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https://www.readbyqxmd.com/read/28938389/shortening-and-angulation-strategies-to-address-composite-bone-and-soft-tissue-defects
#1
Sarah N Pierrie, Joseph R Hsu
Gustilo-Anderson IIIB tibial fractures and infected tibial nonunions represent particular challenges for the orthopaedic trauma surgeon. Debridement of dysvascular bone and soft tissues can create composite bone and soft tissue defects. Restoring the soft tissue envelope is a critical step in preventing or treating ongoing infection and in restoring local blood supply. Shortening and angulation techniques, including the gradual expansion muscle flap, rely on distraction histogenesis to address composite bone and soft tissue loss...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938364/the-role-of-tranexamic-acid-in-plastic-surgery-review-and-technical-considerations
#2
Rod J Rohrich, Min-Jeong Cho
Minimizing blood loss during surgery is critical, and many modalities have been used to decrease unwanted surgical bleeding. Among many methods, use of pharmacological agents such as anti-fibrinolytic drugs have been shown to significantly reduce blood loss and the rates of postoperative blood transfusion in many literatures. Tranexamic acid is an anti-fibrinolytic agent that has been widely used in other surgical specialties, especially in cardiac, orthopedic, and trauma surgery . Despite its known benefits, the use of tranexamic acid in plastic surgery is extremely limited, primarily because most plastic surgery procedures do not involve the extent of blood loss that can lead to anemia and the need for blood transfusion, as is common in major orthopedic and cardiac surgery procedures...
September 15, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28938283/effect-of-tranexamic-acid-on-transfusion-a-randomized-clinical-trial-in-acetabular-fracture-surgery
#3
William D Lack, Brett D Crist, Rachel B Seymour, William Harvin, Madhav A Karunakar
OBJECTIVES: Given the increasing evidence that minimizing blood loss and limiting allogeneic transfusion can improve patient outcome, we are performing a randomized controlled trial of the use of tranexamic acid (TXA) during acetabular fracture surgery. DESIGN: Prospective, multicenter, and randomized. SETTING: Two level I trauma centers. PARTICIPANTS: Eighty-eight patients underwent randomization, with 42 assigned to the TXA group and 46 assigned to the placebo group...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938282/efficacy-and-safety-of-tranexamic-acid-in-orthopaedic-fracture-surgery-a-meta-analysis-and-systematic-literature-review
#4
Kamil M Amer, Saqib Rehman, Kamal Amer, Christopher Haydel
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug that has been shown to be effective in reducing blood loss and the need for transfusions after several orthopaedic surgeries. However, the effectiveness of TXA use in orthopaedic fracture surgeries still remains unclear. The purpose of this meta-analysis was to review existing literature with interest in the effectiveness and safety of TXA treatment in reducing total blood loss and transfusion rates for patients who underwent surgery for fracture repairs...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938281/tranexamic-acid-in-orthopaedic-trauma-surgery-a-meta-analysis
#5
Elizabeth B Gausden, Rameez Qudsi, Myles D Boone, Brian OʼGara, Joseph J Ruzbarsky, Dean G Lorich
AIM: To systematically review and quantify the efficacy of tranexamic acid (TXA) use in reducing the risk of receiving a blood transfusion in patients undergoing orthopaedic trauma surgery, in reducing blood loss, and risk of thromboembolic events. METHODS: A systematic literature search was performed using MEDLINE, Embase, ClinicalTrials.gov, and conference proceeding abstracts from 2014 to 2016. A minimum of 2 reviewers screened each study and graded quality. The primary outcome measure was the risk of receiving a blood transfusion in the TXA group versus control...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28937571/practice-bulletin-no-183-postpartum-hemorrhage
#6
(no author information available yet)
Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2)...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937566/practice-bulletin-no-183-summary-postpartum-hemorrhage
#7
(no author information available yet)
Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2)...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937515/laparoscopic-major-vascular-injury-simulation-using-a-synthetic-compared-with-porcine-model
#8
Magdy P Milad, Farah A Alvi, Michael T Breen, Cynthia Brincat, Peter J Frederick, Christina Lewicky-Gaupp, Mark Lewis, Bryan Rone, Kimberly Swan, Karin Wollschlaeger
BACKGROUND: Major vascular injury training may improve clinical skills and reduce patient morbidity during gynecologic laparoscopy; thus, reliable models for simulation should be identified. METHOD: Two laparoscopic major vascular injury simulations using synthetic or live porcine models were constructed. The primary surgeon was given the opportunity to complete both simulations. After obtaining peritoneal access, the surgeon quickly encountered a major vascular injury...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937456/is-1-stage-posterior-corpectomy-more-favorable-compared-with-decompression-with-fusion-to-control-thoracic-cord-compression-by-metastasis
#9
Dae Geun Kim, Jung-Ki Ha, Chang Ju Hwang, Dong-Ho Lee, Choon Sung Lee, Jae Hwan Cho
STUDY DESIGN: A retrospective comparative study OBJECTIVE:: To compare 1-stage posterior corpectomy to decompression with fusion for the control of thoracic cord compression due to a metastatic tumor. SUMMARY OF BACKGROUND DATA: Thoracic cord compression by a metastatic tumor can cause back pain, paralysis, and urinary/bowel dysfunction and is generally treated by palliative decompressive surgery. However, no studies have assessed the advantages of 1-stage posterior corpectomy compared with decompression with fusion...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28937455/palliative-surgery-for-spinal-metastases-using-posterior-decompression-and-fixation-combined-with-intraoperative-vertebroplasty
#10
Liang Dong, Mingsheng Tan, Di Wu, Ping Yi, Feng Yang, Xiangsheng Tang, Qingying Hao
STUDY DESIGN: Retrospective study. OBJECTIVE: To evaluate the clinical outcome of palliative surgery using posterior decompression and fixation combined with intraoperative vertebroplasty (PDFIV) for the treatment of spinal metastases, and analyze the indications for PDFIV using a neurological, oncologic, mechanical, and systemic framework. SUMMARY OF BACKGROUND DATA: Palliative surgery is widely used to spinal metastatic patients with poor condition for enough postoperative recovery...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28936471/analysis-of-hepatitis-c-virus-particle-heterogeneity-in-immunodeficient-human-liver-chimeric-fah-mice
#11
Ursula Andreo, Ype P de Jong, Margaret A Scull, Jing W Xiao, Koen Vercauteren, Corrine Quirk, Michiel C Mommersteeg, Sonia Bergaya, Arjun Menon, Edward A Fisher, Charles M Rice
BACKGROUND & AIMS: Hepatitis C virus (HCV) is a leading cause of chronic liver diseases and the most common indication for liver transplantation in the United States. HCV particles in the blood of infected patients are characterized by heterogeneous buoyant densities, likely owing to HCV association with lipoproteins. However, clinical isolates are not infectious in vitro and the relative infectivity of the particles with respect to their buoyant density therefore cannot be determined, pointing to the need for better in vivo model systems...
November 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28935573/acrolein-disrupts-tight-junction-proteins-and-causes-er-stress-mediated-epithelial-cell-death-leading-to-intestinal-barrier-dysfunction-and-permeability
#12
Wei-Yang Chen, Min Wang, Jingwen Zhang, Shirish S Barve, Craig J McClain, Swati Joshi-Barve
Increasing evidence suggests that environmental and dietary factors can affect intestinal epithelial integrity leading to gut permeability and bacterial translocation. Intestinal barrier dysfunction is a pathogenic process associated with many chronic disorders. Acrolein is an environmental and dietary pollutant and a lipid-derived endogenous metabolite. The impact of acrolein on the intestine has not been investigated before and is evaluated in this study, both in vitro and in vivo. Our data demonstrate that oral acrolein exposure in mice caused damage to the intestinal epithelial barrier, resulting in increased permeability and subsequently translocation of bacterial endotoxin-LPS into the blood...
September 18, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28935555/vaccination-with-a-dna-vaccine-encoding-toxoplasma-gondii-rop54-induces-protective-immunity-against-toxoplasmosis-in-mice
#13
Wen-Bin Yang, Dong-Hui Zhou, Yang Zou, Kai Chen, Qing Liu, Jin-Lei Wang, Xing-Quan Zhu, Guang-Hui Zhao
Toxoplasma gondii is an obligatory intracellular protozoan, which infects most of the warm-blooded animals, causing serious public health problems and enormous economic losses worldwide. The rhoptry effector protein 54 (ROP54) has been indicated as a virulence factor that promotes Toxoplasma infection by modulating GBP2 loading onto parasite-containing vacuoles, which can modulate some aspects of the host immune response. In order to evaluate the immuno-protective value of ROP54, we constructed a eukaryotic recombinant plasmid expressing T...
September 18, 2017: Acta Tropica
https://www.readbyqxmd.com/read/28935345/robotic-thymectomy-is-feasible-for-large-thymomas-a-propensity-matched-comparison
#14
Peter J Kneuertz, Mohamed K Kamel, Brendon M Stiles, Benjamin E Lee, Mohamed Rahouma, Abu Nasar, Nasser K Altorki, Jeffrey L Port
BACKGROUND: Robotic-assisted thymectomy (RAT) is increasingly performed for resection of thymomas. Its application for large tumors remains controversial. In this study, we evaluated the safety and feasibility of RAT for large thymomas in comparison with transsternal thymectomy (ST). METHODS: A single institution database was reviewed for patients who underwent RAT for thymoma of 4 cm or larger between 2004 and 2016. Propensity scores were applied to match RAT with ST patients, based on age, sex, tumor size, and Masaoka stage...
September 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28935336/transverse-pericardial-sinus-closure-in-acute-type-a-aortic-dissection-operation
#15
Liang-Wan Chen, Xi-Jie Wu, Xiao-Fu Dai
In operations for acute type A aortic dissection with open technique in elderly patients and patients with long-term treatment of anticoagulation, the transverse pericardial sinus was routinely closed before the graft implantation. With the aid of both a bovine pericardial patch covering the pericardial recess between the superior caval vein and the pulmonary artery and an opening in the left inner side of the superior caval vein, this prophylactic transverse pericardial sinus closure could make autotransfusion of blood loss into the central venous system possible to deal with the diffuse oozing from the suture line...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28935012/-combining-3d-ctba-and-3d-vats-single-operation-hole-to-%C3%A2-anatomical-segmentectomy-in-the-treatment-of-non-small-cell-lung-cancer
#16
Xiaowei She, Yunbin Gu, Chun Xu, Xinyu Song, Chang Li, Cheng Ding, Jun Chen, Yongsheng Gong, Jun Zhao
BACKGROUND: China is a high-incidence area of lung cancer, and its morbidity and mortality were the highest in malignant tumors. At present, the popularization of low-dose computed tomography (CT) examination has significantly improved the detection rate of early lung cancer, anatomical segmentectomy is currently widely used early in non-small cell lung cancer (NSCLC) and those who cannot tolerate lobectomy in patients with lung cancer. However, the anatomical structure of segment and its surgical operation is relatively complex, lead to segmentectomy has a high risk and difficulty...
September 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/28934987/lifestyle-precision-medicine-the-next-generation-in-type-2-diabetes-prevention
#17
REVIEW
Pascal M Mutie, Giuseppe N Giordano, Paul W Franks
The driving force behind the current global type 2 diabetes epidemic is insulin resistance in overweight and obese individuals. Dietary factors, physical inactivity, and sedentary behaviors are the major modifiable risk factors for obesity. Nevertheless, many overweight/obese people do not develop diabetes and lifestyle interventions focused on weight loss and diabetes prevention are often ineffective. Traditionally, chronically elevated blood glucose concentrations have been the hallmark of diabetes; however, many individuals will either remain 'prediabetic' or regress to normoglycemia...
September 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28934897/single-incision-versus-multiport-video-assisted-thoracoscopic-surgery-in-the-treatment-of-lung-cancer-a-systematic-review-and-meta-analysis
#18
Zhang Yang, Zhenghai Shen, Qinghua Zhou, Yunchao Huang
OBJECTIVES: Recent studies compared single-incision thoracoscopic surgery (SITS) with more widely used conventional multiport video-assisted thoracoscopic surgery in the treatment of lung cancer. To establish the safety and feasible of SITS in the treatment of lung cancer, we conducted this systematic review and meta-analysis. METHODS: Eleven studies were identified from the databases of PubMed, Cochrane Library, SpringerLink, and ScienceDirect. The randomized controlled trials (RCTs) and non-randomized studies evaluated the outcomes of SITS compared with multiport video-assisted thoracoscopic surgery in the treatment of lung cancer were included for analysis...
September 21, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28934888/influence-of-iliac-stenotic-lesions-on-blood-flow-patterns-near-a-covered-endovascular-reconstruction-of-the-aortic-bifurcation-cerab-stent-configuration
#19
Erik Groot Jebbink, Stefan Engelhard, Guillaume Lajoinie, Jean-Paul P M de Vries, Michel Versluis, Michel M P J Reijnen
PURPOSE: To investigate the effect of distal stenotic lesions on flow patterns near a covered endovascular reconstruction of the aortic bifurcation (CERAB) configuration used in the treatment of aortoiliac occlusive disease. METHOD: Laser particle image velocimetry measurements were performed using in vitro models of the aortic bifurcation with and without a CERAB configuration in place. A hemodynamically nonsignificant stenosis (ΔP: 9 mm Hg), a hemodynamically significant (ΔP: 26 mm Hg) stenosis, and a total occlusion were simulated in the left iliac arteries...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28934884/effect-of-a-rapidly-degrading-presolidified-10-kda-chitosan-blood-implant-and-subchondral-marrow-stimulation-surgical-approach-on-cartilage-resurfacing-in-a-sheep-model
#20
Angela D Bell, Mark B Hurtig, Eric Quenneville, Georges-Étienne Rivard, Caroline D Hoemann
Objective This study tested the hypothesis that presolidified chitosan-blood implants are retained in subchondral bone channels perforated in critical-size sheep cartilage defects, and promote bone repair and hyaline-like cartilage resurfacing versus blood implant. Design Cartilage defects (10 × 10 mm) with 3 bone channels (1 drill, 2 Jamshidi biopsy, 2 mm diameter), and 6 small microfracture holes were created bilaterally in n = 11 sheep knee medial condyles. In one knee, 10 kDa chitosan-NaCl/blood implant (presolidified using recombinant factor VIIa or tissue factor), was inserted into each drill and Jamshidi hole...
October 2017: Cartilage
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