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https://www.readbyqxmd.com/read/28109210/surgical-repair-of-moderate-ischemic-mitral-regurgitation-a-systematic-review-and-meta-analysis
#1
Mahesh Anantha Narayanan, Saurabh Aggarwal, Yogesh N V Reddy, Venkata M Alla, Janani Baskaran, Arun Kanmanthareddy, Rakesh M Suri
Introduction Moderate mitral regurgitation (MR) of ischemic etiology has been associated with worse outcomes after coronary artery bypass grafting (CABG). Studies comparing concomitant mitral valve replacement/repair (MVR/Re) with CABG and standalone CABG have reported conflicting results. We performed a systematic review and meta-analysis of the published literature. Patients and Methods We searched using PubMed, Cochrane, EMBASE, CINAHL, and Google scholar databases from January 1960 to June 2016 for clinical trials comparing CABG to CABG + MVR/Re for moderate MR...
January 21, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28109160/antibiotics-for-infection-prevention-after-excision-of-the-cervical-transformation-zone
#2
REVIEW
Chumnan Kietpeerakool, Bandit Chumworathayi, Jadsada Thinkhamrop, Butsakorn Ussahgij, Pisake Lumbiganon
BACKGROUND: Excision of the transformation zone of the cervix is the most commonly used approach to treat cervical precancerous lesions (cervical intraepithelial neoplasia (CIN)) to reduce the risk of developing cervical cancer. As the excision of the transformation zone leaves a raw area on the cervix, there is a risk of infection following the procedure. The incidence of infection after cold knife conization (CKC) is 36%, whereas the incidence for large loop excision of the transformation zone (LLETZ, also known as loop electrical excision procedure (LEEP)) is much lower (0...
January 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28108774/-hip-dislocation-after-revision-arthroplasty-risk-assessment-and-treatment-strategies
#3
P M Prodinger, J Schauwecker, H Mühlhofer, N Harrasser, F Pohlig, C Suren, R von Eisenhart-Rothe
With a dislocation rate of up to 35% after revision total hip arthroplasty (THA), instability is one of the major causes why this procedure fails. Independent factors for patients at risk are age, sex, and the type of revision needed. The surgical approach, implant choice, and positioning of the components are factors that the surgeon can influence to keep the dislocation rate low. Large femoral heads or double mobility (DM) cups can increase the stability of the joint. After detailed failure analysis, targeted use of different technical innovations enhances stability in revision THA and prevents further revisions...
January 20, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28108755/measurement-of-aortic-valve-coaptation-and-effective-height-using-echocardiography-in-patients-with-ventricular-septal-defects-and-aortic-valve-prolapse
#4
Satoru Iwashima, Hiroki Uchiyama, Takamichi Ishikawa, Kiyohiro Takigiku, Ken Takahashi, Manatomo Toyono, Nao Inoue, Masaki Nii
Decreased coaptation height in adults has been identified as a marker of early valve failure. We evaluated aortic valve coaptation and effective height in healthy children and in children with a ventricular septal defect (VSD) with aortic cusp prolapse (ACP), using echocardiography. We included 45 subjects with VSD with ACP, 27 did not develop aortic regurgitation (AR) by ACP and 18 developed AR by ACP, and 83 healthy children as controls. Aortic root anatomy was estimated using the parasternal long-axis view...
January 21, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28108568/the-role-of-day-one-postoperative-review-of-intraocular-pressure-in-modern-vitrectomy-surgery
#5
Nicholas Brennan, Ian Reekie, Eric Ezra, Keith Barton, Ananth Viswanathan, Mahiul Mk Muqit
BACKGROUND: With the introduction of sutureless 23-gauge (23G) vitrectomy, the risks for elevated intraocular pressure (IOP) and the need for day 1 review of IOP are less certain. AIMS: To assess current practice for postoperative review in the vitreoretinal service at a large tertiary referral centre; to assess whether day 1 review detected complications altering patient management; to identify risk factors for IOP spikes postvitrectomy. METHODS: Retrospective, consecutive case note review of all patients undergoing 23G vitrectomy at the study institution between April and June 2013...
January 20, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28108482/inhibition-of-prolyl-4-hydroxylase-decreases-muscle-fibrosis-following-chronic-rotator-cuff-tear
#6
J P Gumucio, M D Flood, A Bedi, H F Kramer, A J Russell, C L Mendias
OBJECTIVES: Rotator cuff tears are among the most frequent upper extremity injuries. Current treatment strategies do not address the poor quality of the muscle and tendon following chronic rotator cuff tears. Hypoxia-inducible factor-1 alpha (HIF-1α) is a transcription factor that activates many genes that are important in skeletal muscle regeneration. HIF-1α is inhibited under normal physiological conditions by the HIF prolyl 4-hydroxylases (PHDs). In this study, we used a pharmacological PHD inhibitor, GSK1120360A, to enhance the activity of HIF-1α following the repair of a chronic cuff tear, and measured muscle fibre contractility, fibrosis, gene expression, and enthesis mechanics...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28108424/clinical-and-radiological-findings-after-multilevel-cervical-total-disc-replacement-defining-radiological-changes-to-predict-surgical-outcomes
#7
Jung Hwan Lee, Sang-Ho Lee, Jun Ho Lee
OBJECTIVE: This study compared the radiological parameters between preoperation and postoperation for patients who underwent multilevel cervical total disc replacement (MCTDR) and assessed which parameters were related to successful clinical outcomes after MCTDR. METHODS: The study included a consecutive series of 24 patients who were treated with MCTDR following the diagnosis of multilevel cervical disc herniation or stenosis. Numeric Rating Scale (NRS), C2-7 sagittal vertical axis (SVA), range of motion (ROM) of C2-7 segment and TDR implanted levels were evaluated at pre- and post-TDR...
January 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28108173/broach-handle-design-changes-force-distribution-in-the-femur-during-total-hip-arthroplasty
#8
Dustin A Greenhill, Pooyan Abbasi, Kurosh Darvish, Andrew M Star
BACKGROUND: Curved broach handles were developed to overcome limited surgical exposures during total hip arthroplasty. Some authors report increased intraoperative fracture rates during limited exposures. This study evaluates mechanical force ratios transmitted to the bone while broaching with curved vs straight handles. METHODS: An experimental model utilized a 6-axis load cell to measure force distributions produced by 4 different broach handles, each with increasing offset and curvature...
December 29, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28108142/identifying-mronj-affected-bone-with-digital-fusion-of-functional-imaging-fi-and-cone-beam-computed-tomography-cbct-case-reports-and-hypothesis
#9
Gayathri Subramanian, Evelyne Kalyoussef, Meredith Blitz-Goldstein, Jessenia Guerrero, Nasrin Ghesani, Samuel Y P Quek
Surgical debridement of medication-related osteonecrosis of the jaw (MRONJ) lesions is far less predictable than lesion resection. Margins for surgical debridement are guided by surrogate markers of bone viability, such as bleeding and bone fluorescence, which limit debridement to visibly necrotic bone. In contrast, surgical resection is extensive, including a substantial portion of surrounding bone. The concept that the MRONJ lesion is a composite of affected but viable ("compromised") and necrotic bone is supported by histopathological data...
November 28, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28107859/dengue-fever-may-mislead-the-surgeons-when-it-presents-as-an-acute-abdomen
#10
Bingumal Jayasundara, Lalith Perera, Ajith de Silva
OBJECTIVE: To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF (Dengue fever)/DHF (Dengue hemorrhagic fever). METHODS: Clinical data of all cases of apparent acute abdomen (AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed. Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered...
January 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28107849/attitudes-to-and-beliefs-about-animal-assisted-therapy-for-children-with-disabilities
#11
Esther Yap, Adam Scheinberg, Katrina Williams
OBJECTIVES: This study assessed the attitudes and beliefs surrounding animal-assisted therapy (AAT) for the rehabilitation of children with disabilities at the Royal Children's Hospital (RCH), focusing specifically on cerebral palsy (CP), autism spectrum disorder (ASD) and acquired brain injury (ABI). This was an initial step to inform future AAT research and to understand the feasibility of interventions. DESIGN/SETTING/OUTCOME MEASURES: An online survey asking participants their opinions about the inclusion of AAT, and potential barriers to its introduction in a tertiary hospital setting was advertised on the RCH Intranet from 3 March 2015 to 3 April 2015...
February 2017: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/28107847/the-effect-of-watching-funny-and-unfunny-videos-on-post-surgical-pain-levels
#12
Hülya Elmali, Reva Balci Akpinar
OBJECTIVE: The aim of this study was to describe pain intensity before and after watching funny and unfunny videos on post-surgical pain levels. METHODS: Ninety patients were divided into three groups. Group A watched funny videos, Group B watched unfunny videos, Group C did not watch any videos. Pain assessment of the patients was carried out before (first), immediately after (second), and 30 min after (third) watching videos. RESULTS: The first pain scoremean in Group A was 40...
February 2017: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/28107762/thulium-laser-in-interventional-endoscopy-animal-and-human-studies
#13
Gian E Tontini, Helmut Neumann, Luca Pastorelli, Luisa Spina, Flaminia Cavallaro, Paola Soriani, Alessandro Rimondi, Barbara Bruni, Claudio Clemente, Filippo Fagnani, Pavlos Lagoussis, Luca Carmignani, Maurizio Vecchi
Background and study aims The thulium laser system (TLS) is an emerging surgical tool. The 2-μm wavelength provides a confined coagulation depth (0.2 - 0.4 mm) to reduce the potential for inadvertent injuries. For the first time ever, we assessed TLS feasibility for endoscopic hemostasis ex vivo in pigs. In addition, we performed the first in vivo hemostatic treatments in humans. Patients and methods Tissue damage induced by TLS using different settings and optical fibers was compared to that from argon plasma coagulation (APC) in established ex vivo animal models...
January 20, 2017: Endoscopy
https://www.readbyqxmd.com/read/28107594/weighing-the-evidence-from-surgical-trials
#14
Quoc-Dien Trinh, Alexander P Cole, Prokar Dasgupta
With growing calls to improve value in health care, the assessment of surgical outcomes has moved to the spotlight. Public awareness of medical errors has spurred initiatives like the ProPublica "Surgeon Scorecard" to measure and report complications (h t t p s : //projects. propublica. org/surgeons/). High-tech and expensive innovations such as robot-assisted surgery must be measured against traditional approaches. This article is protected by copyright. All rights reserved.
January 20, 2017: BJU International
https://www.readbyqxmd.com/read/28107276/the-effect-of-deep-versus-moderate-neuromuscular-block-on-surgical-conditions-and-postoperative-respiratory-function-in-bariatric-laparoscopic-surgery-a-randomized-double-blind-clinical-trial
#15
Sam Baete, Gerd Vercruysse, Margot Vander Laenen, Pieter De Vooght, Jeroen Van Melkebeek, Dimitri Dylst, Maud Beran, Jan Van Zundert, René Heylen, Willem Boer, Sam Van Boxstael, Tom Fret, Hans Verhelst, Cathy De Deyne, Frank Jans, Pascal Vanelderen
BACKGROUND: In recent literature, it has been suggested that deep neuromuscular block (NMB) improves surgical conditions during laparoscopy; however, the evidence supporting this statement is limited, and this was not investigated in laparoscopic bariatric surgery. Moreover, residual NMB could impair postoperative respiratory function. We tested the hypotheses that deep NMB could improve the quality of surgical conditions for laparoscopic bariatric surgery compared with moderate NMB and investigated whether deep NMB puts patients at risk for postoperative respiratory impairment compared with moderate NMB...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28107241/polytrauma-patients-with-associated-spine-fractures-an-assessment-of-surgical-intervention-on-patient-outcome
#16
Steven R Niedermeier, Safdar N Khan
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To examine perioperative characteristics among polytraumatized patients with operative, unstable spine fractures with and without concomitant operative long bone injuries. SUMMARY OF BACKGROUND DATA: Treatment of polytrauma patients has delicate and time-sensitive protocols to ensure successful recovery. The literature defines standards for vertebral injury and surgical intervention...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28107239/management-of-pharyngeal-fistulas-after-anterior-cervical-spine-surgery-a-treatment-algorithm-for-severe-complications
#17
Christian Simon, Carl H Fürstenberg, Markus Eichler, Stefan Rohde, Cem Bulut, Bernd Wiedenhöfer
STUDY DESIGN: This study is a retrospective database query to identify all anterior spinal approaches. OBJECTIVES: The objectives were to assess all patients with pharyngocutaneous fistulas (PCFs) after anterior cervical spine surgery. SUMMARY OF BACKGROUND DATA: Patients with the diagnosis of PCFs were treated at the University of Heidelberg Spine Medical Center, Spinal Cord Injury Unit and Department of Otolaryngology (Germany), between 2005 and 2011...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28107237/evaluating-a-posterior-approach-for-surgical-treatment-of-thoracolumbar-pseudarthrosis-in-ankylosing-spondylitis
#18
Ting Wang, Dechun Wang, Yanan Cong, Chuqiang Yin, Shuzhong Li, Xiaoliang Chen
STUDY DESIGN: Retrospective study of a posterior approach for surgical treatment of thoracolumbar pseudarthrosis in ankylosing spondylitis (AS). OBJECTIVE: The aim of the current study was to report the surgical results of symptomatic thoracolumbar pseudarthrosis in AS through a posterior approach. SUMMARY OF BACKGROUND DATA: Spinal pseudarthrosis is a well-known complication in AS. The condition may complicate with mechanical back pain, spinal deformity, and sometimes neurological deficits...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28107231/national-database-research-in-spine-surgery-limitations-in-the-current-literature
#19
Arjun S Sebastian
Many of the studies in the spine surgical literature using national databases have been directed at examining adverse events, readmission rates, cost, and risk factors for poorer outcomes. Although such studies allow for assessment of large cohorts taken from multiple institutions, they are limited by data collection methods, short-term follow-up, and minimal assessment of functional outcomes. Furthermore, few studies are directed at producing actionable practice changes to improve patient care. Recent work aimed at producing databases with more relevance to spine surgery represent exciting developments to the rapidly growing field of health outcomes research...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28106696/use-of-acellular-dermal-matrix-in-treatment-of-congenital-muscular-torticollis-in-patients-over-eight-years-of-age
#20
Hyung Min Hahn, Kyung Hoon Cook, Il Jae Lee, Dong Ha Park, Myong Chul Park
BACKGROUND: Treatment for neglected or recurred congenital muscular torticollis should be differentiated from primary patients due to the long-standing adjacent tissue contracture. The aim of this study was to evaluate the effect of acellular dermal matrix (ADM) on surgery of recurred and neglected patients of congenital muscular torticollis. METHODS: Forty-nine patients were included in the study. All patients underwent resection at the distal end of the sternocleidomastoid muscle...
January 18, 2017: Journal of Craniofacial Surgery
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