAAA and describe our technique and report our experience herein...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28255132/extra-anatomical-veno-venous-surgical-bypass-for-central-vein-occlusion-in-patients-with-ipsilateral-arterio-venous-fistula-avf-for-haemodialysis-a-single-centre-experience
#17
K S Saravana, A A Zainal
OBJECTIVE: Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper limb, neck and face. MATERIALS AND METHODS: We report 20 consecutive patients with end-stage renal failure (ESRF) who had central vein occlusion and were not amenable to endovascular intervention...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28245733/targeted-fascicular-biopsy-of-the-brachial-plexus-rationale-and-operative-technique
#18
Pierre Laumonerie, Stepan Capek, Kimberly K Amrami, P James B Dyck, Robert J Spinner
OBJECTIVE Nerve biopsy is useful in the management of neuromuscular disorders and is commonly performed in distal, noncritical cutaneous nerves. In general, these procedures are diagnostic in only 20%-50%. In selected cases in which preoperative evaluation points toward a more localized process, targeted biopsy would likely improve diagnostic yield. The authors report their experience with targeted fascicular biopsy of the brachial plexus and provide a description of the operative technique. METHODS All cases of targeted biopsy of the brachial plexus biopsy performed between 2003 and 2015 were reviewed...
March 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28244937/metastatic-cellular-blue-nevus-a-rare-case-with-metastasis-beyond-regional-nodes
#19
Justin Bui, Nima Mesbah Ardakani, Irene Tan, Andrew Crocker, Muhammad Adnan Khattak, Benjamin A Wood
In this study, we present a rare case of a 35-year-old man with a long-standing blue-black lesion on his left hand with subsequent infraclavicular and axillary lymph node tumor deposits. The hand lesion and lymph nodes were excised revealing histological, immunohistochemical, and molecular findings consistent with cellular blue nevus. Despite nonregional lymph node involvement, there has been no progression at 12-months follow-up. This is an index case of a cellular blue nevus with metastasis to both regional and nonregional lymph nodes...
February 14, 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28224401/synchronous-bilateral-breast-cancer-irradiation-clinical-and-dosimetrical-issues-using-volumetric-modulated-arc-therapy-and-simultaneous-integrated-boost
#20
Alba Fiorentino, Rosario Mazzola, Stefania Naccarato, Niccolò Giaj-Levra, Sergio Fersino, Gianluisa Sicignano, Umberto Tebano, Francesco Ricchetti, Ruggero Ruggieri, Filippo Alongi
OBJECTIVES: The aim of the present retrospective analysis was to evaluate dosimetric parameters, feasibility and outcome for Synchronous Bilateral Breast Cancer (SBBC) patients treated with adjuvant radiotherapy (RT) by Volumetric Modulated Arc Therapy (VMAT). METHODS: From September 2011 to April 2016, 1100 Breast Cancer (BC) patients were referred to our institution to receive adjuvant breast RT, and those with SBBC were selected for the present analysis. A total of 16 patients were identified...
June 2017: La Radiologia Medica
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