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https://www.readbyqxmd.com/read/29058064/less-is-more-the-impact-of-multidisciplinary-thyroid-conference-on-the-treatment-of-well-differentiated-thyroid-carcinoma
#1
Maureen D Moore, Emily Postma, Katherine D Gray, Timothy M Ullmann, James R Hurley, Stanley Goldsmith, Vivian R Sobel, Aaron Schulman, Theresa Scognamiglio, Paul J Christos, Erin Hassett, Jessica Luick, Dana Whitehall, Rasa Zarnegar, Thomas J Fahey
BACKGROUND: In 2006, a multidisciplinary thyroid conference (MDTC) was implemented to better plan management of thyroid cancer patients at our institution. This study assessed the clinical impact of a MDTC on radioactive iodine (RAI) treatment patterns. METHODS: A prospective database (2003-2014) collected patient and tumor characteristics, RAI doses, and tumor recurrences. Patients treated with total thyroidectomy for differentiated thyroid carcinoma ≥1 cm were stratified based on American Thyroid Association (ATA) risk classification...
October 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29056565/risk-factors-and-pharmacologic-prophylaxis-for-venous-thromboembolism-in-elective-spine-surgery
#2
Ryan P McLynn, Pablo J Diaz-Collado, Taylor D Ottesen, Nathaniel T Ondeck, Jonathan J Cui, Patawut Bovonratwet, Blake N Shultz, Jonathan N Grauer
BACKGROUND CONTEXT: Venous thromboembolism (VTE) is a known complication after spine surgery, but prophylaxis guidelines are ambiguous for patients undergoing elective spine surgery. PURPOSE: To characterize the incidence and risk factors for VTE and the association of pharmacologic prophylaxis with VTE and bleeding complications after elective spine surgery. STUDY DESIGN/SETTING: Retrospective cohort study of patients undergoing elective spine surgery in the National Surgical Quality Improvement Program (NSQIP) database and a retrospective cohort analysis at an academic medical center...
October 19, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29053658/low-level-laser-therapy-for-treatment-of-neurosensory-disorders-after-orthognathic-surgery-a-systematic-review-of-randomized-clinical-trials
#3
M-A-V Bittencourt, L-R Paranhos, P-R-S Martins-Filho
BACKGROUND: Low-level laser has been widely used in Dentistry and many studies have focused on its application in oral surgeries. This study was conducted with the aim of searching for scientific evidence concerning the effectiveness of laser to reduce pain or paresthesia related to orthognathic surgery. MATERIAL AND METHODS: An electronic search was performed in PubMed, Scopus, Science Direct, LILACS, SciELO, CENTRAL, Google Scholar, OpenGrey, and ClinicalTrials...
October 20, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/29053647/efficacy-of-different-methods-used-for-dry-socket-prevention-and-risk-factor-analysis-a-systematic-review
#4
M Taberner-Vallverdú, M-Á Sánchez-Garcés, C Gay-Escoda
BACKGROUND: Dry socket is one of the most common complications that develops after the extraction of a permanent tooth, and its prevention is more effective than its treatment. OBJECTIVES: Analyze the efficacy of different methods used in preventing dry socket in order to decrease its incidence after tooth extraction. MATERIAL AND METHODS: A Cochrane and PubMed-MEDLINE database search was conducted with the search terms "dry socket", "prevention", "risk factors", "alveolar osteitis" and "fibrynolitic alveolitis", both individually and using the Boolean operator "AND"...
October 20, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/29052070/the-feasibility-of-laparoscopic-rectal-resection-in-patients-undergoing-reoperation-after-transanal-endoscopic-microsurgery-tem
#5
M Ortenzi, R Ghiselli, A Paolucci, M Guerrieri
BACKGROUND: The success of transanal endoscopic microsurgery (TEM) for early rectal cancer depends on proper indications and strict patient selection. When unfavorable pathologic features are identified after TEM operation, total mesorectal excision is recommended to minimize the risk of recurrence. In this study, data were collected in a retrospective series of patients to determine the results of laparoscopic reoperation after TEM. METHODS: All patients underwent an accurate rectal-digital examination and clinical tumor staging by transanal endosonography, CT, and/or MRI...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29050058/-ambulant-anesthesia-limits-and-possibilities
#6
Harald Hofer, Frank Vescia
The number of operations carried out on an outpatient basis is increasing in Germany. This trend has been observed for years. The prerequisite is an infrastructure that is in line with guidelines. The competence of the anesthetist must not be restricted to that of a standard specialist anesthetist, but the physician should have experience in ambulatory anesthesia. Well-adjusted comorbidities of the patient are generally not a contraindication for an outpatient procedure. The heavily overweight patient can also be operated on an outpatient basis if he is compliant, comorbidities are well adjusted and intensive postoperative care is ensured...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29049115/an-evidence-based-approach-to-the-prescription-opioid-epidemic-in-orthopedic-surgery
#7
Ellen M Soffin, Seth A Waldman, Roberta J Stack, Gregory A Liguori
Orthopedic surgery is associated with significant perioperative pain. Providing adequate analgesia is a critical component of patient care and opioids play a vital role in the acute postoperative setting. However, opioid prescribing for patients undergoing orthopedic procedures has recently been identified as a major contributor to the current opioid epidemic. As opioid usage and related morbidity and mortality continue to rise nationwide, opioid-prescribing practices are under increased scrutiny. Here, we update the evidence base and recommendations behind a set of interventions developed at the Hospital for Special Surgery to address the national epidemic at the local level...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29048972/new-persistent-opioid-use-among-patients-with-cancer-after-curative-intent-surgery
#8
Jay Soong-Jin Lee, Hsou Mei Hu, Anthony L Edelman, Chad M Brummett, Michael J Englesbe, Jennifer F Waljee, Jeffrey B Smerage, Jennifer J Griggs, Hari Nathan, Jacqueline S Jeruss, Lesly A Dossett
Purpose The current epidemic of prescription opioid misuse has increased scrutiny of postoperative opioid prescribing. Some 6% to 8% of opioid-naïve patients undergoing noncancer procedures develop new persistent opioid use; however, it is unknown if a similar risk applies to patients with cancer. We sought to define the risk of new persistent opioid use after curative-intent surgery, identify risk factors, and describe changes in daily opioid dose over time after surgery. Methods Using a national data set of insurance claims, we identified patients with cancer undergoing curative-intent surgery from 2010 to 2014...
October 19, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29044561/aquatic-treadmill-water-level-influence-on-pelvic-limb-kinematics-in-cranial-cruciate-ligament-deficient-dogs-with-surgically-stabilised-stifles
#9
G Bertocci, C Smalley, N Brown, K Bialczak, D Carroll
OBJECTIVE: To compare pelvic limb joint kinematics and temporal gait characteristics during land-based and aquatic-based treadmill walking in dogs that have undergone surgical stabilisation for cranial cruciate ligament deficiency. MATERIALS AND METHODS: Client-owned dogs with surgically stabilised stifles following cranial cruciate ligament deficiency performed three walking trials consisting of three consecutive gait cycles on an aquatic treadmill under four water levels...
October 17, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29039872/vitamin-d-use-and-health-outcomes-after-surgery-for-hip-fracture
#10
Sheila Sprague, Gerard P Slobogean, Earl Bogoch, Brad Petrisor, Alisha Garibaldi, Nathan O'Hara, Mohit Bhandari
Daily administration of vitamin D is important for maintaining bone homeostasis. The orthopedic community has shown increased interest in vitamin D supplementation and patient outcomes after fracture. The current study used data from a large hip fracture trial to determine the proportion of patients who consistently used vitamin D after hip fracture surgery and to determine whether supplementation was associated with improved health-related quality of life and reduced reoperation rates. The FAITH study is a multicenter trial of elderly patients with femoral neck fracture treated with internal fixation...
October 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/29037017/preoperative-chemoradiotherapy-versus-postoperative-chemoradiotherapy-for-stage-ii-iii-resectable-rectal-cancer-a-meta-analysis-of-randomized-controlled-trials
#11
Jin Ho Song, Jae Uk Jeong, Jong Hoon Lee, Sung Hwan Kim, Hyeon Min Cho, Jun Won Um, Hong Seok Jang
PURPOSE: Whether preoperative chemoradiotherapy (CRT) is better than postoperative CRT in oncologic outcome and toxicity is contentious in prospective randomized clinical trials. We systematically analyze and compare the treatment result, toxicity, and sphincter preservation rate between preoperative CRT and postoperative CRT in stage II-III rectal cancer. MATERIALS AND METHODS: We searched Medline, Embase, and Cochrane Library from 1990 to 2014 for relevant trials...
September 2017: Radiation Oncology Journal
https://www.readbyqxmd.com/read/29034090/pre-to-postoperative-coagulation-profile-of-307-patients-undergoing-oesophageal-resection-with-epidural-blockade-over-a-10-year-period-in-a-single-hospital-implications-for-the-risk-of-spinal-haematoma
#12
Owain Thomas, Emanuel Lybeck, Per Flisberg, Ulf Schött
BACKGROUND: Epidural anaesthesia and analgesia are indicated for oesophageal surgery. A rare but serious complication is spinal haematoma, which can occur on insertion, manipulation or withdrawal of catheters. Evidence and guidelines are vague regarding which tests are appropriate and how to interpret their results. We aimed to describe how routine coagulation test results change during oesophagectomy's perioperative course. METHODS: Following ethical approval, we retrospectively identified patients who had undergone oesophagectomy between 2002 and 2012...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29034078/recent-advances-in-cancer-surgery-in-older-patients
#13
REVIEW
Siri Rostoft, Riccardo A Audisio
Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations...
2017: F1000Research
https://www.readbyqxmd.com/read/29030748/neuroimaging-of-cavernous-malformations
#14
REVIEW
Maxim Mokin, Siviero Agazzi, Lowell Dawson, Christopher T Primiani
PURPOSE OF REVIEW: Cerebral cavernous malformations (CCMs) are common vascular abnormalities often discovered on imaging as an incidental finding. The most common clinical presentations of CCMs include seizure, headache, focal neurological deficits, and intracranial hemorrhage. This article discusses the most recent guidelines including imaging diagnostic criteria and radiographic standards of CCMs and reviews the utility of currently available imaging techniques. RECENT FINDINGS: Gradient echo T2*-weighted imaging and susceptibility-weighted imaging are the recommended imaging protocols for evaluation of suspected CCMs...
October 13, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29030676/papillary-thyroid-carcinoma-ptc-in-children-and-adults-comparison-of-initial-presentation-and-long-term-postoperative-outcome-in-4432-patients-consecutively-treated-at-the-mayo-clinic-during-eight-decades-1936-2015
#15
Ian D Hay, Tammi R Johnson, Suneetha Kaggal, Megan S Reinalda, Nicole M Iniguez-Ariza, Clive S Grant, Siobhan T Pittock, Geoffrey B Thompson
BACKGROUND: Contemporary guidelines for managing PTC advise an approach wherein primary tumor and regional metastases (RM) are completely resected at first surgery and radioiodine remnant ablation (RRA) is restricted to high-risk patients, policies our group has long endorsed. To assess our therapeutic efficacy, we studied 190 children and 4242 adults consecutively treated during 1936-2015. SUBJECTS AND METHODS: Mean follow-up durations for children and adults were 26...
October 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29030239/surgical-antibiotic-prophylaxis-and-risk-for-postoperative-antibiotic-resistant-infections
#16
Margot E Cohen, Hojjat Salmasian, Jianhua Li, Jianfang Liu, Philip Zachariah, Jason D Wright, Daniel E Freedberg
BACKGROUND: Antibiotic-resistant infections have high rates of morbidity and mortality and exposure to antibiotics is the crucial risk factor for development of antibiotic resistance. If surgical antibiotic prophylaxis (SAP) increases risk for antibiotic-resistant infections, prophylaxis may cause net harm even if it decreases overall infection rates. STUDY DESIGN: This retrospective cohort study included adults who underwent elective surgical procedures and developed infections within 30 post-operative days...
August 29, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29028436/pain-management-after-hip-arthroscopy-systematic-review-of-randomized-controlled-trials-and-cohort-studies
#17
Jason J Shin, Chris L McCrum, Craig S Mauro, Dharmesh Vyas
BACKGROUND: Hip arthroscopy is often associated with significant postoperative pain and opioid-associated side effects. Effective pain management after hip arthroscopy improves patient recovery and satisfaction and decreases opioid-related complications. PURPOSE: To collect, examine, and provide a comprehensive review of the available evidence from randomized controlled trials and comparative studies on pain control after hip arthroscopy. STUDY DESIGN: Systematic review...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29027773/perioperative-pain-management-in-cardiac-surgery-a-systematic-review
#18
Elena Bignami, Alberto Castella, Vincenzo Pota, Francesco Saglietti, Antonio Scognamiglio, Cinzia Trumello, Maria C Pace, Massimo Allegri
BACKGROUND: Every year, more than 1.5 million patients, who undergo cardiac surgery worldwide, are exposed to a series of factors that can trigger acute postoperative pain associated with hemodynamic instability, respiratory complications, and psychological disorders. Through an evaluation of literature data about postoperative pain in cardiac surgery we define unmet needs and potential objectives for future research on this often underestimated problem. METHODS: Following PRISMA Guidelines, a systematic literature search was carried out by two independent researchers on Scopus, CINAHL, the Cochrane Library, and PubMed using the keywords: [(perioperative OR postoperative) analgesia AND "cardiac surgery"]...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29027688/preoperative-ultrasonographic-assessment-of-the-anterior-pelvic-plane-for-personalized-total-hip-replacement
#19
Andrzej Kochman, Adrian Goral, Josef Kozak, Wojciech Marek, Monika Morawska-Kochman, Marek Synder
OBJECTIVES: Correct positioning of the acetabular component is a key factor in minimizing the risk of dislocation after total hip replacement (THR) surgery. A "safe" orientation of the cup is usually defined by 2 angles measured between its geometric axis and the anterior pelvic plane. However, in the current state-of-the-art approach to THR surgery, the intraoperative orientation of the anterior pelvic plane cannot be measured. Even less is known about the functional orientation of the pelvis, which determines the postoperative orientation of the cup during the patient's everyday activities...
October 13, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29027153/conflicting-data-on-the-incidence-of-leukopenia-and-neutropenia-after-heated-intraperitoneal-chemotherapy-with-mitomycin-c
#20
Yael Feferman, Shanel Bhagwandin, Joseph Kim, Samantha N Aycart, Daniela Feingold, Daniel M Labow, Umut Sarpel
BACKGROUND: During heated intraperitoneal chemotherapy (HIPEC), neutropenia rates of 20 to 40% have been reported when mitomycin C (MMC) is dosed by weight or body surface area (BSA). This study investigated the authors' HIPEC experience using a fixed 40-mg dose of MMC, per consensus guidelines, and analyzed predictors for severe leukopenia and neutropenia. METHODS: Patients who underwent MMC-HIPEC from 2007 to 2016 at a single tertiary care center were retrospectively reviewed...
October 12, 2017: Annals of Surgical Oncology
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