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https://www.readbyqxmd.com/read/29150698/surgical-techniques-for-left-atrial-appendage-exclusion
#1
REVIEW
Sacha P Salzberg, Maximilian Y Emmert, Etem Caliskan
The increasing prevalence of atrial fibrillation with the aging population and its associated major morbidity and mortality due to thromboembolic stroke have resulted in intensive research on stroke prevention or stroke risk reduction strategies. Several surgical techniques for left atrial appendage (LAA) occlusion have evolved over the past decades. Surgeons have been using different techniques leading to highly variable and, in particular, poor data on outcomes. LAA closure is performed either as a concomitant procedure during open-heart surgery or as a stand-alone surgical procedure as part of minimally invasive (mini-thoracotomy or thoracoscopy) arrhythmia surgery...
November 17, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29150478/early-versus-late-application-of-subthalamic-deep-brain-stimulation-to-parkinson-s-disease-patients-with-motor-complications-elass-protocol-of-a-multicentre-prospective-and-observational-study
#2
Lulu Jiang, Wai Sang Poon, Elena Moro, Wenbiao Xian, Chao Yang, Xian Lun Zhu, Jing Gu, Xiaodong Cai, Jinlong Liu, Vincent Mok, Yanmei Liu, Shaohua Xu, Qiyu Guo, Wanru Chen, Ling Chen
INTRODUCTION: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established surgical treatment for Parkinson's disease (PD). However, there is currently no consensus on the best timing for this surgery. The aim of our study is to compare the therapeutic efficacy of bilateral STN DBS in patients with PD with early and late motor complications. METHODS AND ANALYSIS: 200 patients with PD will be enrolled in this multicentre, prospective, observational study, and will be followed up for 4 years...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150394/efficacy-of-prostatic-artery-embolization-for-catheter-dependent-patients-with-large-prostate-sizes-and-high-comorbidity-scores
#3
Shivank Bhatia, Vishal K Sinha, Bruce R Kava, Christopher Gomez, Sardis Harward, Sanoj Punnen, Issam Kably, Jeffrey Miller, Dipen J Parekh
PURPOSE: To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter-dependent patients with large prostate volumes and high comorbidity scores. MATERIALS AND METHODS: A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48-94 y), age-adjusted Charlson comorbidity index was 4.5 (0-10), duration of urinary retention was 63...
November 15, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29149880/analytical-performance-of-envisia-a-genomic-classifier-for-usual-interstitial-pneumonia
#4
Yoonha Choi, Jiayi Lu, Zhanzhi Hu, Daniel G Pankratz, Huimin Jiang, Manqiu Cao, Cristina Marchisano, Jennifer Huiras, Grazyna Fedorowicz, Mei G Wong, Jessica R Anderson, Edward Y Tom, Joshua Babiarz, Urooj Imtiaz, Neil M Barth, P Sean Walsh, Giulia C Kennedy, Jing Huang
BACKGROUND: Clinical guidelines specify that diagnosis of interstitial pulmonary fibrosis (IPF) requires identification of usual interstitial pneumonia (UIP) pattern. While UIP can be identified by high resolution CT of the chest, the results are often inconclusive, making surgical lung biopsy necessary to reach a definitive diagnosis (Raghu et al., Am J Respir Crit Care Med 183(6):788-824, 2011). The Envisia genomic classifier differentiates UIP from non-UIP pathology in transbronchial biopsies (TBB), potentially allowing patients to avoid an invasive procedure (Brown et al...
November 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#5
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29149164/-osservare-project-direct-observation-of-use-of-the-safety-surgery-checklist-in-the-operating-room
#6
Roberto Bentivegna, Annita Caminati, Vanni Agnoletti, Stefano Bonilauri, Stefania Buonaccorso, Giovanna Campaniello, Antonella Dovani, Giuseppina Lanciotti, Vania Maselli, Stefano Mastrangelo, Maria Teresa Montella, Teresa Palladino, Cristiano Pelati, Lorenzo Sciolino, Evita Zoni, Elisa Porcu, Anselmo Campagna, Ottavio Nicastro
INTRODUCTION: Safety Surgery CheckList (SSCL) is a support tool for operating teams, used to carry out safety checks while also encouraging compliance with the implementation of recommended quality and safety standards. In Emilia-Romagna it was deemed appropriate to check actual surgical team compliance with correct checklist application in the operating theatre, through a project called "OssERvare". METHODS: Direct observation was identified as the preferred inspection method...
November 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29149150/the-hopeless-case-palliative-cryoablation-and-cementoplasty-procedures-for-palliation-of-large-pelvic-bone-metastases
#7
Tyler M Coupal, Kevin Pennycooke, Paul I Mallinson, Hugue A Ouellette, Paul W Clarkson, Pippa Hawley, Peter L Munk
BACKGROUND: Metastases to the bone are common in cancer patients, and it has been estimated that up to 50% of patients with pelvic bone metastases will not achieve adequate pain control with medications alone. This has led to a paradigm shift over recent years towards the use and development of minimally invasive image-guided treatment options for palliation of bony metastases. Despite these developments, large metastatic lesions are still often considered to be "hopeless cases" that would garner little to no benefit from image-guided intervention...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149140/optimization-of-postoperative-intravenous-patient-controlled-analgesia-with-opioid-dexmedetomidine-combinations-an-updated-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#8
Ke Peng, Juan Zhang, Xiao-Wen Meng, Hua-Yue Liu, Fu-Hai Ji
BACKGROUND: It is still a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. OBJECTIVES: The aim of this study is to assess the efficacy and safety of opioid-DEX combinations for postoperative PCA, and a trial sequential analysis (TSA) is utilized to evaluate the robustness of the current evidence. STUDY DESIGN: A systematic review and meta-analysis...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148922/feasibility-and-safety-of-using-thoracic-and-lumbar-cortical-bone-trajectory-pedicle-screws-in-spinal-constructs-in-children-technical-note
#9
Jonathan N Sellin, Jeffrey S Raskin, Kristen A Staggers, Alison Brayton, Valentina Briceño, Amee J Moreno, Andrew Jea
Thoracic and lumbar cortical bone trajectory pedicle screws have been described in adult spine surgery. They have likewise been described in pediatric CT-based morphometric studies; however, clinical experience in the pediatric age group is limited. The authors here describe the use of cortical bone trajectory pedicle screws in posterior instrumented spinal fusions from the upper thoracic to the lumbar spine in 12 children. This dedicated study represents the initial use of cortical screws in pediatric spine surgery...
November 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29148009/preoperative-ultrasound-for-runoff-venous-decompression-of-peripheral-nerves-for-arteriovenous-access-related-pain-in-the-upper-limb
#10
Hiroaki Matsuda, Yoshinari Oka, Ryuichi Yoshida, Yuki Katsura, Hidemi Takeuchi, Yasuo Fujimoto, Shigeko Takatsu, Masashi Miyazaki
INTRODUCTION: Arteriovenous access (AVA)-related pain treated successfully with runoff-venous decompression of the causative nerve, following ultrasound (US)-assisted preoperative evaluation, has never been reported. CASE PRESENTATION: A 57-year-old man suffering from constant exhausting pains along the outflow cephalic vein of the radiocephalic arteriovenous fistula at the wrist and the antecubital fossa, was treated surgically after the diagnosis of AVA-related pain derived from cephalic vein compression on two peripheral cutaneous nerves, the superficial radial nerve (SRN) and the lateral antebrachial cutaneous nerve (LACN)...
November 9, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29147809/application-of-actuator-driven-pulsed-water-jet-for-coronary-artery-bypass-grafting-assessment-in-a-swine-model
#11
Tomoyuki Suzuki, Shunsuke Kawamoto, Atsuhiro Nakagawa, Toshiki Endo, Teiji Tominaga, Masatoshi Akiyama, Osamu Adachi, Kiichiro Kumagai, Yoshikatsu Saiki
Actuator-driven pulsed water-jet (ADPJ) dissection is an emerging surgical method for dissecting tissue without heat and mechanical injury to vessels. We elucidated the mechanical properties of the piezo ADPJ and evaluated its usefulness and safety in coronary artery bypass grafting procedures. The relationship between the input voltage (10-100 V) and peak pressure of the pulsed water jet was evaluated. The tissue strengths of swine internal thoracic and coronary arteries and the surrounding tissues were measured to assure tissue-selective dissection...
November 16, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29147773/extraperitoneal-sigmoidostomy-a-surgical-approach-with-less-complications-and-better-functions-for-abdominoperineal-resection-of-rectal-cancer
#12
Peng Wang, Jianwei Liang, Haitao Zhou, Zheng Wang, Lei Shi, Zhixiang Zhou
OBJECTIVE: The aim of this study is to explore the safety and function of extraperitoneal sigmoidostomy for patients with rectal cancer who underwent abdominoperineal resection. METHODS: We systematically reviewed records of patients with rectal cancer who underwent abdominoperineal resection and extraperitoneal or intraperitoneal sigmoidostomy from January 2010 to December 2014 at our department. They were grouped into the extraperitoneal (group A) and intraperitoneal sigmoidostomy (group B) groups...
November 16, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29146758/non-aesthetic-indications-for-periocular-hyaluronic-acid-filler-treatment-a-review
#13
REVIEW
Petrina Tan, Tsong Qiang Kwong, Raman Malhotra
Dermal fillers have been in use for many years for aesthetic rejuvenation of the face. More recently, however, fillers have been increasingly used as an alternative to traditional surgical procedures for non-aesthetic indications. These indications include lagophthalmos, eyelid malpositions and orbital volume deficiency. The advantages of these filler injections are multiple: minimally invasive, repeatable, titratable and even reversible (depending on the product used). We review the current literature of functional uses of filler injections as mentioned above and evaluate the safety profile and efficacy of filler injections for this purpose...
November 16, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29146413/ct-fluoroscopy-guided-core-needle-biopsy-of-anterior-mediastinal-masses
#14
T Iguchi, T Hiraki, Y Matsui, H Fujiwara, J Sakurai, Y Masaoka, M Uka, T Tanaka, H Gobara, S Kanazawa
OBJECTIVE: To retrospectively evaluate the safety, diagnostic yield, and risk factors of diagnostic failure of computed tomography (CT) fluoroscopy-guided biopsies of anterior mediastinal masses. MATERIALS AND METHODS: Biopsy procedures and results of anterior mediastinal masses in 71 patients (32 women/39 men; mean [±standard deviation] age, 53.8±20.0years; range, 14-88years) were analyzed. Final diagnoses were based on surgical outcomes, imaging findings, or clinical follow-up findings...
November 13, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29146307/long-term-visual-outcomes-and-safety-profile-of-27-gauge-pars-plana-vitrectomy-for-posterior-segment-disease
#15
M Ali Khan, Alexander Kuley, Christopher D Riemann, Maria H Berrocal, Rohit R Lakhanpal, Jason Hsu, Arunan Sivalingam, Allen C Ho, Carl D Regillo
PURPOSE: To report longer-term outcomes of 27-gauge pars plana vitrectomy (PPV) in eyes with posterior segment disease. DESIGN: Multicenter, retrospective, interventional case series. PARTICIPANTS: A total of 390 eyes of 360 patients undergoing 27-gauge PPV for a vitreoretinal surgery indication. INTERVENTION: Three-port, transconjunctival, 27-gauge PPV. MAIN OUTCOME MEASURES: Change in visual acuity (VA) and occurrence of intraoperative and postoperative complications with a minimum follow-up of 365 days...
November 13, 2017: Ophthalmology
https://www.readbyqxmd.com/read/29145984/outpatient-pediatric-orthopedic-surgery
#16
REVIEW
Daniel J Miller, Susan E Nelson, Apurva S Shah, Theodore J Ganley, John Jack M Flynn
Outpatient surgery refers to a surgical procedure that is performed without an overnight stay in a hospital. Outpatient surgery is associated with decreased individual and societal costs while achieving equivalent health outcomes and excellent patient satisfaction. Successful outpatient pediatric surgery is predicated on appropriate patient selection, adequate pain control, thorough preoperative education, and close clinical follow-up. Continuous research in quality, value, and patient safety are needed to ensure that this practice continues in as safe and efficient a manner as possible...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29144717/review-of-non-invasive-vagus-nerve-stimulation-gammacore-efficacy-safety-potential-impact-on-comorbidities-and-economic-burden-for-episodic-and-chronic-cluster-headache
#17
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
The FDA has cleared gammaCore (non-invasive vagus nerve stimulator [nVNS]) for the treatment of episodic cluster headache (eCH). With the exception of subcutaneous sumatriptan, all other treatments are used off label and have many limitations. The FDA approval process for devices differs from that of drugs. We performed a review of the literature to evaluate new evidence on various aspects of gammaCore treatment and impact. The ACute Treatment of Cluster Headache Studies (ACT1 and ACT2), both double-blind sham-controlled randomized trials, did not meet the primary endpoints of the trials but each demonstrated significant superiority of gammaCore among patients with eCH...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29143168/limited-influence-of-blunt-aortic-injuries-on-the-outcome-of-polytraumatized-patients-a-matched-pair-analysis
#18
A Omar, C Macke, M Winkelmann, E Beckmann, P Mommsen, C Schröter, C Krettek, Christian Zeckey
INTRODUCTION: Traumatic lesions of great vessels such as the aorta are life-threatening injuries. There is limited evidence about the influence of traumatic aortic injuries in multiple trauma patients in particular with regard to posttraumatic complications. The aim of this study was to evaluate the influence of blunt thoracic aortic injuries in multiple trauma patients compared to a multiple trauma cohort without this specific injury. In addition, the safety of Thoracic Endovascular Aortic Repair (TEVAR) in multiple trauma patients was analyzed...
November 15, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29142601/application-of-spontaneously-closing-cannula-ileostomy-in-laparoscopic-anterior-resection-of-rectal-cancer
#19
Dong Chen, Huiying Zhao, Qiang Huang, Xiangming Xu, Xiaofei Cheng, Bingxin Ke, Danyang Wang, Hanju Hua, Jiahe Xu, Jianjiang Lin, Feng Ye
An anastomotic leak (AL) is the most serious complication observed in laparoscopic anterior resection of rectal cancer (LARRC). In order to protect anastomosis from AL and avoid stoma reversal surgery in patients with ileostomy, spontaneously closing cannula ileostomy (SCCI) was used in LARRC and its safety and feasibility were assessed in the present study. To the best of our knowledge, this is the first time that SCCI has been used in such a case. A total of 41 patients who underwent LARRC with SCCI or ileostomy procedures between November 2013 and August 2014 were retrospectively analyzed...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29142550/clinical-outcome-of-23g-trans-conjunctival-pars-plana-vitrectomy-a-prospective-comparison-of-phaco-vitrectomy-with-only-vitrectomy-in-phakic-eyes
#20
Haroon Tayyab, Asad Aslam Khan, Rana Muhammad Mohsin Javaid
Objective: To evaluate the effectiveness and safety profile of combined phacoemulsification with 23G pars plana vitrectomy when compared to pars plana vitrectomy alone in phakic patients. Methods: This study was performed at Al-Ehsan Eye Hospital (tertiary care eye hospital in Lahore, Pakistan) from January 2016 to August 2016. A total of 40 eyes in two equal groups of 20 eyes each, were enrolled in this prospective study. Group-A underwent combined phaco-vitrectomy, whereas Group-B underwent vitrectomy only for various vitreoretinal pathologies...
September 2017: Pakistan Journal of Medical Sciences Quarterly
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