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https://www.readbyqxmd.com/read/29151054/effect-of-ephedrine-and-phenylephrine-on-brain-oxygenation-and-microcirculation-in-anaesthetised-patients-with-cerebral-tumours-study-protocol-for-a-randomised-controlled-trial
#1
Klaus Ulrik Koch, Anna Tietze, Joel Aanerud, Gorm von Öettingen, Niels Juul, Jens Christian Hedemann Sørensen, Lone Nikolajsen, Leif Østergaard, Mads Rasmussen
INTRODUCTION: During brain tumour surgery, vasopressor drugs are commonly administered to increase mean arterial blood pressure with the aim of maintaining sufficient cerebral perfusion pressure. Studies of the commonly used vasopressors show that brain oxygen saturation is reduced after phenylephrine administration, but unaltered by ephedrine administration. These findings may be explained by different effects of phenylephrine and ephedrine on the cerebral microcirculation, in particular the capillary transit-time heterogeneity, which determines oxygen extraction efficacy...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#2
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29150394/efficacy-of-prostatic-artery-embolization-for-catheter-dependent-patients-with-large-prostate-sizes-and-high-comorbidity-scores
#3
Shivank Bhatia, Vishal K Sinha, Bruce R Kava, Christopher Gomez, Sardis Harward, Sanoj Punnen, Issam Kably, Jeffrey Miller, Dipen J Parekh
PURPOSE: To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter-dependent patients with large prostate volumes and high comorbidity scores. MATERIALS AND METHODS: A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48-94 y), age-adjusted Charlson comorbidity index was 4.5 (0-10), duration of urinary retention was 63...
November 15, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29149707/over-expression-of-cyclooxygenase-2-in-increased-reticulated-platelets-leads-to-aspirin-resistance-after-elective-off-pump-coronary-artery-bypass-surgery
#4
Xiaoxuan Gong, Xuezhong Wang, Zhuowen Xu, Tiantian Zhu, Qiu Zhang, Jinying Zhang, Xiaowei Wang, Chunjian Li
INTRODUCTION: Aspirin resistance (AR) has been reported to present after coronary artery bypass graft causing saphenous vein graft failure. We aimed to investigate the factors that affect the anti-platelet effect of aspirin after off-pump coronary artery bypass surgery (OPCAB). MATERIALS AND METHODS: Thirty OPCAB candidates were successively recruited. Platelet count, platelet aggregation, reticulated platelet (RP), platelets' cyclooxygenase (COX)-1 and COX-2 expressions were determined during the peri-operative period...
November 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29148356/specialization-as-an-organizing-principle-the-case-of-ambulatory-surgery-centers
#5
Kathleen Carey, Jean M Mitchell
Ambulatory surgery centers (ASCs) recently have grown to become the dominant provider of specific surgical procedures in the United States. While the majority of ASCs focus primarily on a single specialty, many have diversified to offer a wide range of surgical specialties. We exploited a unique data set from Pennsylvania for the years 2004 to 2014 to conduct an empirical investigation of the relative cost of production in ASCs over varying degrees of specialization. We found that for the majority of ASCs, focus on a specialty was associated with lower facility costs...
August 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29147744/consistency-in-patient-reported-outcome-measures-after-total-knee-arthroplasty-using-patient-specific-instrumentation-a-5-year-follow-up-of-200-consecutive-cases
#6
Daphne A L Schoenmakers, Martijn G M Schotanus, Bert Boonen, Nanne P Kort
PURPOSE: The purpose of this study was to evaluate the 5-year follow-up results of the first 200 total knee arthroplasties (TKA) performed by one high-volume surgeon, using patient-specific information (PSI). To date, there has been no other research into the mid-term follow-up of TKA performed using PSI. MATERIALS AND METHODS: A total of 184 consecutive patients (200 TKA) were evaluated. Outcome measures included implant survival rate, adverse events, and the following patient-reported outcome measures (PROMs); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), Pain Visual Analogue Score (VAS) and EuroQol-5D Score (EQ-5D)...
November 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29147169/uncomplicated-acute-type-b-aortic-dissection-selection-guidelines-for-tevar
#7
Emilia Krol, Jean M Panneton
Traditionally, the surgical management of acute type B aortic dissections was reserved for patients with signs of malperfusion, rapid expansion, retrograde dissection or rupture. The adjunct of endovascular techniques has brought a paradigm shift, leaning towards preventing long term dissection complications. Multiple risk factors have been proposed to identify patients at risk for long term aortic complications. The patients, who are offered a prophylactic endovascular therapy for uncomplicated aortic dissection, should be selected carefully, and offered intervention by an experienced team in a high-volume center...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147136/step-by-step-strategy-in-the-management-of-residual-hepatolithiasis-using-post-operative-cholangioscopy
#8
REVIEW
Xu-Dong Wen, Tao Wang, Zhu Huang, Hong-Jian Zhang, Bing-Yin Zhang, Li-Jun Tang, Wei-Hui Liu
Hepatolithiasis is the presence of calculi within the intrahepatic bile duct specifically located proximal to the confluence of the left and right hepatic ducts. The ultimate goal of hepatolithiasis treatment is the complete removal of the stone, the correction of the associated strictures and the prevention of recurrent cholangitis. Although hepatectomy could effectively achieve the above goals, it can be restricted by the risk of insufficient residual liver volume, and has a 15.6% rate of residual hepatolithiasis...
November 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29146958/third-repeat-microvascular-reconstruction-in-head-and-neck-cancer-patients-aged-65-years-and-older-a-longitudinal-and-sequential-analysis
#9
Jonas Löfstrand, Kai-Ping Chang, Jennifer An-Jou Lin, Charles Yuen Yung Loh, Hsuan-Yu Chou, Huang-Kai Kao
Performing a sequential third free flap for reconstruction of a head and neck defect after cancer resection can be challenging, and the problem is further compounded in elderly patients. The outcomes in this clinical scenario are currently unknown and this study aims to compare the results in elderly patients with younger patients in a high-volume microsurgical unit. A retrospective review of 126 consecutive patients who had undergone three sequential free flap reconstructions after head and neck cancer was performed...
November 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29146758/non-aesthetic-indications-for-periocular-hyaluronic-acid-filler-treatment-a-review
#10
REVIEW
Petrina Tan, Tsong Qiang Kwong, Raman Malhotra
Dermal fillers have been in use for many years for aesthetic rejuvenation of the face. More recently, however, fillers have been increasingly used as an alternative to traditional surgical procedures for non-aesthetic indications. These indications include lagophthalmos, eyelid malpositions and orbital volume deficiency. The advantages of these filler injections are multiple: minimally invasive, repeatable, titratable and even reversible (depending on the product used). We review the current literature of functional uses of filler injections as mentioned above and evaluate the safety profile and efficacy of filler injections for this purpose...
November 16, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29146166/hip-dysplasia-prevalence-associated-findings-and-procedures-from-large-multicenter-arthroscopy-study-group
#11
Dean K Matsuda, Andrew B Wolff, Shane J Nho, John P Salvo, John J Christoforetti, Benjamin R Kivlan, Thomas J Ellis, Dominic S Carreira
PURPOSE: To report observational findings of patients with acetabular dysplasia undergoing hip arthroscopy. METHODS: We performed a comparative case series of multicenter registry patients from January 2014 to April 2016 meeting the inclusion criteria of isolated hip arthroscopy, a documented lateral center-edge angle (LCEA), and completion of preoperative patient-reported outcome measures. A retrospective analysis compared range of motion, intra-articular pathology, and procedures of patients with dysplasia (LCEA ≤25°) and patients without dysplasia (LCEA >25°)...
November 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29145993/an-absorbable-hydrogel-spray-reduces-postoperative-mediastinal-adhesions-after-congenital-heart-surgery
#12
Nahidh Hasaniya, Anees Razzouk, Jennifer Newcombe, Dana Hassneiah, Jessica Heimes, Joshua Gysbers, Timothy Martens, Leonard Bailey
BACKGROUND: Adhesions encountered during reoperative cardiac surgery can prolong operative time and increase operative risk. The purpose of this clinical study was to investigate the antiadhesion property of a synthetic bioabsorbable polymer spray after cardiac reoperations in infants. METHODS: A prospective randomized double-blinded study was designed. Forty infants requiring staged cardiac operations were randomly allocated to a study group (n = 20) or a control group (n = 20)...
November 14, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29145421/radiographic-prediction-of-meningioma-grade-by-semantic-and-radiomic-features
#13
Thibaud P Coroller, Wenya Linda Bi, Elizabeth Huynh, Malak Abedalthagafi, Ayal A Aizer, Noah F Greenwald, Chintan Parmar, Vivek Narayan, Winona W Wu, Samuel Miranda de Moura, Saksham Gupta, Rameen Beroukhim, Patrick Y Wen, Ossama Al-Mefty, Ian F Dunn, Sandro Santagata, Brian M Alexander, Raymond Y Huang, Hugo J W L Aerts
OBJECTIVES: The clinical management of meningioma is guided by tumor grade and biological behavior. Currently, the assessment of tumor grade follows surgical resection and histopathologic review. Reliable techniques for pre-operative determination of tumor grade may enhance clinical decision-making. METHODS: A total of 175 meningioma patients (103 low-grade and 72 high-grade) with pre-operative contrast-enhanced T1-MRI were included. Fifteen radiomic (quantitative) and 10 semantic (qualitative) features were applied to quantify the imaging phenotype...
2017: PloS One
https://www.readbyqxmd.com/read/29145010/the-use-of-hardened-bone-cement-as-an-impaction-grafting-extender-for-revision-hip-arthroplasty
#14
Mark Ruddy, David P FitzPatrick, Kenneth T Stanton
Impaction bone grafting is a method of restoring bone stock to patients who have suffered significant bone loss due to revision total hip surgery. The procedure requires morsellised cancellous bone (MCB) to be impacted into the site of bone loss in order to stabilise the prosthesis with the aim of long term resorption and reintegration of the impacted bone graft. Due to financial cost and the potential to transmit disease, the use of supplementary material, known as an extender, is frequently used to increase the graft material volume...
November 13, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29143993/how-to-measure-size-of-tubal-ectopic-pregnancy-on-ultrasound-scan
#15
K Rajah, V Goodhart, K P Zamora, T Amin, E Jauniaux, D Jurkovic
OBJECTIVE: To identify the preoperative ultrasound measurements for assessing the size of tubal ectopic pregnancy which correlate best with the findings at surgery. METHODS: We conducted a prospective study of all women with a conclusive transvaginal ultrasound diagnosis of tubal ectopic pregnancy over a 10-month period. In each case, we measured the total size of the ectopic pregnancy by placing the calipers on the outer edges of the visible trophoblastic tissue...
November 16, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29143377/long-term-outcomes-following-transatrial-versus-transventricular-repair-on-right-ventricular-function-in-tetralogy-of-fallot
#16
Massimo A Padalino, Giacomo Cavalli, Sonia B Albanese, Carlo Pace Napoleone, Alvise Guariento, Maria Teresa Cascarano, Martina Perazzolo Marra, Vladimiro Vida, Giovanna Boccuzzo, Giovanni Stellin
BACKGROUND AND AIM OF THE STUDY: Outcomes after repair of tetralogy of Fallot (TOF) are good with either a transventricular (TV) or transatrial (TA) approach. We sought to determine if there is a relationship between the TV or TA approach and right ventricular (RV) function, and the role of residual pulmonary regurgitation (PR) on the long-term outcomes. METHODS: This was a retrospective cohort multicentric study on survivors after surgical repair of TOF (TA versus TV approach, ±transannular patch) between 1990 and 2004...
November 16, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29143065/-complex-joint-reconstruction-and-joint-transplantation-with-the-flocsat-concept-planning-and-surgical-implementation
#17
REVIEW
C Krettek, J-D Clausen, C Neunaber
Cartilage defects in adult patients are so far incurable. Fresh osteochondral allograft (OCA) transplantation is based on the insertion of mature, living, mechanically sound hyaline cartilage into an osteochondral defect where it undergoes osseointegration. Intact hyaline cartilage of OCA does not cause immune reactions in the recipient. Many reports show that small OCA have good osseointegration and show good long-term results. These observations have been incorporated into the development of the fresh large (> 10 cm(2)) osteochondral shell allograft transplantation (FLOCSAT) concept, which is based on the following principles: 1) the thickness of the osseous layer should be kept as thin as possible (target < 6-8 mm) so that the transplant remains stable and fixable...
November 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29142852/thyroidectomy-in-elderly-patients-aged-%C3%A2-70-years
#18
REVIEW
Davide Inversini, Andrea Morlacchi, Giuseppinella Melita, Simona Del Ferraro, Carlo Boeri, Mattia Portinari, Antonino Cancellieri, Francesco Frattini, Antonio Giacomo Rizzo, Gianlorenzo Dionigi
Worldwide, the indications for thyroid surgery have been continuously extended among elderly patients in the last 20 years. The balance between treatment indication and surgical risk is certainly an interesting topic for every thyroid surgeon. This paper is a review of recent literature from January 2005 up to April 2017. We analyzed three principal subjects: indications for surgical treatment, medical complications and surgical complications. We can summarize the conclusions of our analysis, stating that age could not be considered as an absolute factor, but in relation to the comorbidities and the general clinical condition of the patient...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142837/preoperative-management-in-patients-with-graves-disease
#19
REVIEW
Eliana Piantanida
Graves' disease is the most frequent cause of hyperthyroidism in iodine-sufficient geographical areas and is characterized by the presence in patients' serum of autoantibodies directed against the thyrotropin receptor (TRAb) that cause overproduction and release of thyroid hormones. Clinical presentation results from both hyperthyroidism and underlying autoimmunity. The diagnosis is based on characteristic clinical features and biochemical abnormalities. If serum thyrotropin (TSH) is low, serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations should be measured to distinguish between subclinical (with normal circulating thyroid hormones) and overt hyperthyroidism (with increased circulating thyroid hormones)...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142747/clinical-characteristics-of-critically-ill-cancer-patients-who-are-undergoing-isolated-limb-perfusion
#20
Silvio A Ñamendys-Silva, Arturo M Ruiz-Beltran, Mireya Barragán-Dessavre, Andoreni R Bautista-Ocampo, Abelardo Meneses-García, Octavio González-Chon, Angel Herrera-Gómez
The aim of the present study was to investigate the incidence of organ dysfunction, and to describe the clinical characteristics and intensive care unit (ICU) outcomes of critically ill cancer patients who were admitted to an oncological ICU during the isolated limb perfusion post-operative period. The present study was an observational investigation of 42 critically ill cancer patients who were admitted to the ICU of the Instituto Nacional de Cancerología, during the isolated limb perfusion post-operative period, between July 2010 and February 2016...
November 2017: Molecular and Clinical Oncology
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