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https://www.readbyqxmd.com/read/28938661/efficacy-and-safety-of-accelerated-partial-breast-irradiation-a-meta-analysis-of-published-randomized-studies
#1
Gengchun Liu, Zhongyi Dong, Baqun Huang, Yuelong Liu, Yan Tang, Qing Li, Yihui Zhu
BACKGROUND AND PURPOSE: Accelerated partial breast irradiation (APBI) technology has theoretical advantages in comparison with traditional adjuvant radiation therapy (whole-breast irradiation; WBI) after breast-conserving surgery. However, published randomized controlled trials have shown inconsistent outcomes. Therefore, a comprehensive assessment of the effectiveness and safety of APBI technology is needed. RESULTS: A total of 7 studies of 7452 patients were included in this analysis...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28938493/acute-and-chronic-impact-of-bariatric-surgery-on-plasma-ldl-cholesterol-and-pcsk9-levels-in-patients-with-severe-obesity
#2
Marjorie Boyer, Marie-Eve Piché, Audrey Auclair, Thomas Grenier-Larouche, Laurent Biertho, Simon Marceau, Frédéric-Simon Hould, Simon Biron, Stéfane Lebel, Odette Lescelleur, François Julien, Julie Martin, André Tchernof, André C Carpentier, Paul Poirier, Benoit J Arsenault
Context: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key regulator of low-density lipoprotein cholesterol (LDL-C) concentrations. In patients with severe obesity, biliopancreatic diversion with duodenal switch (BPD-DS) surgery induces substantial weight loss and favourably influence lipoprotein metabolism. The impact of BPD-DS surgery on PCSK9 levels is unknown. Objectives: To determine the acute and chronic impact of BPD-DS surgery on PCSK9 levels and whether the acute impact of BPD-DS could be explained by BPD-DS surgery-associated caloric restriction (CR)...
August 24, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#3
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28937466/compressive-myelopathy-in-congenital-kyphosis-of-the-upper-thoracic-spine-a-retrospective-study-of-6-cases
#4
Zhengfeng Zhang, Honggang Wang, Wenjie Zheng
STUDY DESIGN: A retrospective study. OBJECTIVE: The goal of this retrospective study was to describe the uncommon presentation of neurological deficits in patients with congenital kyphosis of the upper thoracic spine (T1-T4). SUMMARY OF BACKGROUND DATA: Congenital kyphosis is an uncommon deformity but can potentially lead to spinal cord compression and paraplegia, particularly in type I (failure of formation) deformities. Few reports have described compressive myelopathy associated with congenital kyphosis of the upper thoracic spine...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28937443/reducing-disability-durations-and-medical-costs-for-patients-with-a-carpal-tunnel-release-surgery-through-the-use-of-opioid-prescribing-guidelines
#5
Fraser W Gaspar, Roman Kownacki, Catherine S Zaidel, Craig F Conlon, Kurt T Hegmann
OBJECTIVE: The impacts of compliance with opioid prescribing guidelines on disability durations and medical costs for carpal tunnel release (CTR) were examined. METHODS: Using a dataset of insured US employees, opioid prescriptions for 7840 short-term disability cases with a CTR procedure were identified. Opioids prescriptions were compared with the American College of Occupational and Environmental Medicine (ACOEM)'s opioid prescribing guidelines for postoperative, acute pain, which recommends no more than a 5-day supply, a maximum morphine equivalent dose of 50 mg/day, and only short-acting opioids...
September 20, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28937097/oral-surgery-ii-part-1-acute-management-of-dentoalveolar-trauma
#6
H Tagar, S Djemal
The aesthetics of the mouth are important in determining overall facial attractiveness. People with a relatively normal dental appearance are perceived as more attractive, more intelligent and more desirable as friends. Although the oral region comprises only 1% of the body area it accounts for 5% of all bodily injuries, and of facial injuries, dental injuries are the most common. A US survey among people aged 6-50 years showed that 1 in 4 had evidence of dental trauma.
September 22, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28937063/a-mini-epidemic-of-anti-glomerular-basement-membrane-disease-clinical-and-epidemiological-study
#7
Umesh Lingaraj, Shivaprasad Sasivehalli Mallappa, Rajiv Elkal Neminah, Satishkumar Madakala Mohan, Leelavathi Venkatesh, Sreedhara Chikkanayakanahalli Gurusiddaiah, Niranjan Manibally Rachaiah
Acute glomerulonephritis due to anti-glomerular basement membrane (anti-GBM) antibody disease is rare, estimated to occur in fewer than one case per million population and accounts for less than 20% of rapidly progressive glomerulonephritis. The prevalence among patients evaluated for potential glomerular disease is lower. It accounts for fewer than 3% of all kidney biopsies done with crescentic glomerulonephritis. Cases of anti-GBM disease occurring in a cluster have rarely been reported. All biopsy proven anti-GBM disease cases were collected from January 2015 to March 2015 at our Institute...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28936915/review-of-the-evidence-best-analgesic-regimen-for-shoulder-surgery
#8
Yolanda Huang, Felicia Chiu, Christopher Aj Webb, Paul David Weyker
Multimodal pain management has been advocated in patients experiencing acute pain after surgical procedures due to tissue damage and the subsequent inflammatory response. For patients undergoing shoulder surgeries, studies have definitively shown that interscalene blocks (ISBs) via single-injection or continuous infusion can reduce the total opioid consumption and can lower pain scores after surgery. In some cases, ISBs can be used as the sole anesthetic during shoulder surgeries and spare patients of receiving general anesthesia...
September 22, 2017: Pain Management
https://www.readbyqxmd.com/read/28936911/postoperative-transient-blindness-after-general-anesthesia-and-surgery-case-report-of-conversion-disorder
#9
Semih Gungor, Rohit Aiyer
Postoperative acute visual loss due to organic pathology has been described after spinal surgery in the prone position. This report describes a case of transient postoperative blindness in a patient after general anesthesia and surgery in the prone position. Postoperative workup did not reveal any organic pathology. Unbeknown to the treating physicians, the patient had a comorbid untreated psychiatric history. Upon psychiatric consultation, the patient was diagnosed with conversion disorder as a cause of postoperative blindness...
September 22, 2017: Pain Management
https://www.readbyqxmd.com/read/28936613/chronic-inflammatory-demyelinating-polyradiculoneuropathy-and-anesthesia-a-case-series
#10
Andrew R Mortenson, Juraj Sprung, James C Watson, P James B Dyck, Toby N Weingarten
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired autoimmune demyelinating polyneuropathy characterized by symmetrical diffuse weakness that also can rarely affect bulbar and respiratory muscles. The study objective was to describe perioperative outcomes of patients with CIDP who received general anesthesia. This retrospective observational study evaluated patients with active (diagnosed or treated within the previous year) CIDP who underwent general anesthesia at our institution between January 1, 2010, and December 31, 2015...
September 21, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28936554/preoperative-flurbiprofen-axetil-administration-for-acute-postoperative-pain-a-meta-analysis-of-randomized-controlled-trials
#11
Ke Wang, Jun Luo, Limin Zheng, Tao Luo
OBJECTIVE: Non-steroidal anti-inflammatory drugs have been shown to effectively decrease postoperative pain and reduce opioid requirements. Flurbiprofen axetil is an injectable non-selective cyclooxygenase inhibitor that has a high affinity for inflammatory tissues to achieve targeted drug therapy and prolonged duration of action. This meta-analysis examined the use of preoperative flurbiprofen axetil and its impact on postoperative analgesia. METHODS: An electronic literature search of the Library of PubMed, Cochrane CENTRAL, and EMBASE databases was conducted in Feb 2016...
September 21, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28935681/sex-differences-in-the-utilization-and-outcomes-of-surgical-aortic-valve-replacement-for-severe-aortic-stenosis
#12
Zakeih Chaker, Vinay Badhwar, Fahad Alqahtani, Sami Aljohani, Chad J Zack, David R Holmes, Charanjit S Rihal, Mohamad Alkhouli
BACKGROUND: Studies assessing the differential impact of sex on outcomes of aortic valve replacement (AVR) yielded conflicting results. We sought to investigate sex-related differences in AVR utilization, patient risk profile, and in-hospital outcomes using the Nationwide Inpatient Sample. METHODS AND RESULTS: In total, 166 809 patients (63% male and 37% female) who underwent AVR between 2003 and 2014 were identified, and 48.5% had a concomitant cardiac surgery procedure...
September 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28935558/immediate-interruption-of-sedation-compared-with-usual-sedation-care-in-critically-ill-postoperative-patients-sos-ventilation-a-randomised-parallel-group-clinical-trial
#13
Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber
BACKGROUND: Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. METHODS: We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group)...
September 18, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28935337/necrotizing-sweet-syndrome-of-the-upper-extremity-after-elective-hand-surgery
#14
Jason S Lipof, Lisa A Beck, Swapna C Reddy, Richard D Southgate, Kimberly Carney-Young, Warren C Hammert
Sweet syndrome, or acute febrile neutrophilic dermatosis, is a systemic disease process mainly characterized by hyperpyrexia and skin lesions. A newly described entity, necrotizing Sweet syndrome, is a severe and locally aggressive dermatological condition that clinically and histopathologically resembles a necrotizing soft tissue infection. It is characterized by pathergy, a nonspecific inflammatory response to cutaneous trauma resulting in a propagation of the disease. In contrast to a necrotizing infection, this condition responds to systemic steroids...
September 19, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28934519/intra-pericardial-use-of-recombinant-factor-viia-in-a-patient-with-acute-hemorrhagic-pericardial-effusion-following-transcutaneous-aortic-valve-replacement-a-case-report
#15
Vanya Jaitly, Kimberly Klein, Hlaing Tint, Alice Chen, Paul Allison, Bindu Akkanti, Pranav Loyalka, Brian Castillo
Perioperative bleeding can be a serious life-threatening complication in adult patients undergoing cardiac surgery, given the older age and additional comorbidities present in this patient population. The standard treatment options include transfusion of blood components and surgical re-exploration. We report the first case of an elderly female patient treated with local administration of recombinant factor VIIa (rFVIIa) for intractable hemorrhagic pericardial effusion, which developed following a transcutaneous aortic valve replacement (TAVR) procedure for severe aortic stenosis...
August 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28934425/human-bocavirus-capsid-messenger-rna-detection-in-children-with-pneumonia
#16
Robert Schlaberg, Krow Ampofo, Keith D Tardif, Chris Stockmann, Keith E Simmon, Weston Hymas, Steven Flygare, Brett Kennedy, Anne Blaschke, Karen Eilbeck, Mark Yandell, Jon A McCullers, Derek J Williams, Kathryn Edwards, Sandra R Arnold, Anna Bramley, Seema Jain, Andrew T Pavia
Background: The role of human bocavirus (HBoV) in respiratory illness is uncertain. HBoV genomic DNA is frequently detected in both ill and healthy children. We hypothesized that spliced viral capsid messenger RNA (mRNA) produced during active replication might be a better marker for acute infection. Methods: As part of the Etiology of Pneumonia in the Community (EPIC) study, children aged <18 years who were hospitalized with community-acquired pneumonia (CAP) and children asymptomatic at the time of elective outpatient surgery (controls) were enrolled...
September 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28932492/kidney-remote-ischemic-preconditioning-as-a-novel-strategy-to-explore-the-accurate-protective-mechanisms-underlying-remote-ischemic-preconditioning
#17
Muobarak J Tuorkey
INTRODUCTION: This study reports a novel strategy for investigating the key factors responsible for the protective effect of remote ischemic preconditioning (RIPC) against renal ischemia-reperfusion (IR) injury, which remains the leading cause of the acute kidney injury that increase the morbidity and mortality in patients with renal impairment. METHODS: The renal blood flow of the right kidneys in kidney remote ischemic preconditioning (KRIPC) group was occluded for 20 min...
March 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28932314/cost-effectiveness-analysis-of-treatment-acute-deep-vein-thrombosis-in-clinic-of-vascular-surgery-sarajevo
#18
Haris Vukas, Samra Kadić-Vukas, Adis Salihbegović, Muhamed Djedović, Dragan Totić, Haris Vranić, Amel Hadžimehmedagić
AIM: To compare hospital costs of acute deep vein thrombosis (ADVT) treatment in two periods of time. Evidence of repercussions on reducing costs during successful treatment. Attention was given to the necessity, costs and effectiveness of diagnostic procedures, treatment and complications. METHODS: A retrospective analysis of data obtained from patients medical history in a period from 2000 to 2016. Model management and safe practice of ADVT care consisted of clinical examination, laboratory, colour Doppler and invasive diagnostics...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28932028/cytological-spectrum-of-salivary-gland-lesions-and-their-correlation-with-epidemiological-parameters
#19
Vaneet Kaur Sandhu, Upender Sharma, Navtej Singh, Arun Puri
BACKGROUND: The role fine-needle aspiration (FNA) in the diagnosis of salivary gland lesions has evolved over the years. Although clinical and radiological parameters help to narrow the differential diagnosis the tissue diagnosis still remains the gold standard. MATERIALS AND METHODS: This study is from January 2013 to December 2015 in our Department of Pathology where 170 salivary gland lesions were aspirated. The aim of the present study was to analyze adequacy rate in relation to the size of lesion and to evaluate varied cytological spectrum of salivary gland lesions with emphasis on differential diagnosis and to correlate cytological diagnosis with age, gender and anatomical site...
May 2017: Journal of Oral and Maxillofacial Pathology: JOMFP
https://www.readbyqxmd.com/read/28931255/initial-single-center-technical-experience-with-the-brainpath-system-for-acute-intracerebral-hemorrhage-evacuation
#20
Andrew M Bauer, Peter A Rasmussen, Mark D Bain
BACKGROUND: Surgical intervention has been proposed as a means of reducing the high morbidity and mortality associated with acute intracerebral hemorrhage (ICH), but many previously reported studies have failed to show a clinically significant benefit. Newer, minimally invasive approaches have shown some promise. OBJECTIVE: We report our early single-center technical experience with minimally invasive clot evacuation using the BrainPath system. METHODS: Prospective data were collected on patients who underwent ICH evacuation with BrainPath at the Cleveland Clinic from August 2013 to May 2015...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
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