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https://www.readbyqxmd.com/read/28748381/is-it-safe-to-perform-lumbar-spine-surgery-on-patients-over-eighty-five
#1
Houssam Bouloussa, Abdulmajeed Alzakri, Soufiane Ghailane, Claudio Vergari, Simon Mazas, Jean-Marc Vital, Pierre Coudert, Olivier Gille
PURPOSE: The purpose of this study was to evaluate the safety and tolerance of lumbar spine surgery in patients over 85. MATERIALS AND METHODS: Patients over 85 years of age with LSS who underwent decompression surgery with or without fusion between February 2011 and July 2014 were included. Comorbidities, autonomy (Activities of Daily Life and Braden scales), surgical parameters and complications (Clavien-Dindo classification) were collected. A telephone survey was performed to assess survival and patients' satisfaction at last follow-up...
July 26, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28748380/autologous-bone-marrow-concentrate-intradiscal-injection-for-the-treatment-of-degenerative-disc-disease-with-three-year-follow-up
#2
Kenneth A Pettine, Richard K Suzuki, Theodore T Sand, Matthew B Murphy
PURPOSE: The purpose of this study is to assess safety and feasibility of intradiscal bone marrow concentrate (BMC) injections to treat low back discogenic pain as an alternative to surgery with three year minimum follow-up. METHODS: A total of 26 patients suffering from degenerative disc disease and candidates for spinal fusion or total disc replacement surgery were injected with 2 ml autologous BMC into the nucleus pulposus of treated lumbar discs. A sample aliquot of BMC was characterized by flow cytometry and CFU-F assay to determine progenitor cell content...
July 26, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28746936/defining-standards-in-experimental-microsurgical-training-recommendations-of-the-european-society-for-surgical-research-essr-and-the-international-society-for-experimental-microsurgery-isem
#3
René H Tolba, Zoltán Czigány, Suzanne Osorio Lujan, Mihai Oltean, Michael Axelsson, Yelena Akelina, Antonio Di Cataldo, Iren Miko, Istvan Furka, Uta Dahmen, Eiji Kobayashi, Mihai Ionac, Norbert Nemeth
BACKGROUND: Expectations towards surgeons in modern surgical practice are extremely high with minimal complication rates and maximal patient safety as paramount objectives. Both of these aims are highly dependent on individual technical skills that require sustained, focused, and efficient training outside the clinical environment. At the same time, there is an increasing moral and ethical pressure to reduce the use of animals in research and training, which has fundamentally changed the practice of microsurgical training and research...
July 26, 2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/28746074/understanding-the-multidimensional-effects-of-resident-duty-hours-restrictions-a-thematic-analysis-of-published-viewpoints-in-surgery
#4
Katharine S Devitt, Michael J Kim, Lesley Gotlib Conn, Frances C Wright, Carol-Anne Moulton, Itay Keshet, Najma Ahmed
PURPOSE: Individuals representing various surgical disciplines have expressed concerns with the impact of resident duty hours (RDH) restrictions on resident education and patient outcomes. This thematic review of published viewpoints aimed to describe the effects of these restrictions in surgery. METHOD: The authors conducted a qualitative systematic review of non-research-based literature published between 2003 and 2015. Articles were included if they focused on the RDH restrictions in surgery and resident wellness, health promotion, resident safety, resident education and/or training, patient safety, medical errors, and/or heterogeneity regarding training or disciplines...
July 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28745701/-early-reconstruction-of-brachiocephalic-arteries-as-a-prevention-of-recurrent-ischemic-stroke
#5
A I Khripun, A V Salikov, A D Pryamikov, A B Mironkov, S A Asratyan, M V Abashin, V P Mikhailenko
AIM: To assess an efficacy and safety of brachiocephalic arteries reconstruction at the acute stage of stroke. MATERIAL AND METHODS: Early reconstruction of brachiocephalic arteries was made in 7 patients (mean age 67±9 years). Mean terms of brachiocephalic arteries reconstruction after stroke were 4.6 days (range 2-7 days). Pre- and postoperative neurological state was assessed by NIHSS score (mean preoperative score was 3.9±2.7 in these 7 patients, range 0-7)...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28745699/-sacral-resection-in-surgical-treatment-of-locally-advanced-primary-and-recurrent-rectal-and-anal-cancer-short-term-outcomes
#6
P V Tsarkov, S K Efetov, L V Sidorova, I A Tulina
AIM: To assess safety of rectum removal with distal sacral resection. MATERIAL AND METHODS: The short-term results of surgical treatment of primary and recurrent locally advanced rectal and anal cancer with sacral fixation have been analyzed. 32 patients underwent combined operations with sacral resection at the level of S2-S5. In 12 patients only one point of tumor fixation (F1) was revealed, 10 patients had two points of fixation (F2), three patients had three fixation points (F3) and in 7 cases the tumor was fixed to four points (F4) of fixation to different pelvic structures...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28745410/short-and-medium-term-outcomes-following-primary-ileocaecal-resection-for-crohn-s-disease-in-two-specialist-centres
#7
A de Buck van Overstraeten, E J Eshuis, S Vermeire, G Van Assche, M Ferrante, G R D'Haens, C Y Ponsioen, A Belmans, C J Buskens, A M Wolthuis, W A Bemelman, A D'Hoore
BACKGROUND: Despite improvements in medical therapy, the majority of patients with Crohn's disease still require surgery. The aim of this study was to report safety, and clinical and surgical recurrence rates, including predictors of recurrence, after ileocaecal resection for Crohn's disease. METHODS: This was a cohort analysis of consecutive patients undergoing a first ileocaecal resection for Crohn's disease between 1998 and 2013 at one of two specialist centres...
July 26, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28744975/factors-related-to-teamwork-performance-and-stress-of-operating-room-nurses
#8
Yukio Sonoda, Daisuke Onozuka, Akihito Hagihara
AIM: To evaluate operating room nurses' perception of teamwork performance and their level of mental stress and to identify related factors. BACKGROUND: Little is known about the factors affecting teamwork and the mental stress of surgical nurses, although the performance of the surgical team is essential for patient safety. METHODS: The questionnaire survey for operation room nurses consisted of simple questions about teamwork performance and mental stress...
July 25, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28744807/the-effectiveness-of-low-dose-and-high-dose-tranexamic-acid-in-posterior-lumbar-interbody-fusion-a-double-blinded-placebo-controlled-randomized-study
#9
Ki-Tack Kim, Cheung-Kue Kim, Yong-Chan Kim, Hyung-Suk Juh, Hyo-Jong Kim, Hyeon-Soo Kim, Se Jung Hong, Hwee Weng Dennis Hey
PURPOSE: Tranexamic acid is a proven drug used for reduction of intraoperative blood loss in spinal surgery. However, optimal dosing considering risk/benefits is not well established owing to the heterogeneity in patient selection and surgical procedures of previous studies. This study aimed to evaluate the effectiveness and safety of various tranexamic acid regimens in reducing perioperative blood loss in single-level posterior lumbar interbody fusion (PLIF). METHODS: Patients were randomly grouped into three different interventions: low-dose tranexamic acid (LD), high-dose tranexamic acid (HD), and placebo-controlled (PC) groups...
July 25, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28743227/suitability-of-a-7-f-exoseal-vascular-closure-device-for-femoral-artery-punctures-made-by-8-f-or-9-f-introducer-sheaths
#10
Shunsaku Goto, Tomotaka Ohshima, Kojiro Ishikawa, Taiki Yamamoto, Toshihisa Nishizawa, Shinji Shimato, Kyozo Kato
PURPOSE: To establish the safety and efficacy of the 7-F ExoSeal device for the closure of femoral puncture sites made by 8-F or 9-F introducer sheaths. METHODS: Between January 2013 and December 2016, 332 patients (mean age 68.4±12.1 years; 195 men) underwent neurointerventional procedures via percutaneous puncture of the common femoral artery and an 8-F (n=272, 81.9%) or 9-F (n=60, 18.1%) introducer. The access sites were sealed with a 7-F ExoSeal in all cases...
August 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28743147/-development-of-anaesthesia-related-mortality-and-impact-on-perioperative-outcome
#11
Peter Rosenberger, Berthold Drexler
Achievements in anaesthesiology form the basis for the tremendous development of surgical therapy. Reliable monitoring technology, which is scrutinized on a regular basis using checklists, is allowing anaesthesia at the borders of physiology. During the last decades, anaesthesia-related mortality has been decreasing considerably. Well-trained anaesthesiology staff, who considers patient- and procedure-specific risks in anaesthetic management, is of major importance. Furthermore, postoperative care in specialised units and intensive care wards is a key factor of improved patient outcome after surgery...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28742731/endoscopic-ultrasound-guided-portal-venous-access-diagnostic-and-therapeutic-implications
#12
Rajat Garg, Tarun Rustagi
Endoscopic ultrasound (EUS) has evolved from a purely diagnostic to an interventional modality offering minimally invasive alternatives to surgical and radiologic interventions. This has led to a rapidly growing interest in EUS-guided vascular interventions. EUS-guided portal venous access is an emerging technique which opens a new arena for interventional vascular EUS. Portal vein can be accessed under EUS guidance with high precision and low risk of complications thus expanding its application for both benign and malignant conditions...
July 24, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28742116/sutureless-microvascular-anastomosis-assisted-by-an-expandable-shape-memory-alloy-stent
#13
Noriko Saegusa, Shunji Sarukawa, Kunihiro Ohta, Kensuke Takamatsu, Mitsuhiro Watanabe, Takashi Sugino, Masahiro Nakagawa, Yasuto Akiyama, Masatoshi Kusuhara, Kazuo Kishi, Keita Inoue
Vascular anastomosis is the highlight of cardiovascular, transplant, and reconstructive surgery, which has long been performed by hand using a needle and suture. However, anastomotic thrombosis occurs in approximately 0.5-10% of cases, which can cause serious complications. To improve the surgical outcomes, attempts to develop devices for vascular anastomosis have been made, but they have had limitations in handling, cost, patency rate, and strength at the anastomotic site. Recently, indwelling metal stents have been greatly improved with precise laser metalwork through programming technology...
2017: PloS One
https://www.readbyqxmd.com/read/28741303/open-retropubic-colposuspension-for-urinary-incontinence-in-women
#14
REVIEW
Marie Carmela M Lapitan, June D Cody, Atefeh Mashayekhi
BACKGROUND: Urinary incontinence is a common and potentially debilitating problem. Stress urinary, incontinence as the most common type of incontinence, imposes significant health and economic burdens on society and the women affected. Open retropubic colposuspension is a surgical treatment which involves lifting the tissues near the bladder neck and proximal urethra in the area behind the anterior pubic bones to correct deficient urethral closure to correct stress urinary incontinence...
July 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28741196/how-safe-is-performing-cholecystectomy-in-the-oldest-old-a-15-year-retrospective-study-from-a-single-institution
#15
Matteo Novello, Davide Gori, Salomone Di Saverio, Matteo Bianchin, Lorenzo Maestri, Francesco Vito Mandarino, Giuseppe Cavallari, Bruno Nardo
BACKGROUND: Globally, the number of people aged 80 years or over, the "oldest old," is the fastest growing population group. Because of the strong association between age and gallstone disease, both prevalence and incidence of this disease are increasing. The feasibility of the cholecystectomy in octogenarians has been evaluated in several studies that confirmed the safety of the operation. However, the safety of this procedure in nonagenarians is still controversial. The aim of this study was to evaluate the safety of cholecystectomies in nonagenarians and identify related predictors for postoperative hospital length of stay (LOS) and in-hospital mortality up to 30 days postoperatively...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28740773/botulinum-toxin-a-as-an-adjunct-to-abdominal-wall-reconstruction-for-incisional-hernia
#16
Sinor Soltanizadeh, Frederik Helgstrand, Lars N Jorgensen
BACKGROUND: Repair of large incisional hernias remains a surgical and costly challenge. Temporary paralysis of the lateral abdominal wall muscles with topical administration of botulinum toxin A (BTA) is a new therapeutic concept, which may obviate the need for component separation technique (CST) for repair of large incisional hernias. Current literature on the administration of BTA as adjunct to surgical repair of abdominal incisional hernias was investigated. METHODS: The electronic databases PubMed and Embase were searched for eligible studies...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740682/combined-analgesic-treatment-of-epidural-and-paravertebral-block-after-thoracic-surgery
#17
Yujiro Yokoyama, Takahiro Nakagomi, Daichi Shikata, Taichiro Goto
In pulmonary surgical practice, appropriate pain management after thoracotomy is essential for patient recovery and the prevention of complications. Although epidural analgesia (EPI) has been established for chest surgery, it has some limitations and contraindications. Recently, paravertebral block (PVB) was reported as a good alternative method with fewer side effects. Despite the significant effects of these two treatments, postoperative pain remains among the greatest patient burdens. In our institution, we apply a combination of epidural and PVBs after thoracic surgery to reduce pain more effectively...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740675/feasibility-of-four-arm-robotic-lobectomy-as-solo-surgery-in-patients-with-clinical-stage-i-lung-cancer
#18
Seong Yong Park, Jee Won Suh, Kyoung Sik Narm, Chang Young Lee, Jin Gu Lee, Hyo Chae Paik, Kyoung Young Chung, Dae Joon Kim
BACKGROUND: This study was performed to investigate the feasibility of four-arm robotic lobectomy (FARL) as a solo surgical technique in patients with non-small cell lung cancer (NSCLC). Early outcome and long-term survival of FARL were compared with those of video-assisted thoracoscopic lobectomy (VATL). METHODS: Prospective enrollment of patients with clinical stage I NSCLC undergoing FARL or VATL (20 patients in each group) was planned. Interim analysis for early postoperative outcome was performed after the initial 10 cases in each group...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740417/efficacy-and-safety-of-0-75-ropivacaine-instillation-into-subinguinal-wound-in-patients-after-bilateral-microsurgical-varicocelectomy-a-bi-center-randomized-double-blind-placebo-controlled-trial
#19
Wan Shou Cui, Yu Seob Shin, Jae Hyung You, A Ram Doo, Kiran Kumar Soni, Jong Kwan Park
OBJECTIVE: To evaluate the efficacy and safety of 0.75% ropivacaine instillation into inguinal wound in patients who have undergone bilateral microsurgical varicocelectomy. PATIENTS AND METHODS: Eighty-five men who were screened for bilateral varicoceles from March 2015 to July 2016 were randomized for the treatment. All patients underwent inguinal varicocelectomy by general anesthesia. After ligation of the internal spermatic veins from the spermatic cord, additional delivery of testis through inguinal incision site was done to ligate external spermatic veins and gubernacular veins...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28740261/sustained-efficacy-of-closed-loop-electrical-stimulation-for-long-term-treatment-of-absence-epilepsy-in-rats
#20
Gábor Kozák, Antal Berényi
Closed-loop brain stimulation is a promising alternative to treat drug-resistant epilepsies. In contrast to optogenetic interventions, transcranial electrical stimulation (TES) does not require cellular modification of neurons to be effective, and it is less invasive compared to deep brain stimulation. Furthermore, on-demand TES of targeted brain regions allows the potential for normal function of these networks during interictal periods, a possibility that is eliminated by resective surgical treatment approaches...
July 24, 2017: Scientific Reports
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