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Postoperative managment

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https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#1
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319514/do-not-resuscitate-status-is-associated-with-increased-mortality-but-not-morbidity
#2
Elisa C Walsh, Ethan Y Brovman, Angela M Bader, Richard D Urman
BACKGROUND: Do-not-resuscitate (DNR) orders instruct medical personnel to forego cardiopulmonary resuscitation in the event of cardiopulmonary arrest, but they do not preclude surgical management. Several studies have reported that DNR status is an independent predictor of 30-day mortality; however, the etiology of increased mortality remains unclear. We hypothesized that DNR patients would demonstrate increased postoperative mortality, but not morbidity, relative to non-DNR patients undergoing the same procedures...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319508/exercise-combined-with-ultrasound-attenuates-neuropathic-pain-in-rats-associated-with-downregulation-of-il-6-and-tnf-%C3%AE-but-with-upregulation-of-il-10
#3
Po-Ching Huang, Kun-Ling Tsai, Yu-Wen Chen, Heng-Teng Lin, Ching-Hsia Hung
BACKGROUND: Although there are several evidences that suggest efficacies of therapeutic ultrasound (TU) or treadmill exercise (TE) to alleviate nerve injury-associated pain, molecular mechanisms are less clear. We aimed to investigate the impact of TU and/or TE on neuropathic pain induced by chronic constriction injury (CCI) of the sciatic nerve and their roles of proinflammatory and anti-inflammatory cytokines. METHODS: Rats were randomly divided into (n = 10 per group) sham operation (sham), CCI procedure followed by false application of TU (CCI + TU0), CCI procedure followed by false application of TU and TE (CCI + TU0 + TE), CCI, and CCI procedure followed by TU alone (CCI + TU), TE alone (CCI + TE), or both TU and TE (CCI + TU + TE) groups...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319025/is-robot-assisted-laparoscopic-bilateral-extravesical-ureteral-reimplantation-associated-with-greater-morbidity-than-unilateral-surgery-a-comparative-analysis
#4
Arun K Srinivasan, Daniel Maass, Dhiren Shrivastava, Christopher J Long, Aseem R Shukla
INTRODUCTION: Voiding dysfunction after bilateral extravesical ureteral reimplantation for vesicoureteral reflux has long remained a concern. Robotic approach with improved visualization that enables focused and minimal dissection may help with this concern. OBJECTIVES: To compare postoperative outcomes after bilateral robot-assisted laparoscopic ureteral reimplantation to unilateral robot-assisted laparoscopic ureteral reimplantation. STUDY DESIGN: This was a retrospective study using data abstracted from an institutional review board-approved registry prospectively maintained at our institution since 2012...
March 6, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28318860/a-prospective-randomized-trial-comparing-liposomal-bupivacaine-vs-fascia-iliaca-compartment-block-for-postoperative-pain-control-in-total-hip-arthroplasty
#5
Molly A McGraw-Tatum, Michael T Groover, Nicole E George, John S Urse, Victor Heh
BACKGROUND: Increasing demand for total hip arthroplasty (THA) in a climate of increasing focus on clinical outcomes, patient satisfaction, and cost has created a need for better acute postoperative pain control for patients. An ideal pain control method would have few side effects, decreased opioid consumption, improved pain control, early ambulation, and decreased hospital length of stay (LOS). METHODS: We performed a prospective randomized, controlled study involving 79 patients undergoing elective THA between June 2015 and February 2016...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28317802/port-site-infections-by-nontuberculous-mycobacterium-a-retrospective-clinico-microbiological-study
#6
Roumi Ghosh, Soumen Das, Asmita De, Harish Kela, Makhan Lal Saha, Prasanta Kumar Maiti
BACKGROUND: Port-site infection (PSI) is a prevailing, chronic, nagging, treatment refractory complication of laparoscopic surgery (LS). It neutralizes the advantages of minimally invasive surgery and increases morbidity, treatment cost of patient, leading to loss of confidence on operating surgeon. PSIs are preventable with appropriate preoperative, intraoperative, and postoperative measures. Atypical mycobacterium is most commonly associated with nonhealing postlaparoscopic wound infections, causing outbreaks or sporadic cases worldwide...
January 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28317528/surgical-therapies-for-vitiligo
#7
REVIEW
Tasneem F Mohammad, Iltefat H Hamzavi
Surgical management is a safe and effective treatment modality for select patients with vitiligo. Many techniques of vitiligo surgery exist, each with unique advantages and disadvantages. Preoperative screening for appropriate candidates, selection of surgical technique, and postoperative management are all key elements in enabling patients to achieve maximal repigmentation.
April 2017: Dermatologic Clinics
https://www.readbyqxmd.com/read/28317357/-study-on-postoperative-infusion-management-of-cleft-patients
#8
Chen Lixian, Gong Caixia, Wu Yuhong, Yang Luping, Zheng Qian, Shi Bing
OBJECTIVE: The study aims to investigate the correlation between total input for a period of 24 h and the daily physiological requirements to develop practical guidelines for postoperative infusion management of cleft patients. METHODS: Sixty-three cleft lip and palate patients under three years old who underwent surgery were included in the study. The amount of liquid taken orally as well as intravenous input were recorded for a period of 24 h and compared with the daily physiological requirements...
August 1, 2016: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
https://www.readbyqxmd.com/read/28317045/fibrolamellar-variant-of-hepatocellular-carcinoma-presenting-during-pregnancy-management-dilemmas
#9
Nagalapuram Vishnu, Aditya V Kulkarni, Sreenivasan Vidhyalakshmi, Swaminathan Sambandam, Prerna Garg, Venkatakrishnan LeelaKrishnan, Krishnaveni Janarthan, Gursharan Singh, Maninder Kaur, T V Chitra, Biku Joseph John
The Fibrolamellar variant of Hepatocellular Carcinoma (FLHCC) is a rare form of liver cancer that presents in the 3(rd) decade of life, is rarely associated with cirrhosis or chronic Hepatitis B/C virus infection, and usually presents with normal serum alpha-fetoprotein (AFP) levels. FLHCC presenting during pregnancy is extremely rare, with only 4 cases reported. We present a case of FLHCC in pregnancy and discuss the dilemmas in management. A 26 year-old primigravida, 26 weeks of gestation presented with a month's history of obstructive jaundice secondary...
February 2017: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28316223/-biweekly-paclitaxel-and-platinum-chemotherapy-followed-by-surgery-for-esophageal-squamous-cell-carcinoma
#10
L Z Zhang, W W Li, C X Cui, H T Zhang, Y Song, Y S Mao, J Huang
Objective: To evaluate the feasibility and efficacy of biweekly paclitaxel and platinum chemotherapy followed by surgery for esophageal squamous cell carcinoma. Methods: We retrospectively analyzed the clinicopathological data of 20 patients with esophageal squamous cell carcinoma treated in our hospital between January 2012 and March 2016. All patients received biweekly paclitaxel and platinum chemotherapy followed by surgery. Results: 20 cases received preoperative chemotherapy for 3-8 cycles with an average of 4 cycles...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28315968/the-efficacy-of-bipolar-sealer-on-blood-loss-in-spine-surgery-a-meta-analysis
#11
REVIEW
Tao Lan, Shi-Yu Hu, Xin-Jian Yang, Yang Chen, Yi-Yan Qiu, Wei-Zhuang Guo, Jian-Ze Lin, Kai Ren
OBJECTIVE: The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to gather data to evaluate the efficacy and safety of bipolar sealer versus standard electrocautery in the management of spinal disease. METHODS: The electronic databases including Embase, PubMed and Cochrane library were searched to identify relevant studies published from the time of the establishment of these databases up to January 2017. The primary outcomes were total blood loss, requirement of transfusion (rate and amount), and operation time...
March 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28315817/a-figure-eight-suture-loop-with-kirschner-wires-for-fixation-of-anteromedial-coronoid-process-fractures-a-case-series
#12
Longxiang Shen, Xingang Yu, Biao Zhong, Jian Ding
PURPOSE: Sufficient fixation of an anterior or anteromedial facet fracture of the coronoid process in fracture-dislocation of elbow is important to maintain joint stability. The purpose of this study was to report our experience with 11 patients who were managed with an original fixation technique using a "figure-eight" suture loop. METHODS: From February 2010 to March 2011, 11 cases with a fracture of the anterior or anteromedial facet of the coronoid process were treated by coronoid fixation using a figure-eight suture loop...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28315737/botulinum-toxin-as-an-adjunct-to-monocular-recession-resect%C3%A4-on-surgery-for-large-angle-sensory-strabismus
#13
Betül Tuğcu, Eda Sönmezay, Fadime Nuhoğlu, Hakan Özdemir, Seyhan Bahar Özkan
PURPOSE: To evaluate the result of using intraoperative botulinum toxin A (BTA) as an adjunct to monocular recession-resection surgery in the management of large-angle sensory strabismus. METHODS: The medical records of patients diagnosed with sensory strabismus with constant large-angle strabismus were reviewed retrospectively to identify those who underwent monocular recession-resection surgery combined with 5 units of BTA injection into the recessed muscle of the nonfixating eye...
March 15, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28315515/tailored-corneo-conjunctival-autografting-in-primary-and-secondary-pterygium-surgery
#14
Mahmoud M Genidy, Ahmed A Abdelghany, Jorge L Alio
PURPOSE: To describe the outcomes of a novel technique for pterygium removal: tailored corneo-conjunctival autograft, which offers the advantages of better postoperative cosmetic outcomes and recurrence prevention. METHODS: This retrospective interventional noncomparative study included 420 eyes in 370 patients (ages 25-60 years) (127 women, 243 men). We divided the patients into 2 groups. The first group included 348 primary pterygium; the second group included 72 recurrent pterygium...
February 28, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28315411/extrauterine-choriocarcinoma-in-the-fallopian-tube-following-infertility-treatment-implications-for-the-management-of-early-detected-ectopic-pregnancies
#15
Seung Chik Jwa, Shigeru Kamiyama, Hisako Takayama, Yoshimitsu Tokunaga, Tetsuro Sakumoto, Masahiro Higashi
Extrauterine choriocarcinoma in the fallopian tube is highly rare and is often diagnosed and treated as an ectopic tubal pregnancy. A 34-year old woman who initially became pregnant after infertility treatment using ovulation induction with clomiphene citrate and intrauterine insemination was later diagnosed as having an extrauterine choriocarcinoma in the left fallopian tube. Because of a suspicion of left ectopic tubal pregnancy by ultrasonographic findings and high levels of beta human chorionic gonadotropin (β-hCG; 7054...
March 14, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28314555/the-effects-of-intra-articular-levobupivacain-versus-levobupivacain-plus-magnesium-sulfate-on-postoperative-analgesia-in-patients-undergoing-arthroscopic-meniscectomy-a-prospective-randomized-controlled-study
#16
Nurcan Kizilcik, Turhan Özler, Ferdi Menda, Çağatay Uluçay, Özge Köner, Faik Altintaş
OBJECTIVE: The aim of this study was to compared the effectiveness of intraarticular levobupivacain with levobupivacain and magnesium sulfate. METHODS: In this prospective randomized double blinded study, 96 patients (67 male, 29 female; age range: 18-65 years) with ASA (American Society of Anesthesiologist) score I and II, who had undergone arthroscopic meniscectomy operation, were divided to 3 groups that had postoperative analgesia with intra-articular saline injection (control group), levobupivacain injection (L group) or levobupivacain and magnesium sulfate injection (LM group)...
March 14, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28314316/non-whipple-operations-in-the-management-of-benign-premalignant-and-early-cancerous-duodenal-lesions
#17
Alexandros Papalampros, Demetrios Moris, Athanasios Petrou, Nikolaos Dimitrokallis, Ioannis Karavokyros, Dimitrios Schizas, Ioanna Delladetsima, Theodore N Pappas, Evangelos Felekouras
AIM: We reviewed our 20-year experience with non-Whipple operations (pancreas-preserving duodenectomy and transduodenal ampullectomy) for the treatment of benign, premalignant or early-stage malignant duodenal lesions. PATIENTS AND METHODS: Twenty-four patients who underwent non-Whipple operations between January 1996 and December 2015 were identified from an institutional database and retrospectively analyzed. RESULTS: Between 1996 and 2015, 10 patients underwent pancreas-preserving duodenectomy and 14 patients underwent transduodenal ampullectomy...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28306680/anaesthesia-in-patients-with-liver-disease
#18
Malgorzata H Starczewska, Wint Mon, Peter Shirley
PURPOSE OF REVIEW: The purpose of this review is to summarize the most recent up to date research data and recommendations regarding anaesthetic management of patients with liver disease undergoing surgery. The incidence of chronic liver disease (CLD) continues to rise and perioperative mortality and morbidity remains unacceptably high in this group. Meticulous preoperative assessment and carefully planned anaesthetic management are vital in improving outcomes in patients with liver disease undergoing surgery...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306578/selective-low-volume-nerve-block-for-the-open-surgical-fixation-of-a-midshaft-clavicle-fracture-in-a-conscious-high-risk-patient-a-case-report
#19
Carlos I Salvadores de Arzuaga, José M Naya Sieiro, Oscar Salmeron Zafra, Miguel A González Posada, Esther Marquez Martínez
We report a case of successful intraoperative management using only low-volume regional anesthesia for the open surgical fixation of a traumatic clavicle fracture in a conscious 69-year-old man with severe chronic obstructive pulmonary disease. To avoid general anesthesia, we provided low-volume C5 and C6 nerve root blocks along with a superficial cervical plexus block using only 9 mL of anesthetic solution to avoid the often encountered complications of higher volume injections. Throughout the procedure, the patient remained comfortable and cooperative with stable hemodynamics and respiration...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28306417/the-management-and-outcome-for-patients-with-chronic-subdural-hematoma-a-prospective-multicenter-observational-cohort-study-in-the-united-kingdom
#20
Paul M Brennan, Angelos G Kolias, Alexis J Joannides, Jonathan Shapey, Hani J Marcus, Barbara A Gregson, Patrick J Grover, Peter J Hutchinson, Ian C Coulter
OBJECTIVE Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland...
March 17, 2017: Journal of Neurosurgery
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