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Mei-Chun Chen, Wan-Yu Chen, Wan-Yu Tsui, Guey-Ling Chang, Ming-Ying Hong
BACKGROUND & PROBLEMS: The return-to-treatment rate is an important indicator of treatment outcome and care effectiveness in cancer patients. The return-to-treatment rates for patients at National Taiwan University Hospital (NTUH) in 2011 and 2012 were 38.5% and 33.3%, respectively. In order to improve the quality of care that is provided to patients, we reviewed NTUH's current clinical case management protocols for handling patients who refused treatment and then identified and resolved the potential problems in these protocols...
April 2018: Hu Li za Zhi the Journal of Nursing
Jobbe P L Leenen, Judith E K R Hentzen, Henrietta D L Ockhuijsen
It has been a standard practice to perform mechanical bowel preparation (MBP) prior to colorectal surgery to reduce the risk of colorectal anastomotic leakages (CAL). The latest Cochrane systematic review suggests there is no benefit for MBP in terms of decreasing CAL, but new studies have been published. The aim of this systematic review and meta-analysis is to update current evidence for the effectiveness of preoperative MBP on CAL in patients undergoing colorectal surgery. Consequently, PubMed, MEDLINE, Embase, CENTRAL and CINAHL were searched from 2010 to March 2017 for randomised controlled trials (RCT) that compared the effects of MBP in colorectal surgery on anastomotic leakages...
March 21, 2018: Updates in Surgery
Andrea Veljkovic, Vu Le, Mario Escudero, Peter Salat, Kevin Wing, Murray Penner, Alastair Younger
Reamed intramedullary (IM) screw fixation for proximal fifth metatarsal fractures is technically challenging with potentially devastating complications if basic principles are not followed. A case of an iatrogenic fourth-degree burn after elective reamed IM screw fixation of a proximal fifth metatarsal fracture in a high-level athlete is reported. The case was complicated by postoperative osteomyelitis with third-degree soft-tissue defect. This was successfully treated with staged autologous bone graft reconstruction, tendon reconstruction, and local bi-pedicle flap coverage...
March 21, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Elizabeth Mathew Iype, Santhosh Kumar N, Sreekanth S Kumar, Bipin T Varghese, Jaya C Jose
To study the clinicopathological and molecular factors which correlate with nodal metastasis in laryngeal and hypopharyngeal carcinoma, a retrospective analysis of 170 patients who underwent surgery for laryngeal and hypopharyngeal carcinoma at RCC, Trivandrum from 2006 to 2010 was done. The pathological nodal stage and levels of involvement were correlated with the clinicopathologic features of the primary disease. Neck node positivity was significantly more for lesions of pyriform sinus lesion (61%), with thyroid cartilage erosion (56%) and with base tongue involvement (88%)...
March 2018: Indian Journal of Surgical Oncology
K G Gopakumar, T Priyakumari, Manjusha Nair, P Kusumakumary
In India, the clinical guidelines and laws governing consent for blood transfusion in a minor are meager and vague. In an elective situation, whether the parents can make a decision for the child on his/her behalf or whether the doctor has the right to make the decision in the best interests of the child is not clear. We present the case scenario of a child belonging to Jehovah's Witness denomination diagnosed with Burkitt lymphoma. His parents were in a dilemma whether to opt for blood transfusion or not. In the absence of laws and guidelines in this context, and considering the complications that he developed during the treatment period, it was very challenging for us to manage the situation both medically and medico-legally...
January 2018: Asian Journal of Transfusion Science
Amihai Rottenstreich, Yosef Kalish, Uriel Elchalal, Alexander Klimov, Allan I Bloom
OBJECTIVES: To evaluate patterns of use and outcomes of retrievable inferior vena cava filters (rIVCF) in obstetric patients. METHODS: A single center review of consecutive patients who underwent rIVCF placement during pregnancy/postpartum in 2005-2016. A pooled analysis of the relevant cases in the English literature was conducted. RESULTS: The current cohort comprised 24 women, median age 27 [interquartile range 24-30] years. Among 10 filters placed during pregnancy, the most common indication (n = 4) was the need to withhold anticoagulation therapy before delivery, in the presence of acute thrombosis...
March 21, 2018: Journal of Maternal-fetal & Neonatal Medicine
Kerri Bell, Eugene Warnick, Kristen Nicholson, Sarah Ulcoq, Seong Jin Kim, Gregory D Schroeder, Alexander Vaccaro
Health care increasingly collects patient-reported outcomes (PROs) via web-based platforms. The purpose of this study was to evaluate how patient age influences portal engagement. Patients undergoing elective surgery at a single multispecialty orthopedic practice from September 2014 to February 2017 had access to an online portal to complete PROs, message the clinic, and view physical therapy instructions. A mobile app was optionally available. Age, sex, log-in frequency, PRO completion rates, and number of messages sent were reviewed retrospectively...
March 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Paul McGreevy, Jeannine Berger, Nic de Brauwere, Orla Doherty, Anna Harrison, Julie Fiedler, Claudia Jones, Sue McDonnell, Andrew McLean, Lindsay Nakonechny, Christine Nicol, Liane Preshaw, Peter Thomson, Vicky Tzioumis, John Webster, Sarah Wolfensohn, James Yeates, Bidda Jones
The aim of this study was to conduct a series of paper-based exercises in order to assess the negative (adverse) welfare impacts, if any, of common interventions on domestic horses across a broad range of different contexts of equine care and training. An international panel (with professional expertise in psychology, equitation science, veterinary science, education, welfare, equestrian coaching, advocacy, and community engagement; n = 16) met over a four-day period to define and assess these interventions, using an adaptation of the domain-based assessment model...
March 18, 2018: Animals: An Open Access Journal From MDPI
Kate S Collison, Angela Inglis, Sherin Shibin, Soad Saleh, Bernard Andres, Rosario Ubungen, Jennifer Thiam, Princess Mata, Futwan A Al-Mohanna
RATIONALE: Aspartame (L-aspartyl phenylalanine methyl ester) is a non-nutritive sweetener (NNS) approved for use in more than 6000 dietary products and pharmaceuticals consumed by the general public including adults and children, pregnant and nursing mothers. However a recent prospective study reported a doubling of the risk of being overweight amongst 1-year old children whose mothers consumed NNS-sweetened beverages daily during pregnancy. We have previously shown that chronic aspartame (ASP) exposure commencing in utero may detrimentally affect adulthood adiposity status, glucose metabolism and aspects of behavior and spatial cognition, and that this can be modulated by developmental N-methyl-D-aspartate receptor (NMDAR) blockade with the competitive antagonist CGP 39551 (CGP)...
2018: PloS One
Elizabeth G Lieberman, Ryan M Boone, Stephanie Radoslovich, Valentina Haj, Jayme Hiratzka, Lynn M Marshall, Jung U Yoo
STUDY DESIGN: Cross sectional cohort study OBJECTIVE.: To determine the prevalence of moderate-to-severe lower urinary tract symptoms (LUTS) in patients undergoing elective lumbar spine surgery, and to describe associations between prevalence, severity of symptoms, demographic variables, and spine pathology. SUMMARY OF BACKGROUND DATA: The prevalence of LUTS is unknown in patients with lumbar spine disease. Furthermore, the extent of LUTS severity and the relationship between spine pathology and LUTS is not well documented...
March 20, 2018: Spine
Z B Khalilov, A Yu Kalinichenko, R Kh Azimov, M A Chinikov, I S Panteleeva, F S Kurbanov
AIM: To evaluate the role of laparoscopic surgery for colorectal cancer in advanced age patients. MATERIAL AND METHODS: 290 patients with colorectal cancer were enrolled including 121 patients with rectal cancer and 169 patients with colon cancer. Main group consisted of 171 patients over 60 years old, control group - 119 patients younger 60 years old. RESULTS: Radical advanced procedures on different parts of colon including laparoscopic approach were performed in the majority of advanced age patients...
2018: Khirurgiia
S I Achkasov, Yu A Shelygin, A I Moskalev, Yu L Trubacheva, S A Senashenko
AIM: To estimate efficacy of laparoscopic-assisted procedures for chronic complications of diverticular disease (DD). MATERIAL AND METHODS: It was made a prospective comparative study within 2007-2015. Inclusion criteria were verified chronic DD (>6 weeks after the first attack) and bowel resection followed by primary anastomosis. EXCLUSION CRITERIA: contraindications for pneumoperitoneum, BMI ≥35 kg/m2 , infiltrate dimension >10 cm, preoperatively non-excluded neoplasm...
2018: Khirurgiia
Suleyman Orman, Haci Murat Cayci
BACKGROUND AND AIM: The present multicenter, retrospective study aimed at determining the factors affecting survival in patients who were operated on due to gastric cancer (GC). PATIENTS AND METHODS: The data of 234 patients, who underwent elective surgery due to GC were retrospectively analyzed. The demographic characteristics, tumor localization and diameter, type of resection and lymph node dissection, experience of the operating surgeon (senior or junior), tumor grade, pT stage, number of lymph nodes harvested, number of lymph nodes with and without metastasis, tumor stage and survival data were recorded...
March 21, 2018: Acta Chirurgica Belgica
Kumar Rajnish, Sathasivam Sureshkumar, Manwar S Ali, Chellappa Vijayakumar, Sundaramurthi Sudharsanan, Chinnakali Palanivel
Introduction Laparoscopic cholecystectomy (LC) is the most commonly done, minimally invasive surgical procedure. Routinely used electrocautery produces more smoke, which masks the operating field, thereby prolongs the surgery and posing an increased risk of gallbladder (GB) perforation. The titanium clips used for clipping the cystic artery and cystic duct have a risk of slippage, which may lead to bleeding, and an increased risk for bile leakage. In addition, it may act as a nidus for stone formation. Advanced energy sources, such as the harmonic scalpel, though expensive, may provide the advantage of shorter operating time by reducing smoke, bloodless dissection in the GB bed, lower risk of bleeding from the cystic artery due to secure vessel sealing, and avoiding the use of a larger number of titanium clips...
January 18, 2018: Curēus
Zhipeng Zhu, Hongmei Zhou, Yunjian Ni, Cheng Wu, Caijun Zhang, Xiaoyan Ling
Purpose: Cardiac surgery patients always present with atrial fibrillation (AF) after admission to the intensive care unit, leading to high mortality and lengthy hospitalization. Dexmedetomidine (DEX) is a popular medication used for sedation in the intensive care unit; however, whether it can reduce AF needs to be analyzed. Materials and methods: Three primary databases, Medline, Embase (Ovid SP) and the Cochrane Central Register of Controlled Trials (CENTRAL), were searched...
2018: Drug Design, Development and Therapy
Florian Falter, Nabeel Razzaq, Martin John, Jens Fassl, Markus Maurer, Sean Ewing, Ross Hofmeyr
Unfractionated heparin is the mainstay of anticoagulation during cardiac surgery on cardiopulmonary bypass (CPB) due to its low cost, quick onset, and ease of reversal. Since over 30 years, the activated clotting time (ACT) has been used to assess the level of heparin activity both before and after CPB. We compared two different methods of measuring the ACT: i-STAT, which uses amperometric detection of thrombin cleavage, and Hemochron Jr, which is based on detecting viscoelastic changes in blood. We included 402 patients from three institutions (Papworth Hospital, Cambridge, UK; Groote Schuur, Cape Town, South Africa; University Hospital Basel, Basel, Switzerland) undergoing elective cardiac surgery on CPB in our study...
March 2018: Journal of Extra-corporeal Technology
Peter-Henning Clausen, Sandra Stelzer, Ard Nijhof, Jürgen Krücken, Georg von Samson-Himmelstjerna
The teaching of veterinary parasitology to the large number of students at the Freie Universität Berlin is mainly limited to conventional face-to-face lectures, supplemented by practical classes. Extensive parasite descriptions and diagnostic techniques are at the core of the practical classes, which are also intended to emphasise key biological and veterinary aspects covered in lectures. Further in-depth and specific learning is achieved within a detailed framework of elective courses, with defined learning outcomes for small groups of students, focusing on themes such as 'diagnosis and treatment of ectoparasites in companion animals' or 'zoonotic parasites'...
March 15, 2018: Veterinary Parasitology
Manuela Schnyder, Hubertus Hertzberg, Alexander Mathis, Marietta Schönmann, Adrian Hehl, Peter Deplazes
Pursuant to the Joint Declaration by 29 European education ministers in June 1999 in the city of Bologna, Italy, the so-called 'Bologna Process' was officially introduced at the Vetsuisse Faculty (Universities of Zurich and Berne) in Switzerland in 2007. The long-term goal of restructuring the study programmes was to create a common European Higher Education Area (EHEA), with uniform and clearly defined standards for degrees ("diplomas"). Accordingly, the Vetsuisse curriculum was organised as a 3-year Bachelor and a 2-year Master study program...
March 15, 2018: Veterinary Parasitology
John O DeLancey, Eddie Blay, D Brock Hewitt, Kathryn Engelhardt, Karl Y Bilimoria, Jane L Holl, David D Odell, Anthony D Yang, Jonah J Stulberg
BACKGROUND: Adverse postoperative outcomes related to smoking are well established, yet current smokers continue to be offered elective surgery in the US. It is unknown whether patients undergoing low-risk, elective procedures, who actively smoke experience increased risk of complications. We sought to determine the increased burden of complications following elective hernia repair procedures in patients identified as current smokers. METHODS: We identified patients undergoing elective incisional, inguinal, umbilical, or ventral hernia repair from 2011 to 2014 using the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) database...
March 6, 2018: American Journal of Surgery
Pedro A A Monteleone, Pedro F M Peregrino, Edmund C Baracat, Paulo C Serafini
INTRODUCTION: Assisted reproductive technologies (ARTs) are associated with potential risks, mainly related to multiple pregnancies, which are around 20% to 25%. Iatrogenic multiple pregnancies due to ovarian stimulation with multiples embryos transferred can be avoided by the elective single-embryo transfer (eSET), a growing practice worldwide. Adequately applied eSET, which impact on the incidence of complications without compromising treatment success, is still a challenge. The aim of this study was to compare the cumulative success rates of elective transfer of 2 embryos when transferred one by one (eSET), versus the success rates of elective double-embryo transfer (DET) in a single procedure, in a good prognosis population...
January 1, 2018: Reproductive Sciences
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