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https://www.readbyqxmd.com/read/28641358/-pain-treatment-after-thoracic-surgery
#1
Holger Hendrix, Vladimir Kamlak, Georgi Prisadov, Katrin Welcker
The treatment of pain after thoracic surgery is a challenge and takes place in the individual clinics mostly according to clinic internal standards. It exists no currently valid S3 guideline for the treatment of acute perioperative and posttraumatic pain. For an effective pain treatment as well individual pain experience as the pain intensity of the various thoracic surgical procedures must be considered. Regular pain assessment with appropriate methods and their documentation form the basis for adequate and adapted pain therapy...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28641357/-the-german-thorax-registry-implementation-of-an-established-tool-of-perioperative-health-care-research
#2
Jérôme Defosse, Mark Schieren, Torsten Loop, Cerstin Arndt, Rainer Röhrig, Erich Stoelben, Corinna Ludwig, Alexander Schleppers, Frank Wappler, Mark Gerbershagen, Alberto Lopez-Pastorini
The collection of clinical treatment data in registry databases is an important aspect of health services research. It allows for a critical evaluation of the safety, efficacy and cost-effectiveness of clinical treatment concepts in large patient populations. The findings of registry research represent real-world patients and treatment structures as they are not limited by strict inclusion criteria or unrealistic conditions as applied in prospective clinical trials. The implementation of the German Thorax Registry has enabled the collection and analysis of data on the interdisciplinary care (thoracic surgery, anaesthesiology, intensive care, pain management) of patients undergoing thoracic surgery...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28640112/cement-leakage-in-osteoporotic-vertebral-compression-fractures-with-cortical-defect-using-high-viscosity-bone-cement-during-unilateral-percutaneous-kyphoplasty-surgery
#3
Tie Liu, Zhe Li, Qingjun Su, Yong Hai
The purpose of this study was to investigate cement leakage (CL) in osteoporotic vertebral compression fractures (OVCFs) with cortical defect using high-viscosity bone cement during unilateral percutaneous kyphoplasty (PKP) surgery.This study included a series of 77 patients (23 males, 54 females) with single level osteoporotic vertebral body fracture (OVCF) who underwent unilateral PKP in our hospital. Preoperative x-ray, computed tomography (CT) scan, and 3-dimensional reconstructions were studied. During the PKP procedure, needle was carefully put to avoid too near to the cortical defect according to CT image...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28640085/familial-lumbar-scheuermann-disease-with-idiopathic-scoliosis-in-china-first-case-report
#4
Yuliang Dai, Yawei Li, Pengzhi Li, Lei Li, Zhiming Tu, Bing Wang
RATIONALE: Given that Scheuermann disease rarely occurs in the lumbar region and that the co-occurrence of Scheuermann disease and idiopathic scoliosis (IS) has not been reported-the etiology of Scheuermann disease and IS is not clear. In this case report, we present familaiar lumbar Scheuermann disease with IS, in a Chinese proband, who was successfully treated with surgery. PATIENT CONCERNS: A 16-year-old boy presented at the Second XiangYa Hospital of Central South University with a chief complaint of kyphotic deformity in the lower back for 4 years and obvious lower back pain...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28637821/endovascular-management-of-aneurysms-associated-with-spinal-arteriovenous-malformations
#5
Sung Chul Jung, Yunsun Song, Su Hee Cho, Joonggoo Kim, Seung Yeon Noh, Sang Hun Lee, Jae Jon Sheen, Seung Chul Rhim, Sang Ryong Jeon, Dae Chul Suh
BACKGROUND: Spinal aneurysms are rare among spinal arteriovenous malformations (SAVMs). There are few reports of endovascular management of spinal aneurysms associated with SAVM. OBJECTIVE: To present endovascular management of aneurysms associated with SAVM. METHODS: Of 91 patients with SAVMs,eight (9%) presented with aneurysms. Of these, three were male and five were female with a median age of 18 years (range 11-38). We evaluated the presenting pattern, lesion level, type of the target aneurysm related to the presenting pattern and AVM nidus, and the result obtained after embolization or open surgery...
June 21, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28637424/gabapentin-in-procedure-specific-postoperative-pain-management-preplanned-subgroup-analyses-from-a-systematic-review-with-meta-analyses-and-trial-sequential-analyses
#6
Maria Louise Fabritius, Anja Geisler, Pernille Lykke Petersen, Jørn Wetterslev, Ole Mathiesen, Jørgen Berg Dahl
BACKGROUND: It has been argued that postoperative pain treatment should be "procedure-specific", since different analgesics may have specific effects dependent on the surgical procedure. The aim of the present subgroup analysis was to compare the beneficial and harmful effects of perioperative gabapentin treatment in different surgical procedures. METHODS: Relevant databases were searched for randomized clinical trials (RCTs) comparing gabapentin versus placebo...
June 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28632556/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#7
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan D Dilip
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurological complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: CSF leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28632551/comparative-study-of-c-arms-for-intraoperative-3-dimensional-imaging-and-navigation-in-minimally-invasive-spine-surgery-part-i-applicability-and-image-quality
#8
Jan-Helge Klingler, Ronen Sircar, Christian Scheiwe, Evangelos Kogias, Florian Volz, Marie T Krüger, Ulrich Hubbe
STUDY DESIGN: This was a retrospective analysis. OBJECTIVE: This study compares 2 different 3-dimensional (3D) C-arm devices for intraoperative imaging and navigation with regard to clinical applicability and image quality. SUMMARY OF BACKGROUND DATA: Minimally invasive spine surgery requires intraoperative imaging techniques to adequately visualize the unexposed spine. For this purpose, mobile 3D C-arms became available along with the evolution of intraoperative navigation techniques...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28631050/analgesia-nociception-index-ani-monitoring-in-patients-with-thoracic-paravertebral-block-a-randomized-controlled-study
#9
Nurseda Dundar, Alparslan Kus, Yavuz Gurkan, Kamil Toker, Mine Solak
The goal of the study was to evaluate the effectiveness of analgesia nociception index (ANI) monitoring during intraoperative period for patients with thoracic paravertebral block (TPVB) undergoing breast surgery under general anesthesia. This prospective randomized trial was performed after receiving ethics committee approval in 44 patients who were scheduled to undergo breast surgery under general anesthesia. TPVB was performed in the preoperative period using 20 mL of bupivacaine 0.25% at T4 level. Anesthesia maintenance was provided with sevoflurane in O2: air mixture and remifentanil infusion...
June 19, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28627353/-ultrasonographic-evaluation-of-diaphragm-structure-and-function
#10
Feifei Wang, Xiaoping Zhu, Shaolin Ma
Diaphragm is the principal respiratory muscle. Diaphragm dysfunction resulting from mechanical ventilation, chronic cardiopulmonary disease, medicine, cardio-thoracic surgery, septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay. Traditionally, the method of assessment of diaphragm structure and function was invasive, lacking specific, and was difficult to be used bedside. A number of recent studies have been suggested that ultrasonographic evaluation has been proposed as an accurate, safe and noninvasive method of quantification of diaphragm structure and function...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28626632/synchronous-mucinous-and-non-mucinous-lung-adenocarcinomas-with-different-epidermal-growth-mutational-status
#11
Rita Linhas, David Tente, Margarida Dias, Ana Barroso
In recent years, the spread of more-sensitive diagnostic methods has resulted in an increase of synchronous multiple primary lung cancer diagnosis. Nevertheless, its occurrence is still rare. Distinction between synchronous lesions from second independent primary tumors is a problem when dealing with multiple lung tumors, particularly if the histological type is the same. We present a case report of a 78-year-old female patient referred to our institution due to pneumonia. A subsequent thoracic computed tomography (CT) was performed showing two suspicious lesions, one in the right upper lobe and the other in the right inferior lobe...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28624466/resectable-clinical-n2-non-small-cell-lung-cancer-what-is-the-optimal-treatment-strategy-an-update-by-the-british-thoracic-society-lung-cancer-specialist-advisory-group
#12
Matthew Evison, Amelia Clive, Lianne Castle, Helen Powell, Rachel Thomas, Robert Buttery, Vidan Masani, Susan Harden, Doug West, Ian Woolhouse
Patients and clinicians are faced with uncertainty on the optimal treatment strategy for potentially resectable non-small cell lung cancer where there is clinical evidence of involvement of the ipsilateral mediastinum. Randomised controlled trials and meta-analyses have failed to demonstrate superiority of one bimodality strategy over another (chemotherapy plus surgery versus chemotherapy plus radiotherapy). One trial of trimodality treatment with chemotherapy, radiotherapy and surgery demonstrated an improvement in progression-free, but not overall, survival versus chemotherapy and radiotherapy...
June 14, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28624411/incremental-prognostic-utility-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-patients-with-significant-chronic-aortic-regurgitation-and-preserved-left-ventricular-ejection-fraction
#13
Alaa Alashi, Amgad Mentias, Amjad Abdallah, Ke Feng, A Marc Gillinov, L Leonardo Rodriguez, Douglas R Johnston, Lars G Svensson, Zoran B Popovic, Brian P Griffin, Milind Y Desai
OBJECTIVES: We sought to examine the prognostic utility of left ventricular (LV) global longitudinal strain (GLS) in asymptomatic patients with ≥III+ aortic regurgitation (AR), an indexed LV end-systolic dimension of <2.5 cm/m(2), and preserved left ventricular ejection fraction (LVEF). BACKGROUND: Management of asymptomatic patients with severe chronic AR and preserved LVEF is challenging and is typically based on LV dimensions. METHODS: We studied 1,063 such patients (53 ± 16 years; 77% men) seen between 2003 and 2010 (excluding those with symptoms, obstructive coronary artery disease, acute AR/dissection, aortic/mitral stenosis, more than moderate mitral regurgitation, and previous cardiac surgery)...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28621630/evaluation-of-surgical-treatment-for-neuropathic-pain-from-neuroma-in-patients-with-injured-peripheral-nerves
#14
Valérie Decrouy-Duruz, Thierry Christen, Wassim Raffoul
OBJECTIVE Chronic neuropathic pain after peripheral nerve injury is a major clinical problem. Its management is difficult, and therapeutic approaches vary and include oral medication, neurostimulation, and surgery. The aim of this study was to assess the adequacy of surgical nerve revision in a large series of patients with long-term follow-up. METHODS The authors reviewed the charts of 231 patients (335 nerve injuries) who experienced neuropathic pain after peripheral nerve injury and underwent surgery for nerve revision at the authors' institution between 1997 and 2012...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28621602/resolution-of-nonurine-transudative-pleural-effusion-in-a-cat-after-removal-of-a-hydronephrotic-kidney
#15
Maura E Duffy, Andrew J Specht, Ahmira R Torres, May-Li Cuypers
CASE DESCRIPTION A 3-year-old spayed female Bengal cat was evaluated because of a history of bilateral pleural effusion and hydronephrosis of the right kidney. CLINICAL FINDINGS Cytologic analysis of a pleural fluid sample revealed characteristics of a pure transudate with a high percentage of lymphocytes. Results of fluid biochemical testing were not consistent with urine or chyle. Serum biochemical analysis and echocardiography yielded no evidence of hypoalbuminemia or high hydrostatic pressure secondary to cardiac disease...
July 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28621512/endovascular-redo-aortic-surgery
#16
Jacob Budtz-Lilly, Kiattisak Hongku, Björn Sonesson, Nuno Dias, Tim Resch
Endovascular redo aortic operations are a challenging undertaking. Techniques for treatment date almost as far back as the original open repair itself. Risk factors for failure following aortic repair include larger AAA necks, severe neck angulation, as well as clinical variables such as age, family history, obesity and chronic obstructive pulmonary disease. The armamentarium of endovascular treatments is vast and increasing. Aside from provisional embolization of endoleaks or deferment to open repair conversion, attention should be directed toward obtaining adequate proximal and distal sealing...
June 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28619540/video-assisted-thoracic-surgery-thymectomy-versus-sternotomy-thymectomy-in-patients-with-thymoma
#17
Hiroyuki Agatsuma, Kazuo Yoshida, Ichiro Yoshino, Meinoshin Okumura, Masahiko Higashiyama, Kenji Suzuki, Masanori Tsuchida, Jitsuo Usuda, Hiroshi Niwa
BACKGROUND: This study was designed to evaluate the feasibility of video-assisted thoracoscopic surgery (VATS) and to compare the oncologic outcomes of VATS with those of sternotomy in patients with thymoma. METHODS: The clinical outcomes of 2,835 patients with thymic epithelial tumors treated between 1991 and 2010 in 32 Japanese institutions were collected retrospectively. The study compared postoperative complications, positive surgical margins, location of recurrence, and survival in 140 of 142 VATS-treated patients (VATS group) matched with 140 of 1,294 sternotomy-treated patients (ST group) by using propensity scores...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28619111/two-minute-disconnection-technique-with-a-double-lumen-tube-to-speed-the-collapse-of-the-non-ventilated-lung-for-one-lung-ventilation-in-thoracoscopic-surgery
#18
Qiongzhen Li, Xiaofeng Zhang, Jingxiang Wu, Meiying Xu
BACKGROUND: Thoracic surgery requires the effective collapse of the non-ventilated lung. In the majority of cases, we accomplished, accelerated lung collapse using a double-lumen tube (DLT). We hypothesized that using the two-minute disconnection technique with a DLT would improve lung collapse during subsequent one-lung ventilation. METHODS: Fifty patients undergoing thoracoscopic surgery with physical classification I or II according to the American Society of Anesthesiologists were randomly divided into two groups for respiratory management of one-lung ventilation (OLV)...
June 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28617981/what-is-the-variability-in-shoulder-axillae-and-waist-position-in-a-group-of-adolescents
#19
Adrian Gardner, Fiona Berryman, Paul Pynsent
The clinical assessment of scoliosis is based on the recognition of asymmetry. It is not clear what the degree of asymmetry is in a population without scoliosis, which could make the differentiation between abnormal and normal uncertain. This study defines the range of normality in certain parameters of torso shape that are also associated with the clinical assessment of scoliosis. This was done by analysing the surface topography of a group of 195 children serially measured over a 5-year period. The analysis considered both the spinal curvature and the relative position of shoulders, axillae and waist on each side...
June 15, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28616883/treatment-for-thoracic-ossification-of-posterior-longitudinal-ligament-with-posterior-circumferential-decompression
#20
Zhao-Wan Xu, Yong-Cheng Hu, Chui-Guo Sun, Xiao-Peng Shang, Deng-Xing Lun, Feng Li, Xu-Bin Ji, Da-Yong Liu, Nai-Wang Chen, Qing-Shan Zhuang
OBJECTIVE: To report the results of the posterior approach for thoracic ossification of posterior longitudinal ligament (TOPLL) by using a special "L" osteotome. METHODS: The present study enrolled 16 consecutive patients (9 men and 7 women) between May 2009 and September 2013. All patients underwent a posterior circumferential decompression osteotomy and segmental instrumentation with interbody fusion. The mean age at surgery was 57.3 years (range, 37-68 years)...
June 14, 2017: Orthopaedic Surgery
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