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https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#1
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27900328/blunt-traumatic-tension-chylothorax-case-report-and-mini-review-of-the-literature
#2
Kamal Idris, Michael Sebastian, Ashraf F Hefny, Navidul Haq Khan, Fikri M Abu-Zidan
Tension chylothorax following blunt thoracic trauma is an extremely rare condition. Here we report such a case and review its management. A 31-year-old man was involved in a road traffic collision. The car rolled over and the patient was ejected from the vehicle. On arrival at the Emergency Department the patient was conscious and haemodynamically stable. Clinical examination of the chest and abdomen was normal. The patient had sustained fractures of the sixth cervical vertebra and the tenth thoracic vertebra, left pleural effusion, haematoma around the descending aorta and fracture of the right clavicle...
November 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27899541/subinterlobular-pleural-location-is-a-risk-factor-for-pneumothorax-after-bronchoscopy
#3
Haruka Chino, Motoyasu Iikura, Nayuta Saito, Nahoko Sato, Manabu Suzuki, Satoru Ishii, Eriko Morino, Go Naka, Jin Takasaki, Shinyu Izumi, Masayuki Hojo, Yuichiro Takeda, Haruhito Sugiyama
BACKGROUND: Pneumothorax is one of the most important complications after bronchoscopy. This study was conducted to determine the risk factors for post-bronchoscopy pneumothorax. METHODS: We retrospectively reviewed the medical records of 23 consecutive subjects who were diagnosed with iatrogenic pneumothorax after bronchoscopy between August 2010 and February 2014. Forty-six control subjects who did not develop pneumothorax after bronchoscopy were randomly selected...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27898253/establishing-equipoise-national-survey-of-the-treatment-of-pediatric-para-pneumonic-effusion-and-empyema
#4
Morgan K Richards, Jarod P Mcateer, Todd C Edwards, Lucas R Hoffman, Matthew P Kronman, Dennis W Shaw, Adam B Goldin
BACKGROUND: Despite six randomized trials of various treatments for pediatric para-pneumonic effusion (PPE), management approaches differ. The purpose of this study was to gain insight into opinions on PPE treatment with the goal of designing a definitive trial to generate consensus intervention guidelines. METHODS: To evaluate physician opinions regarding PPE management, we developed a survey based on input from a nationwide, multi-disciplinary advisory group that established content validity...
November 29, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27894764/thoracoscopic-bilateral-t3-sympathectomy-for-primary-focal-hyperhidrosis-in-children
#5
Pablo Laje, Kali Rhodes, Leanne Magee, Mary Kate Klarich
AIM OF THE STUDY: Present our experience in the surgical treatment of primary focal hyperhidrosis of the hands by thoracoscopic bilateral T3 sympathectomy in pediatric patients. METHODS: Retrospective chart review of all patients operated between 2013 and 2015. RESULTS: We operated and included in the study 28 patients, 22 females and 6 males. Mean age was 14 (6-21) years. All patients had previously tried at least one form of medical therapy with no success...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27894759/pancreaticoduodenectomy-for-pediatric-and-adolescent-pancreatic-malignancy-a-single-center-retrospective-analysis
#6
Erika B Lindholm, Abdulaziz K Alkattan, Sara J Abramson, Anita P Price, Todd E Heaton, Vinod P Balachandran, Michael P La Quaglia
PURPOSE: While pancreaticoduodenectomy (PD) has been extensively studied in adults, there are few data pertaining specifically to pediatric patients. We retrospectively analyzed PD-associated morbidity and mortality in pediatric patients. METHODS: Our analytic cohort included all consecutive patients ≤18years of age treated at our institution from 1993 to 2015 who underwent PD. Patient data (demographics, disease characteristics, surgical and adjuvant treatment, length of hospital stay, and postoperative course) were extracted from the medical records...
November 16, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27890654/sublobectomy-versus-lobectomy-for-stage-i-non-small-cell-lung-cancer-in-the-elderly
#7
Chen Qiu, Guanghui Wang, Jun Xu, Lixuan Cui, Wei Dong, Yang Ni, Xiao Qu, Jiajun Du
OBJECTIVE: The aim of our study was to compare the operative characteristics and long term survival for elderly patients with stage I non-small cell lung cancer (NSCLC) who underwent sublobectomy versus lobectomy. METHODS: We identified 245 consecutive elderly patients (≥65y) with pathologic stage I NSCLC who underwent lobectomy or sublobectomy at our institution between 2006 and 2012, and assessed the operative characteristics, recurrence, and survival differences between these approaches...
November 24, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27889066/does-thoracoscopy-have-advantages-over-open-surgery-for-asymptomatic-congenital-lung-malformations-an-analysis-of-1626-resections
#8
Stephen Adams, Matthew Jobson, Patarawan Sangnawakij, Adam Heetun, Anthony Thaventhiran, Navroop Johal, Dankmar Böhning, Michael P Stanton
AIM: The apparent incidence of antenatally diagnosed congenital lung malformations (CLM) is rising (1 in 3000), and the majority undergo elective resection even if asymptomatic. Thoracoscopy has been popularized, but early series report high conversion rates and significant complications. We aimed to perform systematic review/meta-analysis of outcomes of thoracoscopic vs open excision of asymptomatic CLMs. METHODS: A systematic review according to PRISMA guidelines was performed...
November 13, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27886021/revision-of-orthovoltage-chest-wall-treatment-by-monte-carlo-simulations
#9
R Faghihi, B Zeinali-Rafsanjani, M A Mosleh-Shirazi, A Mosalaei, K Hadad
PURPOSE: Given the high local control rates observed in breast cancer patients undergoing chest wall irradiation by kilovoltage x-rays, we aimed to revisit this treatment modality by accurate calculation of dose distributions using Monte Carlo simulation. METHODS AND MATERIAL: The machine components were simulated using the MCNPX code. This model was used to assess the dose distribution of chest wall kilovoltage treatment in different chest wall thicknesses and larger contour or fat patients in standard and mid sternum treatment plans...
November 18, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/27884332/thoracostomy-tube-function-not-trajectory-dictates-reintervention
#10
Nathan W Kugler, Thomas W Carver, Paul Knechtges, David Milia, Lawrence Goodman, Jasmeet S Paul
BACKGROUND: Hemothorax and/or pneumothorax can be managed successfully managed with tube thoracostomy (TT) in the majority of cases. Improperly placed tubes are common with rates near 30%. This study aimed to determine whether TT trajectory affects the rate of secondary intervention. METHODS: A retrospective review of all adult trauma patients undergoing TT placement over a 4-y period was performed. TT trajectory was classified as ideal, nonideal, or kinked-based on anterior-posterior chest x-ray...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27882084/staged-bilateral-single-port-thoracoscopic-lung-volume-reduction-surgery-a-report-of-11-cases
#11
Miao Zhang, Heng Wang, Xue-Feng Pan, Wen-Bin Wu, Hui Zhang
The aim of the present study was to investigate the feasibility and efficacy of staged bilateral single-port thoracoscopic lung volume reduction surgery (LVRS) for patients with chronic obstructive pulmonary emphysema (COPE). Eleven male patients with a mean age of 60.27±12.11 years with bilateral COPE and bullae were admitted to the Department of Thoracic Surgery, Xuzhou Central Hospital from January 2013 to June 2014. The patients underwent staged bilateral single-port thoracoscopic LVRS. The hyperinflated bullae were resected using endoscopic staplers (Endo-GIA), followed by continuous suture and biological glue for reinforcement of the margin...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27881590/pyopneumothorax-secondary-to-streptococcus-milleri-infection
#12
Mohd Jazman Che Rahim, Nurashikin Mohammad, Wan Syamimee Wan Ghazali
We report a case of a 46-year-old Malay woman with underlying hypothyroidism post thyroidectomy who presented with worsening breathlessness, orthopnoea, productive cough and left-sided pleuritic chest pain of 3 days duration. Chest X-ray on admission showed left-sided massive hydropneumothorax. Pleural tapping revealed empyema. A chest tube was inserted immediately. The culture of pleural fluid grew Streptococcus constellatus The patient was treated with antibiotics for a total of 6 weeks and underwent open thoracotomy and decortication during admission...
November 23, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27878479/total-transthoracic-approach-facilitates-laparoscopic-hepatic-resection-in-patients-with-significant-prior-abdominal-surgery
#13
Suguru Yamashita, Evelyne Loyer, Hyunseon C Kang, Thomas A Aloia, Yun Shin Chun, Reza J Mehran, Cathy Eng, Jeffrey E Lee, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: While the oncologic safety of minimally invasive hepatectomy for colorectal liver metastases (CLM) has been demonstrated, lesions in the postero-superior segments may be challenging.1 (-) 3 For these lesions, a transthoracic approach may be particularly helpful, especially in patients with a hostile/reoperative abdomen or morbid obesity.4 (,) 5 PATIENT: A 43-year-old man with a body mass index of 36.0 who had undergone rectosigmoid resection for primary cancer 5 years ago recurred with a solitary liver metastasis in SVIII...
November 22, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27873512/antimicrobial-resistance-and-clinical-outcomes-in-nursing-home-acquired-pneumonia-compared-to-community-acquired-pneumonia
#14
Yun Seong Kang, Soo Ryeong Ryoo, Seung Joo Byun, Yun Jeong Jeong, Jin Young Oh, Young Soon Yoon
PURPOSE: Patients with nursing home-acquired pneumonia (NHAP) should be treated as hospital-acquired pneumonia (HAP) according to guidelines published in 2005. However, controversy still exists on whether the high mortality of NHAP results from multidrug resistant pathogens or underlying disease. We aimed to outline differences and factors contributing to mortality between NHAP and community-acquired pneumonia (CAP) patients. MATERIALS AND METHODS: We retrospectively evaluated patients aged 65 years or older with either CAP or NHAP from 2008 to 2014...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27870824/efficacy-of-a-dehydrated-hydrogel-plug-to-reduce-complications-associated-with-computed-tomography-guided-percutaneous-transthoracic-needle-biopsy
#15
Rolf A Grage, Muhammad A Naveed, Shane Keogh, Dongliang Wang
PURPOSE: The aim of the study was to determine whether a hydrogel plug, when placed in the needle tract after a computed tomography-guided percutaneous transthoracic needle lung biopsy, reduces the rate of complications. MATERIALS AND METHODS: This retrospective analysis included biopsies of lung lesions from 200 consecutive patients. The first 100 consecutive biopsies made up the control group, in which no plug intervention was used. The next 100 consecutive biopsies made up the treatment group, in which a hydrogel plug was deployed through a 19-G coaxial needle system after 20-G core samples were obtained...
November 18, 2016: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/27867569/does-11-5-mm-guided-single-port-surgery-has-clinical-advantage-than-multi-port-thoracoscopic-surgery-in-spontaneous-pneumothorax
#16
Hyun Woo Jeon, Young-Du Kim
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) has been widely used for spontaneous pneumothorax (SP). In recent years, thoracic surgeons have attempted single incision or single port surgery with the development of surgical technology and skills. Theoretically, single port surgery is expected to provide benefits such as less pain and early recovery. The purpose of this study was to determine the benefits of single port surgery in SP. METHODS: The 107 patients with SP who underwent surgery, between July 2013 and May 2015, were reviewed retrospectively...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867567/influence-of-old-pulmonary-tuberculosis-on-the-management-of-secondary-spontaneous-pneumothorax-in-patients-over-the-age-of-70-years
#17
Sang Cjeol Lee, Deok Heon Lee
BACKGROUND: This study aimed to investigate the treatment outcomes and influence of old pulmonary tuberculosis (TB) in elderly patients (over 70 years) with secondary spontaneous pneumothorax (SSP). METHODS: A retrospective analysis was performed on patients with SSP between January 2002 and December 2014. Treatment outcomes including chest tube duration (CTD), type and complication of surgery, recurrence and survival rate were obtained from the review of medical records and analyzed statistically...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27866545/-value-of-low-dose-multi-slice-spiral-ct-chest-scan-in-diagnosis-of-coal-workers-pneumoconiosis
#18
P Du, A H Cao, Z W Guo, Q Shao, K Xu
Objective: To investigate the value of low-dose multi-slice CT (MSCT) chest scan in the diagnosis of coal workers' pneumoconiosis. Methods: A total of 90 patients with a confirmed diagnosis of coal workers' pneumoconiosis were enrolled, and under the conditions of fixed tube voltage, pitch, and slice thickness, they underwent CT scan with a normal dose (150 mA) and a low dose (30-50 mA). The quality of images obtained from two scans was compared, and the imaging findings, opacity profusion, stage, and radiation doses were also compared...
September 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/27866276/manual-intrapleural-saline-flushing-plus-urokinase-a-potentially-useful-therapy-for-complicated-parapneumonic-effusions-and-empyemas
#19
José M Porcel, Horacio Valencia, Silvia Bielsa
PURPOSE: We sought to evaluate the safety profile and effectiveness of manual pleural saline flushing, in addition to urokinase, for managing complicated parapneumonic effusions and empyemas. METHODS: Retrospective comparative review of 23 consecutive patients with complicated parapneumonic effusions or empyemas who received saline flushing plus urokinase through small-bore chest catheters, and 39 who were only treated with fibrinolytics. Both groups had similar baseline characteristics and treatments were mostly protocol-driven...
November 19, 2016: Lung
https://www.readbyqxmd.com/read/27865474/tubeless-uniportal-thoracoscopic-wedge-resection-for-peripheral-lung-nodules
#20
Shun-Mao Yang, Man-Ling Wang, Ming-Hui Hung, Hsao-Hsun Hsu, Ya-Jung Cheng, Jin-Shing Chen
BACKGROUND: Endotracheal intubation and chest tube drainage are considered mandatory for thoracoscopic pulmonary resection. The management of peripheral lung nodules by tubeless uniportal thoracoscopic surgical repair has not been reported previously. METHODS: From October 2015 through January 2016, 30 consecutive patients with peripheral lung nodules underwent uniportal thoracoscopic wedge resection without endotracheal intubation and chest tube drainage (tubeless group)...
November 16, 2016: Annals of Thoracic Surgery
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