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https://www.readbyqxmd.com/read/29334556/decoding-grade-b-pancreatic-fistula-a-clinical-and-economical-analysis-and-subclassification-proposal
#1
Laura Maggino, Giuseppe Malleo, Claudio Bassi, Valentina Allegrini, Matthew T McMillan, Alex Borin, Bofeng Chen, Jeffrey A Drebin, Brett L Ecker, Douglas L Fraker, Major K Lee, Salvatore Paiella, Robert E Roses, Roberto Salvia, Charles M Vollmer
OBJECTIVE: The aim of this study was to describe characteristics and management approaches for grade B pancreatic fistula (B-POPF) and investigate whether it segregates into distinct subclasses. BACKGROUND: The 2016 ISGPS refined definition of B-POPF is predicated on various postoperative management approaches, ranging from prolonged drainage to interventional procedures, but the spectrum of clinical severity within this entity is yet undefined. METHODS: Pancreatectomies performed at 2 institutions from 2007 to 2016 were reviewed to identify B-POPFs and their treatment strategies...
January 12, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29334508/practical-valvular-issues-in-patients-requiring-ventricular-assist-devices
#2
Mitesh Badiwala, Terrence Yau
PURPOSE OF REVIEW: As ventricular assist device (VAD) therapy in patients with advanced heart failure continues to grow, experience with concomitant valvular diseases present either before or after VAD implantation continues to accrue. In this review, we discuss recent data and current practice as it pertains to the subject of concomitant valvular disease in patients requiring VADs. RECENT FINDINGS: Persistent aortic valve closure has been identified as a potential contributor to aortic valve 'disuse atrophy' resulting in valve degeneration...
January 13, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29333531/patient-reported-outcome-measures-prom-as-a-preoperative-assessment-tool
#3
Sunghye Kim, Pamela W Duncan, Leanne Groban, Hannah Segal, Rica Moonyeen Abbott, Jeff D Williamson
Aim of review: Patient-reported outcomes (PRO) on functional, social, and behavioral factors might be important preoperative predictors of postoperative outcomes. We conducted a literature review to explore associations of preoperative depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, and nutritional status with surgical outcomes. Methods: Two electronic data bases, including PubMed and Google Scholar, were searched linking either depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, or nutritional status with surgery, postoperative complications, or perioperative period within the past 2 decades...
November 28, 2017: Journal of Anesthesia and Perioperative Medicine
https://www.readbyqxmd.com/read/29333425/outcomes-of-selective-surgery-in-patients-with-suspected-small-bowel-injury-from-blunt-trauma
#4
Hyoung-Chul Park, Jong Whan Kim, Min Jeong Kim, Bong Hwa Lee
Purpose: The role of initial conservative therapy with selective surgery for patients with suspected blunt bowel injury by radiologic evaluation is less clear. The aim of the study is to assess the outcomes of patients who received initial conservative therapy with selective delayed surgery, compared to emergency surgery. Methods: During this 8-year study, a total of 77 patients who were hemodynamically stable were enrolled, in which computed tomography verified suspected bowel injury from blunt trauma (mesenteric hematoma, mesenteric fat infiltration, bowel wall thickening, and free fluid without solid organ injury) was managed with either initial conservative therapy with selective delayed surgery (group A; n = 42) or emergency surgery (group B; n = 35)...
January 2018: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29333371/use-of-repeat-anterior-maxillary-distraction-to-correct-residual-midface-hypoplasia-in-cleft-patients
#5
Sunil Richardson, Shreya Krishna, Avi Bansal
Objectives: The study was designed to evaluate the efficacy of performing a second, repeat anterior maxillary distraction (AMD) to treat residual cleft maxillary hypoplasia. Materials and Methods: Five patients between the ages of 12 to 15 years with a history of AMD and with residual cleft maxillary hypoplasia were included in the study. Inclusion was irrespective of gender, type of cleft lip and palate, and the amount of advancement needed. Repeat AMD was executed in these patients 4 to 5 years after the primary AMD procedure to correct the cleft maxillary hypoplasia that had developed since the initial procedure...
December 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/29332206/oncological-outcomes-after-cytoreductive-nephrectomy-for-patients-with-metastatic-renal-cell-carcinoma-with-inferior-vena-caval-tumor-thrombus
#6
Hideaki Miyake, Takayuki Sugiyama, Ryota Aki, Yuto Matsushita, Keita Tamura, Daisuke Motoyama, Toshiki Ito, Atsushi Otsuka
BACKGROUND: To evaluate the oncological outcomes of patients with metastatic renal cell carcinoma (mRCC) involving the inferior vena cava (IVC) who received cytoreductive nephrectomy. METHODS: This study included 75 consecutive metastatis renal cell carcinoma (mRCC) patients with inferior vena cava (IVC) tumor thrombus undergoing cytoreductive nephrectomy and tumor thrombectomy followed by systemic therapy. RESULTS: Of the 75 patients, 11, 33, 24 and 7 had level I, II, III and IV IVC thrombus, respectively...
January 13, 2018: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29332084/thalamic-deep-brain-stimulation
#7
Benjamin B Whiting, Alexander C Whiting, Donald M Whiting
The use of deep brain stimulation (DBS) of the thalamus has been proven to be a safe and efficacious treatment for the management of many diseases. The most common indication for thalamic DBS remains essential tremor (ET), one of the most common movement disorders in the world. ET patients should be considered for surgical intervention when their tremor has demonstrated to be refractory to medication, a characteristic estimated to be present in roughly 50% of ET cases. Advantages of DBS over thalamotomy include its reversibility, the ability to adjust stimulation settings to optimize efficacy and minimize side effects, the ability to perform bilateral procedures safely, and an association with a lower risk of postoperative cognitive problems...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29331260/multifaceted-behavior-of-meckel-s-diverticulum-in-children
#8
Qingjiang Chen, Zhigang Gao, Lifeng Zhang, Yuebin Zhang, Tao Pan, Duote Cai, Qixing Xiong, Qiang Shu, Yunzhong Qian
PURPOSE/BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital malformations of gastrointestinal tract in children. However, the nonspecific clinical manifestations of MD often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. This study aimed to review our experience in managing this disease while evaluating the management strategies. METHODS: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our center between January 2010 and December 2015...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29330979/early-versus-delayed-laparoscopic-cholecystectomy-for-acute-cholecystitis
#9
Sadaf Khalid, Zahid Iqbal, Afsar Ali Bhatti
BACKGROUND: Laparoscopic cholecystectomy is considered the gold standard for the management of acute cholecystitis but controversy surrounds the timings of the surgery. Studies are available favouring both early and delayed laparoscopic cholecystectomy. The objective of this study was to compare early versus delayed laparoscopic cholecystectomy for acute cholecystitis. METHODS: This quasi-experimental study included 180 patients irrespective of their age and sex presented at department of Surgery, Lahore General Hospital between January to December 2014 with a diagnosis of acute cholecystitis were assigned randomly to early laparoscopic cholecystectomy within 24 h of admission or to initial conservative treatment followed by delayed laparoscopic cholecystectomy, 6-12 weeks later...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#10
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29330268/pelvic-and-buttock-hypoplasia-reconstructed-with-anatomical-breast-implants
#11
Felicity Page, Ayad Harb, Garth Titley
Radiation therapy is used in the management of a number of childhood cancers and can have significant effects on skeletal growth. We present the case of a 35-year-old woman who developed a hypoplastic pelvis and buttocks following radiotherapy for rhabdomyosarcoma of the vagina at the age of 2. At the age of 25, the patient underwent bilateral buttock augmentation with a two-stage reconstruction using tissue expansion followed by definitive augmentation with anatomical breast implant insertion. The patient continues to have a satisfactory outcome 10 years following reconstruction, having undergone a single uplift procedure and exchange of implants through the original incision 9 years postoperatively...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29330267/case-of-acute-severe-postpartum-urinary-incontinence-an-extravesical-subsphincteric-prolapsed-ureterocoele
#12
Jai H Seth, Roger Walker
A 32-year-old woman presents to outpatients 10 days postpartum, with symptoms of an intermittent vaginal lump and urinary incontinence. Vaginal examination revealed no demonstrable prolapse or stress incontinence. A swelling in the bladder was noted during an antenatal scan suggesting a ureterocoele. She was referred for pelvic floor physiotherapy in the first instance. Forty-eight hours later, she represented to casualty with discomforting vaginal lump symptoms and continuous urinary incontinence. At this stage on vaginal inspection, there was an evident dusky lump emerging from the urethra with continuous incontinence...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29329881/defining-and-mitigating-the-challenges-of-an-older-and-obese-population-in-minimally-invasive-gynecologic-cancer-surgery
#13
Andrea R Hagemann, Carolyn K McCourt, Swarup S Varaday, Kathleen N Moore
The incidence of endometrial cancer (EC) is steadily increasing due in large part to an aging world population and rise in rates of obesity. Patients with obesity and advancing age can be seen as vulnerable populations, as they are both often subject to physician bias regarding surgical choices and assumptions regarding long-term outcomes. As we operate on an older and/or obese patient population, it is increasingly important that we adopt peri-operative management strategies and surgical techniques to best serve this complex patient population...
January 9, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29329768/management-of-pediatric-ovarian-torsion-evidence-of-follicular-development-after-ovarian-preservation
#14
Sarah K Walker, Dave R Lal, Kevin P Boyd, Thomas T Sato
PURPOSE: This study reviews contemporary management and follow-up of pediatric ovarian torsion. METHODS: This is a retrospective series of patients from birth to 19 years undergoing operative management of ovarian torsion from 2012 to 2016. RESULTS: We studied 43 girls who underwent 51 operations for ovarian torsion. The median age was 8.3 years. Ultrasound was utilized for diagnosis in 24/29 patients (83%) evaluated in a children's hospital...
January 9, 2018: Surgery
https://www.readbyqxmd.com/read/29329444/prevention-of-ivr-a-need-for-investigation
#15
Idir Ouzaid, Evanguelos Xylinas
Intravesical recurrence (IVR) after RNU for UTUC is a frequent event, occurring in 20-50% of patients, mostly in the first postoperative year. Several retrospective studies have shown that predictors of IVR include clinical characteristics, surgical features and as well pathological characteristics (previous history of bladder cancer, pathological stage, lymph node involvement, cis, endoscopic distal ureter, etc.) management. Two prospective studies provide level I evidence for the safety and efficacy of intravesical single postoperative chemotherapy for patients treated with radical nephroureterectomy (RNU) for UTUC in order to prevent IVR...
January 10, 2018: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29329172/clinical-features-and-outcomes-of-post-traumatic-silent-sinus-syndrome
#16
Edward J Wladis, Robert C Kersten, M Reza Vagefi, Carlos Pinheiro-Neto, Roman Shinder, H Jane Kim
PURPOSE: To identify demographic features and clinical outcomes associated with post-traumatic silent sinus syndrome. METHODS: A retrospective review was carried out at 3 academic medical centers to identify all cases of post-traumatic silent sinus syndrome. Clinical features and management strategies were recorded. Postoperative outcomes were assessed, and statistical analyses were performed via a dedicated computerized software package. RESULTS: Twenty cases were identified (14 men and 6 women, mean age = 44...
January 10, 2018: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29328846/a-review-of-nausea-and-vomiting-in-the-anaesthetic-and-post-anaesthetic-environment
#17
Claire Matthews
Postoperative nausea and vomiting (PONV) has long been known as a complication of anaesthesia and surgery. This paper focuses on the assessment of the risk factors related to PONV along with the strategies and interventions which can be put in place to manage the condition. The pharmacological and multi-modal treatment methods of managing the risk factors that contribute to PONV are discussed.
October 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328032/-tactics-of-choosing-cognitive-dysfunction-therapy-in-the-postoperative-period
#18
S Dubivska, O Kudinova, Yu Grigorov, N Bitchuk
The aim of the study is to formulate the tactics of assigning adequate neuroprotective therapy to patients with postoperative cognitive dysfunctions on the basis of subtracting the indicator of the total cognitive deficiency. To achieve this goal, we conducted a study of cognitive function in patients of different age groups: young age, middle age, elderly age with acute surgical pathology before surgery and at 1, 7, 30 days after surgery compared with preoperative data. Methods of research. The study of the cognitive sphere: scale MMSE, test drawing hours, test "10 words", battery tests for frontal dysfunction, method Schulte...
December 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29327961/tracheal-resection-in-a-secretary-bird-sagittarius-serpentarius-with-granulomatous-foreign-body-induced-tracheitis
#19
Carsten Ludwig, Imke Lueders, Volker Schmidt, Hermann Kempf
A 24-year-old female secretary bird ( Sagittarius serpentarius) was presented with acute, mild dyspnea occurring only during feeding times. Despite initial conservative therapy consisting of antibiotics and antifungal, antiparasitic, and anti-inflammatory drugs, the dyspnea worsened progressively, resulting in severe respiratory distress. Radiographs of the trachea suggested stenosis in the caudal one-third of the trachea. Tracheal endoscopy revealed an obstruction of approximately 90% of the tracheal lumen, in addition to mild suspected aspergillosis of the air sacs...
December 2017: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/29327736/balloon-dilation-of-the-eustachian-tube-clinical-experience-in-the-management-of-126-children
#20
M Tisch, H Maier, H Sudhoff
Balloon dilation of the Eustachian tube has been recently introduced as a novel and minimally invasive method for treating chronic obstructive Eustachian tube dysfunction. For the first time worldwide, we assessed the role of this technique in the treatment of children with Eustachian tube dysfunction who did not respond to other treatments. We retrospectively analysed the medical records of 60 children (mean age: 6.3 years, range: 28 months to 12 years) who underwent balloon dilation of the Eustachian tube using the Bielefeld balloon catheter...
December 2017: Acta Otorhinolaryngologica Italica
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