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Postoperative management

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https://www.readbyqxmd.com/read/29045853/symptomatic-vasospasms-as-a-life-threatening-complication-after-transsphenoidal-surgery
#1
Katharina Osterhage, Patrick Czorlich, Till R Burkhardt, Roman Rotermund, Ulrich Grzyska, Jörg Flitsch
OBJECTIVE: To identify symptomatic vasospasms as a rare complication after pituitary surgery with emphasis on management and outcome. DESIGN AND METHODS: In a retrospective design, 1997 patient charts undergoing microscopic transsphenoidal surgery from 2008 till 2016 were retrospectively analyzed regarding postoperative vasospastic events, its' clinical management, and neurological outcome. RESULTS: Four patients (0.2%) were identified, who developed neurological deficits in the postoperative phase caused by proven vasospasms due to subarachnoid hemorrhage (SAH)...
October 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29045320/autologous-lens-capsular-flap-transplantation-combined-with-autologous-blood-application-in-the-management-of-refractory-macular-hole
#2
Jie Peng, Chunli Chen, Haiying Jin, Hongtao Zhang, Peiquan Zhao
PURPOSE: To report results of lens capsular flap transplantation (LCFT) and autologous whole blood application in refractory macular hole (MH) treatment. METHODS: Seven phakic and three aphakic eyes with persistent MH after standard surgery with internal limiting membrane peeling were studied. Lens capsule flap was acquired from the same eye in eight cases (seven phakic and one aphakic). The fellow eye was used in two aphakic eyes without sufficient lens capsule...
October 17, 2017: Retina
https://www.readbyqxmd.com/read/29044905/efficacy-and-safety-of-postoperative-pain-relief-by-parecoxib-injection-after-laparoscopic-surgeries-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#3
Jun-Ming Huang, Zheng-Tao Lv, Ya-Nan Zhang, Wen-Xiu Jiang, Han-Ning Li, Ming-Bo Nie
OBJECTIVE: This study aims to evaluate the efficacy and safety of parecoxib injection in pain relief after laparoscopic surgeries. METHODS: Comprehensive literature search based on four online databases (Pubmed, EMBASE, CENTRAL, ISI Web of Science) was applied to retrieve all related randomized controlled trials (RCTs). Two independent reviewers screened each article for eligibility according to the predetermined inclusion criteria. The Cochrane's Tool was applied to evaluate the methodological quality of included studies...
October 17, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29044790/acute-appendicitis
#4
REVIEW
Mark D Stringer
Acute appendicitis is the most common reason for abdominal surgery in children. Luminal obstruction of the appendix progresses to suppurative inflammation and perforation, which causes generalised peritonitis or an appendix mass/abscess. Classical features include periumbilical pain that migrates to the right iliac fossa, anorexia, fever, and tenderness and guarding in the right iliac fossa. Atypical presentations are particularly common in preschool children. A clinical diagnosis is possible in most cases, after a period of active observation if necessary; inflammatory markers and an ultrasound scan are useful investigations when the diagnosis is uncertain...
October 17, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29044631/frailty-hospital-volume-and-failure-to-rescue-after-head-and-neck-cancer-surgery
#5
Carrie L Nieman, C Matthew Stewart, David W Eisele, Peter J Pronovost, Christine G Gourin
OBJECTIVES/HYPOTHESIS: We previously reported that high-volume hospital head and neck cancer (HNCA) surgical care is associated with decreased mortality, largely explained by reduced rates of failure to rescue. Frailty is an independent predictor of mortality, but is significantly less likely in patients receiving high-volume care. We investigate whether differences in frailty rates explain the relationship between volume and outcomes in HNCA patients and whether frailty confounds the relationship between failure to rescue and mortality...
October 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29044088/management-of-idiopathic-intracranial-hypertension-in-an-infant-with-bilateral-congenital-cataract-and-associated-comitant-sensory-esotropia
#6
Jyoti Himanshu Matalia, Sheetal Shirke, Hemant Anaspure, Pooja Ghalla, Minal Kekatpure
In this report, we describe the management of a child with bilateral cataract, nystagmus, and comitant sensory esotropia. Routine ultrasonography done before cataract surgery revealed bilateral disc edema confirmed as idiopathic intracranial hypertension by a pediatric neurologist. The primary intervention for cataract surgery was followed by nonresolving papilledema, despite maximum medical therapy. To salvage the optic nerve function in a nonverbal child, bilateral optic nerve sheath decompression was planned with simultaneous medial rectus recessions for the persistent esotropia with the satisfactory postoperative outcome...
October 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29044081/retained-intraocular-iron-foreign-body-presenting-with-acute-retinal-necrosis
#7
Manavi D Sindal, Sabyasachi Sengupta, Dhaivat Vasavada, Sivaraman Balamurugan
We report an unusual case of retained metallic intraocular foreign body (IOFB) presenting with acute retinal necrosis (ARN). A healthy young man presented with signs of ARN including hypopyon, dense vitritis, and peripheral retinal necrosis following alleged history of trauma with a high-velocity projectile. After initial management of ARN with systemic antivirals, a retained metallic IOFB was identified and subsequently removed surgically. The patient was followed up for 12 months postoperatively and retained excellent vision without recurrence of the ARN...
October 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29043849/absorption-of-ibuprofen-orodispersible-tablets-in-early-postoperative-phase-a-pharmacokinetic-study
#8
A Piirainen, M Kokki, H M Lidsle, M Lehtonen, V P Ranta, H Kokki
OBJECTIVE: Patient-controlled oral analgesia has gained popularity in postoperative pain management. Anesthesia and surgery delay gastrointestinal tract function and this may therefore decrease bioavailability of drugs taken by mouth. To hasten absorption, an orodispersible ibuprofen tablet has been developed. In this study, we evaluated the pharmacokinetics and feasibility of orodispersible ibuprofen tablets in spine surgery patients. METHODS: The study design was a prospective clinical trial where each patient served as her/his own control...
October 18, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29043565/eccentric-macular-hole-after-pars-plana-vitrectomy-for-epiretinal-membrane-without-internal-limiting-membrane-peeling-a-case-report
#9
Christina Garnavou-Xirou, Tina Xirou, Stamatina Kabanarou, Ilias Gkizis, Stavros Velissaris, Irini Chatziralli
INTRODUCTION: Postoperative eccentric macular hole formation is an uncommon complication after pars plana vitrectomy (PPV) without internal limiting membrane (ILM) peeling for the treatment of epiretinal membrane (ERM). We present a case of eccentric macular hole formation after PPV for ERM without ILM peeling. CASE REPORT: A 68-year-old male patient presented with ERM and visual acuity of 6/24 in his left eye. He underwent 23-gauge PPV without ILM peeling for treatment of ERM...
October 17, 2017: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/29043480/body-mass-index-bmi-postoperative-appearance-satisfaction-and-sexual-function-in-breast-cancer-survivorship
#10
K E Rojas, N Matthews, C Raker, M A Clark, M Onstad, A Stuckey, J Gass
PURPOSE: We sought to explore the correlation between BMI and postoperative sexual function, body image, and breast-specific sensuality before and after breast cancer surgery. METHODS: A cross-sectional survey of patients at least 1 year from surgery employed the Female Sexual Function Index (FSFI) and investigator-generated questions. Patients who underwent lumpectomy (L), mastectomy (M), and mastectomy with reconstruction (MR) were compared across three BMI groups: normal weight, overweight, and obese...
October 17, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29042835/double-blind-randomized-placebo-controlled-trial-of-single-dose-intravenous-acetaminophen-for-pain-associated-with-adenotonsillectomy-in-pediatric-patients-with-sleep-disordered-breathing
#11
Arlyne K Thung, Charles A Elmaraghy, N'Diris Barry, Dmitry Tumin, Kris R Jatana, Julie Rice, Vidya Raman, Tarun Bhalla, David P Martin, Marco Corridore, Joseph D Tobias
OBJECTIVES: Adequate pain control is an important component in the postoperative outcome for pediatric adenotonsillectomy patients with sleep-disordered breathing (SDB). Intravenous acetaminophen appears to be a favorable analgesic adjunct owing to its predictable pharmacokinetics and opioid-sparing effects; however, its role in pediatric adenotonsillectomy pain management remains unclear. METHODS: In this prospective, randomized, double-blinded, controlled study, subjects with the diagnosis of SDB, aged 2 to 8 years, who required extended postoperative admission, received intravenous acetaminophen (15 mg/kg) or saline placebo intraoperatively in addition to morphine (0...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29042755/clinical-data-combined-with-radiological-imaging-improves-the-accuracy-of-tnm-staging-of-pancreatic-body-and-tail-adenocarcinoma
#12
Wei Xu, Bo Jiang, Xinmin Yin
PURPOSE: Pancreatic body and tail adenocarcinoma (PBTA) remains one of the deadliest cancers, and current radiological modalities still have limitations on the staging of PBTA. Improving PBTA staging will contribute to the management of this disease. PATIENTS AND METHODS: Clinicopathological characteristics of 91 surgically treated PBTA patients were retrospectively retrieved. Clinical data associated with postoperative tumor staging (pTNM) were assessed using ordinal logistic regression model...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29042333/postoperative-intravenous-acetaminophen-for-craniotomy-patients-a-randomized-controlled-trial
#13
Steven Greenberg, Glenn S Murphy, Michael J Avram, Torin Shear, Jessica Benson, Kruti N Parikh, Aashka Patel, Rebecca Newmark, Vimal Patel, Julian Bailes, Joseph W Szokol
OBJECTIVE: To determine whether opioids during the first 24 postoperative hours were significantly altered when receiving intravenous (IV) acetaminophen during that time compared to those receiving placebo (normal saline). METHODS: One hundred forty patients undergoing any craniotomy were randomly assigned to receive either 1g of IV acetaminophen or placebo upon surgical closure, and every six hours thereafter, up to 18 hours postoperatively. Analgesic requirements for the first 24 hours postoperatively were recorded...
October 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29042125/survival-outcomes-of-men-with-lymph-node-positive-prostate-cancer-after-radical-prostatectomy-a-comparative-analysis-of-different-postoperative-management-strategies
#14
Karim A Touijer, Robert Jeffery Karnes, Niccolo Passoni, Daniel D Sjoberg, Melissa Assel, Nicola Fossati, Giorgio Gandaglia, James A Eastham, Peter T Scardino, Andrew Vickers, Cesare Cozzarini, Francesco Montorsi, Alberto Briganti
BACKGROUND: Optimal management of patients with lymph node metastasis (LNM) after radical prostatectomy (RP) remains undefined. OBJECTIVE: We evaluated the association between three different management strategies and survival in prostate cancer with LNM after RP. DESIGN, SETTING, AND PARTICIPANTS: We analyzed data of 1338 patients with LNM after RP from three tertiary care centers. Three hundred and eighty-seven patients (28%) were observed, 676 (49%) received lifelong adjuvant androgen deprivation therapy (ADT), and 325 (23%) received adjuvant external beam radiation therapy (EBRT) and ADT...
October 14, 2017: European Urology
https://www.readbyqxmd.com/read/29040482/strategies-to-reduce-pulmonary-complications-after-transhiatal-esophagectomy
#15
A M Gillinov, R F Heitmiller
Background: By eliminating a thoracotomy, transhiatal esophagectomy (THE) is purported to reduce postoperative pulmonary complications. However, data from many early series do not support this contention, documenting pulmonary complications in up to 50% of patients and pneumonia in 5%-20%. Since 1990, we have implemented a management strategy designed to maximize airway protection in the postoperative period. The purpose of this study was to determine the current incidence of pulmonary complications after transhiatal esophagectomy without thoracotomy...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29040147/longitudinal-assessment-of-developmental-outcomes-in-infants-undergoing-late-craniosynostosis-repair
#16
Stefani C Fontana, Skylar Belinger, Debby Daniels, Margaret Tuttle, Paul J Camarata, Brian T Andrews
Evaluation of infants with craniosynostosis for surgical intervention, as opposed to conservative management, remains a challenge within the field of craniofacial surgery. Studies have consistently demonstrated that surgical repair of craniosynostosis is ideally performed between 3 and 12 months of age. As such, there is limited data regarding neurocognitive development in infants who initially present with uncorrected craniosynostosis after 12 months of age. Moreover, the impact of cranial vault surgery on neurocognitive development at all ages remains under investigation...
October 16, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29040146/the-role-of-preoperative-imaging-in-the-management-of-nonsyndromic-lambdoid-craniosynostosis
#17
Kavitha Ranganathan, Antonio Rampazzo, Asra Hashmi, Karin Muraszko, Jennifer Strahle, Christian J Vercler, Steven R Buchman
BACKGROUND: The necessity of imaging for patients with craniosynostosis is controversial. Lambdoid synostosis is known to be associated with additional anomalies, but the role of imaging in this setting has not been established. The purpose of this study was to evaluate the impact of preoperative imaging on intraoperative and postoperative management among patients undergoing operative intervention for lambdoid craniosynostosis. METHODS: A retrospective review of patients undergoing cranial vault remodeling for lambdoid craniosynostosis between January 2006 and 2014 was conducted...
October 16, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29039258/diagnosis-and-treatment-of-laryngeal-schwannoma-a-systematic-review
#18
Michele Tulli, Stefano Bondi, Chanel Elisha Smart, Leone Giordano, Matteo Trimarchi, Andrea Galli, Davide Di Santo, Matteo Biafora, Mario Bussi
Objective This review summarizes the clinical features, diagnostic workup, and surgical treatment of laryngeal schwannoma with the aim of providing guidance for the management of this rare disease. The collated data allowed the statistical testing of several hypotheses, including the efficacy of endoscopic vs open surgical intervention and the usefulness of preoperative biopsy. Data Sources PubMed, Google Scholar, Cochrane, and SCOPUS. Review Methods Basic epidemiological and clinical presentation data were collated together with details of diagnostic image modality, lesion attributes, and the use of preoperative biopsy...
October 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29039052/effect-of-bariatric-surgery-on-thyroid-function-in-obese-patients-a-systematic-review-and-meta-analysis
#19
REVIEW
Bingsheng Guan, YanYa Chen, Jingge Yang, Wah Yang, Cunchuan Wang
We aimed to make a meta-analysis regarding the effect of bariatric surgery on thyroid function in obese patients. PubMed, EMBASE, CENTRAL, and four Chinese databases were searched for clinical studies. Data were pooled using Review Manager 5.3, and subgroup and sensitivity analyses were performed if necessary and feasible. As a result, 24 articles were included into meta-analysis. Bariatric surgery was associated with significant decrease in TSH, FT3, and T3 levels. However, FT4, T4, and rT3 levels were not significantly changed postoperatively...
October 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29038843/per-oral-endoscopic-salpingo-oophorectomy-poesy-in-humans-a-prospective-clinical-feasibility-study
#20
Amadeus Hornemann, Marc Suetterlin, Georg Kaehler
BACKGROUND AND AIMS: Natural orifice translumenal endoscopic surgery (NOTES) procedure describes a surgical approach using natural orifices. We describe a prospective non-comparative clinical study on transgastric salpingo-oophorectomy in humans. METHODS: Patients with indication for salpingo-oophorectomy were offered the transgastric approach. This paper presents the data of the first 6 patients, in whom the procedure was performed. After gastroscopic incision in the anterior corpus wall we advanced the flexible gastroscope into the abdominal cavity...
October 16, 2017: Archives of Gynecology and Obstetrics
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