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https://www.readbyqxmd.com/read/28445897/adrenal-vein-catecholamine-levels-and-ratios-reference-intervals-derived-from-patients-with-primary-aldosteronism
#1
Candy W C Sze, Samuel Matthew O'Toole, Roger Kent Tirador, Scott A Akker, Matthew Matson, Leslie Perry, Maralyn Rose Druce, Tanja Dekkers, Jaap Deinum, Jacques W M Lenders, Graeme Eisenhofer, William Martyn Drake
Phaeochromocytoma localisation is generally reliably achieved with modern imaging techniques, particularly in sporadic cases. On occasion, however, there can be diagnostic doubt due to the presence of bilateral adrenal abnormalities, particularly in patients with mutations in genes predisposing them to the development of multiple phaeochromocytomas. In such cases, surgical intervention is ideally limited to large or functional lesions due to the long-term consequences associated with hypoadrenalism. Adrenal venous sampling (AVS) for catecholamines has been used in this situation to guide surgery, although there are few data available to support diagnostic thresholds...
April 26, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28445869/silicone-oil-related-visual-loss
#2
Hamouda Hamdy Ghoraba, Adel Galal Zaky, Mohamed Amin Heikal, Emad Eldin Mohamed Elgemai, Haithem Mamoun Abd Al Fatah
BACKGROUND: Silicone oil (SO) is used as an intravitreal tamponade agent in vitreoretinal surgery for rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy or with large, multiple retinal tears. Usually, SO is left in the eye for at least 3 months. Although its use can lead to well-known complications, intraocular SO is generally well tolerated. Some studies have reported unexpected central vision loss after SO use or removal. OBJECTIVE: To investigate and analyze the reason for visual loss after the use or removal of intraocular SO in patients who underwent vitrectomy surgeries for RRD...
April 27, 2017: Ophthalmologica. Journal International D'ophtalmologie
https://www.readbyqxmd.com/read/28445567/emergency-general-surgery-needs-for-lesbian-gay-bisexual-and-transgender-patients-are-we-prepared
#3
Ryan Shields, Brandyn Lau, Adil H Haider
No abstract text is available yet for this article.
April 26, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28445372/longitudinal-photogrammetric-analysis-of-the-columellar-labial-angle-following-primary-repair-of-bilateral-cleft-lip-and-nasal-deformity
#4
S Alex Rottgers, So Young Lim, Amber M Hall, David Zurakowski, John B Mulliken
BACKGROUND: The changing nasolabial dimensions after repair of bilateral cleft lip and nasal deformity can be documented by anthropometry; however, the columellar-labial angle is rarely measured. METHODS: This is a study of white patients who had synchronous repair of bilateral cleft lip performed by one surgeon (J.B.M.). The columellar-labial angle was measured on lateral photographs with the subject in neutral head position. Average values for columellar-labial angle at two or more time points were analyzed with a general estimating equation and cubic modeling...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28445349/surgical-determinants-of-patient-reported-outcomes-following-postmastectomy-reconstruction-in-women-with-breast-cancer
#5
Ranjeet Jeevan, John P Browne, Carmel Gulliver-Clarke, Jerome Pereira, Christopher M Caddy, Jan H P van der Meulen, David A Cromwell
BACKGROUND: This national prospective cohort study compared the patient-reported outcomes of breast cancer patients undergoing postmastectomy autologous reconstruction to those who had breast implants, in terms of aesthetic appearance; levels of psychological, physical, and sexual well-being; and overall satisfaction. METHODS: Of 5063 women who underwent immediate reconstruction (n = 3349) or delayed reconstruction (n = 1714) between January 1, 2008, and March 31, 2009, in England, 2923 women who gave informed consent were sent validated, procedure-specific, 18-month follow-up questionnaires...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28445319/intraoperative-cardiac-arrest-a-10-year-study-of-patients-undergoing-tumorous-surgery-in-a-tertiary-referral-cancer-center-in-china
#6
Fei Han, Yufeng Wang, Yue Wang, Jiaxu Dong, Chaoran Nie, Meng Chen, Lina Hou
Intraoperative cardiac arrest (IOCA) is a lethal complication of noncardiac surgery. According to several reports, immediate survival after IOCA is approximately 50%. In this study, a retrospective case analysis was performed to determine the incidence of IOCA, the potential causes of cardiac arrest, and the risk factors of no resuscitation in patients undergoing tumorous surgery.The medical records of surgery patients who experienced cardiac arrest during the intraoperative period between 2005 and 2014 were reviewed...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28445291/efficacy-of-sevoflurane-as-an-adjuvant-to-propofol-based-total-intravenous-anesthesia-for-attenuating-secretions-in-ocular-surgery
#7
Hou-Chuan Lai, Yun-Hsiang Chang, Ren-Chih Huang, Nan-Kai Hung, Chueng-He Lu, Jou-Hsiu Chen, Zhi-Fu Wu
BACKGROUND: The incidence of nasal secretions into the operative field is as high as 5% in ophthalmic surgery under general anesthesia. It may induce postoperative endophthalmitis. Secretions under propofol-based total intravanous anesthesia (TIVA) are greater than sevoflurane anesthesia during surgery. Postoperative nausea and vomiting (PONV) after inhalational anesthesia is higher than TIVA and may increase intraocluar pressure. We investigated the effect of sevoflurane combination with propofol-based TIVA on nasopharyngeal secretions and PONV in ocular surgery...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28445286/remote-ischemic-preconditioning-improves-the-cognitive-function-of-elderly-patients-following-colon-surgery-a-randomized-clinical-trial
#8
Zhenqiu He, Nan Xu, Sihua Qi
BACKGROUND: Cognitive function impairment is one of the most common complications in elderly patients after surgery, and an ideal nonpharmacological therapy has not yet been identified. Thus, we hypothesized that remote ischemic preconditioning could improve cognitive functions in elderly patients after surgery and investigated the mechanism underlying this effect. METHODS: Ninety patients classified as American Society of Anaesthesiologists (ASA) physical status of 2 or 3 and aged 65 to 75 years who were scheduled for elective colon surgery under general anesthesia were randomly allocated to either a remote ischemic preconditioning group (Group R, n = 45) or a control group (Group C, n = 45)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28445024/an-economic-evaluation-of-the-enhanced-recovery-after-surgery-eras-multisite-implementation-program-for-colorectal-surgery-in-alberta
#9
Nguyen X. Thanh, Anderson W. Chuck, Tracy Wasylak, Jeannette Lawrence, Peter Faris, Olle Ljungqvist, Gregg Nelson, Leah M. Gramlich
BACKGROUND: In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites (initial phase) that perform more than 75% of all colorectal surgeries in the province. We conducted an economic evaluation of this initiative to not only determine its cost-effectiveness, but also to inform strategy for the spread and scale of ERAS to other surgical protocols and sites. METHODS: We assessed the impact of ERAS on patients’ health services utilization (HSU; length of stay [LOS], readmissions, emergency department visits, general practitioner and specialist visits) within 30 days of discharge by comparing pre- and post-ERAS groups using multilevel negative binomial regressions...
December 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28444779/a-randomised-controlled-trial-of-propofol-vs-thiopentone-and-desflurane-for-fatigue-after-laparoscopic-cholecystectomy
#10
T Nostdahl, O M Fredheim, T Bernklev, T S Doksrod, R M Mohus, J Raeder
Fatigue may delay functional recovery after day surgery and may be more common after propofol anaesthesia. We randomly allocated 123 participants scheduled for ambulatory laparoscopic cholecystectomy to induction and maintenance of general anaesthesia with propofol or thiopentone and desflurane. Postoperative fatigue was unaffected by the allocated anaesthetic. The combined mean (SD) Identity-Consequences Fatigue Scale of 34.3 (15.1) before surgery increased in the first postoperative week: to 60.4 (21.1) on day 1, p < 0...
April 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28444697/population-pharmacokinetics-of-dexmedetomidine-in-infants
#11
Rachel G Greenberg, Huali Wu, Matthew Laughon, Edmund Capparelli, Stevie Rowe, Kanecia O Zimmerman, P Brian Smith, Michael Cohen-Wolkowiez
Despite limited pharmacokinetic (PK) data, dexmedetomidine is increasingly being used off-label for sedation in infants. We aimed to characterize the developmental PK changes of dexmedetomidine during infancy. In this open-label, single-center PK study of dexmedetomidine in infants receiving dexmedetomidine per clinical care, ≤10 blood samples per infant were collected. A set of structural PK models and residual error models were explored using nonlinear mixed-effects modeling in NONMEM. Covariates including postmenstrual age (PMA), serum creatinine, and recent history of cardiac surgery requiring cardiopulmonary bypass were investigated for their influence on PK parameters...
April 25, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28444559/effectiveness-of-an-interdisciplinary-medical-hospital-admission-center-the-role-of-the-dental-section-in-the-interdisciplinary-system-for-perioperative-management-of-patients-awaiting-surgery
#12
Akifumi Enomoto, Eri Morikage, Takeshi Shimoide, Kazuhide Matsunaga, Suguru Hamada
Perioperative oral functional management (POFM) involves total oral management of a patient before surgery. Considerable benefits have been reported, but POFM remains scarce in medical settings. An interdisciplinary Medical Hospital Admission Center (MHAC) opened in our hospital in December 2014, and has since provided unified perioperative management for patients. This study reports on the clinical system and contributions of the systematized, standardized POFM applied through the MHAC. Patients awaiting surgery undergo oral screening before admission, with patients classified into three groups: red, needing surgical oral management (tooth extraction or other oral surgery) before surgery; yellow, needing non-surgical oral management before surgery, due to the planned surgery or the risk of tooth injury in connection with general anesthesia; or green, patients with good oral hygiene considered capable of suitable oral self-management...
June 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28444407/-aseptic-loosening-of-total-ankle-replacement-and-conversion-to-ankle-arthrodesis
#13
M D Wimmer, M Hettchen, M M Ploeger, B Hintermann, D C Wirtz, A Barg
OBJECTIVE: To remove loosened prosthesis components, to perform augmentation, to address osseous defects, to perform neutrally aligned ankle arthrodesis, and to achieve postoperative pain relief. INDICATIONS: Symptomatic, aseptic loosening of total ankle replacement (TAR) with/without substantial bone defect of the tibial and/or talar bone stock. CONTRAINDICATIONS: General surgical or anesthesiological risks, periprosthetic infection, local or systemic infection, nonmanageable soft tissue problems...
April 25, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28444256/outcomes-after-the-mustard-senning-and-arterial-switch-operation-for-treatment-of-transposition-of-the-great-arteries-in-finland-a-nationwide-4-decade-perspective
#14
Alireza Raissadati, Heta Nieminen, Heikki Sairanen, Eero Jokinen
OBJECTIVES: We analysed nationwide early and late results after the Mustard, Senning and arterial switch operation. METHODS: We included all paediatric patients (<18 years) who underwent a Senning, a Mustard or an arterial switch operation for transposition of the great arteries from 1968 to 2009 in Finland. Data were obtained retrospectively from a paediatric cardiac surgical database and population data from the Finnish national registry. RESULTS: Early mortality (<30 days) was 11% after Mustard and 5% after Senning operation, while the rate decreased from 19% during 1976-1999 to 2% during 2000-2009 for arterial switch patients ( P  < 0...
April 24, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28443951/bariatric-surgery-in-individuals-with-severe-cognitive-impairment-report-of-two-cases
#15
Everton Cazzo, Martinho Antonio Gestic, Murillo Pimentel Utrini, Felipe David Mendonça Chaim, Elaine Cristina Cândido, Luciana Bueno da Silveira Jarolavsky, Ana Maria Neder de Almeida, José Carlos Pareja, Elinton Adami Chaim
CONTEXT: Bariatric surgery has become the gold-standard treatment for refractory morbid obesity. Obesity is frequently associated with certain syndromes that include coexisting cognitive deficits. However, the outcomes from bariatric surgery in this group of individuals remain incompletely determined. CASE REPORT: A 25-year-old male with Prader-Willi syndrome, whose intelligence quotient (IQ) was 54, was admitted with a body mass index (BMI) of 55 kg/m2, associated with glucose intolerance...
April 20, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28443268/complicated-postoperative-course-after-pulmonary-artery-sling-repair-and-slide-tracheoplasty
#16
Angelika Weber, Birgit Donner, Marie-Hélène Perez, Stefano Di Bernardo, Daniel Trachsel, Kishore Sandu, Nicole Sekarski
Pulmonary artery sling (PAS) is a rare congenital condition in which the left pulmonary artery (LPA) arises from the right pulmonary artery, and then passes between the trachea and the esophagus to reach the left lung, thereby forming a sling around the airway. It is often associated with intrinsic tracheal stenosis due to complete cartilaginous rings. Therapeutic management nowadays consists of one-stage reimplantation of the LPA and tracheoplasty with cardiopulmonary bypass support. Here, we present a 7-week-old boy with PAS and long-segment tracheal stenosis (LSTS) who underwent surgical intervention consisting of reimplantation of the LPA and slide tracheoplasty...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28442964/-graded-epidural-anesthesia-for-renal-transplant-in-a-patient-with-dilated-cardiomyopathy-and-severe-left-ventricle-systolic-dysfunction
#17
Rupesh Yadav, Sohan Lal Solanki
Dilated cardiomyopathy with decreased contractility of left or both ventricles impose a serious risk to patient posted for major surgery. Even after best medical optimization, careful perioperative management with risk and benefit of general and regional anesthesia should be discussed beforehand. We here reporting a case of successful management of a patient with dilated cardiomyopathy with ejection fraction of 15% posted for renal transplant surgery under graded epidural anesthesia.
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28442931/postoperative-pain-and-patient-controlled-epidural-analgesia-related-adverse-effects-in-young-and-elderly-patients-a-retrospective-analysis-of-2-435-patients
#18
Jae Chul Koh, Young Song, So Yeon Kim, Sooyeun Park, Seo Hee Ko, Dong Woo Han
In this retrospective study, data of 2,435 patients who received fentanyl and ropivacaine-based patient-controlled epidural analgesia (PCEA) for pain relief after elective surgery under general or spinal anesthesia were reviewed. Differences in postoperative pain, incidence of patient-controlled analgesia (PCA)-related adverse effects, and risk factors for the need for rescue analgesics for 48 hours postsurgery in young (age 20-39 years) and elderly (age ≥70 years) patients were evaluated. Although there were no significant differences in postoperative pain intensity between the two groups until 6 hours postsurgery, younger patients experienced greater postoperative pain intensity compared with older patients 6-48 hours postsurgery...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28442930/thoracic-epidural-analgesia-reduces-myocardial-injury-in-ischemic-patients-undergoing-major-abdominal-cancer-surgery
#19
Mohamad Farouk Mohamad, Montaser A Mohammad, Diab F Hetta, Eman Hasan Ahmed, Ahmed A Obiedallah, Alaa Ali M Elzohry
BACKGROUND AND OBJECTIVES: Major abdominal cancer surgeries are associated with significant perioperative mortality and morbidity due to myocardial ischemia and infarction. This study examined the effect of perioperative patient controlled epidural analgesia (PCEA) on occurrence of ischemic cardiac injury in ischemic patients undergoing major abdominal cancer surgery. PATIENTS AND METHODS: One hundred and twenty patients (American Society of Anesthesiologists grade II and III) of either sex were scheduled for elective upper gastrointestinal cancer surgeries...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28442802/study-of-prevalence-of-sexually-transmitted-infections-human-immunodeficiency-virus-and-condom-use-among-male-to-female-transgender-a-retrospective-analysis-from-a-tertiary-care-hospital-in-chennai
#20
Subhash Dasarathan, S Kalaivani
CONTEXT: A "Transgender" person is one who dresses as, desires to be, has undergone surgery to become or identifies with opposite sex. They have a higher risk of sexually transmitted infection (STI) due to a combination of biological and social reasons. They have risky sexual behaviors but low-risk perception. AIMS: The aim of this study is to determine the prevalence of STI/human immunodeficiency virus (HIV) in transgender (TG) and association with condom use. SETTINGS AND DESIGN: A retrospective study of 82 male-to-female TGs attending our sexually transmitted disease (STD) clinic from 2011 to 2014 was undertaken...
January 2017: Indian Journal of Sexually Transmitted Diseases
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