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https://www.readbyqxmd.com/read/29789815/challenging-case-robot-assisted-laparoscopic-prostatectomy-after-prior-suprapubic-open-prostatectomy
#1
Shirin Razdan, Sanjay Razdan
Introduction: Given the ubiquity of robot-assisted laparoscopic prostatectomy (RALP) for treatment of localized prostate cancer, more surgeons are encountering challenging cases, either secondary to difficult anatomy, prior abdominal surgery, or prior radiation therapy. Our case is of RALP in a patient after prior suprapubic prostatectomy. Case Presentation: A 61-year-old otherwise healthy Hispanic gentleman presented for consultation after being found to have Gleason 4 + 4 = 8 prostate cancer on transrectal ultrasound-guided biopsy by an outside provider in July 2017...
2018: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29789798/the-relation-between-sarcopenia-and-mortality-in-patients-at-intensive-care-unit
#2
Mehmet Toptas, Mazhar Yalcin, İbrahim Akkoc, Eren Demir, Cagatay Metin, Yildiray Savas, Muhsin Kalyoncuoglu, Mehmet Mustafa Can
Background and Aim: Psoas muscle area (PMA) can reflect the status of skeletal muscle in the whole body. It has been also reported that decreased PMA was associated with postoperative mortality or morbidity after several surgical procedures. In this study, we aimed to investigate the relation between PMA and mortality in all age groups in intensive care unit (UNIT). Materials and Method: The study consists of 362 consecutive patients. The demographic characteristics of patients, indications for ICU hospitalization, laboratory parameters, and clinical parameters consist of mortality and length of stay, and surgery history was obtained from intensive care archive records...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29787959/high-voltage-electrical-injury-complicated-by-compartment-syndrome-and-acute-kidney-injury-with-successful-limb-salvage-a-case-report-and-review-of-the-literature
#3
Christopher Wei Guang Ho, Shi-Hui Yang, Chu Hui Wong, Si Jack Chong
INTRODUCTION: Although an uncommon form of admission to a burns centre, the deep, penetrating nature of noxious currents mean that electrical burns have the most catastrophic consequences of all burn injuries. Understanding the physics of electricity is crucial to explaining the mechanisms of tissue damage and organ failure in electrical injuries which necessitate special management above and beyond that of regular thermal burns. PRESENTATION OF CASE: We present a young man who suffered significant occupation-related electrical burns that was complicated by compartment syndrome, rhabdomyolysis and acute kidney injury...
May 16, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29784600/breast-reconstruction-after-mastectomy-a-survey-of-surgeons-and-patients-perceptions
#4
Ariffuddin Ishak, Maya Mazuwin Yahya, Ahmad Sukari Halim
BACKGROUND: Breast reconstruction after mastectomy is important in breast cancer care. MATERIALS AND METHODS: A cross-sectional study was designed to assess surgeons' and patients' perceptions toward breast reconstruction. Questionnaires were distributed to general and breast surgeons in East Coast Malaysian hospitals and Hospital Kuala Lumpur and to postmastectomy patients with and without breast reconstruction at the Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II...
April 28, 2018: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29784455/incidence-and-risk-factors-associated-with-30-day-post-operative-venous-thromboembolism-a-nsqip-pediatric-analysis
#5
Jennifer J Ahn, Paul A Merguerian, Margarett Shnorhavorian
INTRO: Venous thromboembolism (VTE) is a rare event in children, but can cause significant morbidity and mortality. The majority of research on pediatric VTE has been in the trauma and critical care populations. The incidence of VTE after surgery in children is not well-established. OBJECTIVE: The objective was to evaluate the incidence of VTE in the 30 days after surgery, as well as associated risk factors. STUDY DESIGN: All cases in the National Surgical Quality Improvement Program Pediatric (NSQIPP) database from 2012 to 2015 were assessed for presence of post-operative VTE...
May 8, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29782406/population-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine-in-children-undergoing-ambulatory-surgery
#6
María-Gabriela Pérez-Guillé, Alejandra Toledo-López, Liliana Rivera-Espinosa, Radames Alemon-Medina, Chiharu Murata, Ismael Lares-Asseff, Juan Luis Chávez-Pacheco, Josefina Gómez-Garduño, Ana-Lilia Zamora Gutiérrez, Claudia Orozco-Galicia, Karina Ramírez-Morales, Gustavo Lugo-Goytia
BACKGROUND: Dexmedetomidine (DEX) is an α-2 adrenergic agonist with sedative and analgesic properties. Although not approved for pediatric use by the Food and Drug Administration, DEX is increasingly used in pediatric anesthesia and critical care. However, very limited information is available regarding the pharmacokinetics of DEX in children. The aim of this study was to investigate DEX pharmacokinetics and pharmacodynamics (PK-PD) in Mexican children 2-18 years of age who were undergoing outpatient surgical procedures...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29781847/identification-of-the-critical-nontechnical-skills-for-surgeons-needed-for-high-performance-in-a-variable-resource-context-notss-vrc
#7
John W Scott, Yihan Lin, Georges Ntakiyiruta, Zeta Mutabazi, William A Davis, Megan A Morris, Douglas S Smink, Robert Riviello, Steven Yule
OBJECTIVE: To identify the critical nontechnical skills (NTS) required for high performance in variable-resource contexts (VRC). BACKGROUND: As surgical training and capacity increase in low- and middle-income countries (LMICs), new strategies for improving surgical education and care in these settings are required. NTS are critical for high performance in surgery around the world. However, the essential NTS used by surgeons operating in LMICs to overcome the challenges specific to their contexts have never been described...
May 17, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29774817/bladder-reconstruction-with-bowel-robot-assisted-laparoscopic-ileocystoplasty-with-mitrofanoff-appendicovesicostomy-in-pediatric-patients
#8
Nimrod S Barashi, Maria Veronica Rodriguez, Vignesh T Packiam, Mohan S Gundeti
Neurogenic bladder occur as a consequence of several conditions, most commonly posterior urethral valves syndrome, spina bifida, tethered cord, sacral agenesis, and Arnold-Chiari malformation. It is characterized by diminished bladder capacity and/or reduced compliance, associated with high-pressure voiding that can lead to deterioration of renal function if left untreated. When medical management fails, bladder reconstruction with bowel (aumentation ileocystoplasty) becomes the treatment of choice for these patients...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#9
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29770847/the-investigation-of-the-survival-time-after-recurrence-in-patients-with-pancreatic-ductal-adenocarcinoma-for-individualization-of-adjuvant-chemotherapy
#10
Daisaku Yamada, Hidetoshi Eguchi, Yoshifumi Iwagami, Tadafumi Asaoka, Takehiro Noda, Koichi Kawamoto, Kunihito Gotoh, Shogo Kobayashi, Masaki Mori, Yuichiro Doki
PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease; however, the frequency of recurrence can be reduced if curative surgery following adjuvant chemotherapy is applied. At present, adjuvant chemotherapy is uniformly performed in all patients, as it is unclear which tumor types are controlled best or worst. We investigated patients with recurrence to establish the optimum treatment strategy. METHODS: Of 138 patients who underwent curative surgery for PDAC, 85 developed recurrence...
May 17, 2018: Surgery Today
https://www.readbyqxmd.com/read/29770294/three-dimensional-modelling-and-three-dimensional-printing-in-pediatric-and-congenital-cardiac-surgery
#11
REVIEW
Laszlo Kiraly
Three-dimensional (3D) modelling and printing methods greatly support advances in individualized medicine and surgery. In pediatric and congenital cardiac surgery, personalized imaging and 3D modelling presents with a range of advantages, e.g., better understanding of complex anatomy, interactivity and hands-on approach, possibility for preoperative surgical planning and virtual surgery, ability to assess expected results, and improved communication within the multidisciplinary team and with patients. 3D virtual and printed models often add important new anatomical findings and prompt alternative operative scenarios...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29769505/efficacy-of-0-5-hyperbaric-bupivacaine-with-dexamethasone-versus-0-5-hyperbaric-bupivacaine-alone-in-spinal-anaesthesia-for-patient-undergoing-lower-abdominal-urological-and-lower-limb-orthopedic-surgeries
#12
M M Haque, M A Aleem, F H Haque, A B Siddique, R Afrose
Spinal anaesthesia with local anaesthetics has limited duration. Different additives have been used to prolong spinal anaesthesia. The aim of this study was to determine the efficacy of adding dexamethasone to bupivacaine in spinal anaesthesia specially whether it would prolong the duration of sensory block/ surgical analgesia and post-operative analgesia/pain free period or not. This randomized, prospective, double-blind, clinical study was conducted in the Department of Anaesthesia, Analgesia and Critical Care of Combined Military Hospital, Chittagong from October 2016 to August 2017...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29766138/risk-stratification-tools-in-emergency-general-surgery
#13
REVIEW
Joaquim Michael Havens, Alexandra B Columbus, Anupamaa J Seshadri, Carlos V R Brown, Gail T Tominaga, Nathan T Mowery, Marie Crandall
The use of risk stratification tools (RST) aids in clinical triage, decision making and quality assessment in a wide variety of medical fields. Although emergency general surgery (EGS) is characterized by a comorbid, physiologically acute patient population with disparately high rates of perioperative morbidity and mortality, few RST have been explicitly examined in this setting. We examined the available RST with the intent of identifying a tool that comprehensively reflects an EGS patients perioperative risk for death or complication...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29766136/can-necrotizing-soft-tissue-infection-be-reliably-diagnosed-in-the-emergency-department
#14
Sharon M Henry, Kimberly A Davis, Jonathan J Morrison, Thomas M Scalea
Necrotizing soft tissue infections (NSTIs) are associated with a high mortality and require prompt recognition and treatment, consisting of aggressive surgical debridement and critical care support. Diagnosis is a key step, which is generally made in the operating room (OR), but the decision to debride requires guidance. This is frequently made on clinical grounds, but NSTI can be occult in presentation and several other infective processes can mimic NSTI. It is unknown whether the various scoring systems described in the literature can enable clinicians to reliably diagnose NSTI in the emergency department, rather than the OR...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29766132/red-cell-distribution-width-predicts-out-of-hospital-outcomes-in-critically-ill-emergency-general-surgery-patients
#15
Joaquim Michael Havens, Anupamaa J Seshadri, Ali Salim, Kenneth B Christopher
Introduction: Red cell distribution width (RDW) is associated with mortality and bloodstream infection risk in critically ill patients. We hypothesized that an increase in RDW at hospital discharge in critically ill patients who received emergency general surgery (EGS) would be associated with increased mortality after hospital discharge. Methods: We performed a two-center observational study of patients treated in medical and surgical intensive care units. We studied 1567 patients, who received critical care between 1998 and 2012 who underwent EGS and survived hospitalization...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#16
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29762304/effectiveness-and-harms-of-pharmacological-interventions-in-the-treatment-of-delirium-in-adults-in-intensive-care-units-post-cardiac-surgery-a-systematic-review-protocol
#17
Vivienne Leigh, Catalin Tufanaru, Rosalind Elliott
The review objective is to synthesize the best available evidence on the effectiveness and harms of pharmacological interventions in the treatment of delirium in adults in intensive care units (ICU) after cardiac surgery.The specific review question is: What is the effectiveness and what are the harms of pharmacological interventions in relation to the duration and severity of delirium episodes, length of stay in ICU, length of stay in hospital, functional capacity and quality of life and mortality for critically ill adult patients treated in intensive care after cardiac surgery?...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29756609/impact-of-resection-margin-status-on-oncological-outcomes-after-co2-laser-cordectomy
#18
P Aluffi Valletti, F Taranto, A Chiesa, F Pia, G Valente
The management of positive resection margins in micro-endoscopic glottic laser surgery remains a controversial and critical point. This study aims to assess the impact of margin status after transoral laser surgery on local control, survival and organ preservation rates; the decision-making process and treatment options in cases with positive margins are also discussed. We retrospectively reviewed the clinical and histological records of 308 consecutive patients with primary early glottic carcinoma (T1a, T1b, selected T2) and treated with endoscopic laser cordectomy...
February 2018: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29756521/cost-analysis-of-initial-treatment-with-endovascular-revascularization-open-surgery-or-primary-major-amputation-in-patients-with-peripheral-artery-disease
#19
Linda Tang, Sharath C V Paravastu, Shannon D Thomas, Elaine Tan, Eric Farmer, Ramon L Varcoe
PURPOSE: To compare the total initial treatment costs for open surgery, endovascular revascularization, and primary major amputation within a single-payer healthcare system. METHODS: A multicenter, retrospective analysis was undertaken to evaluate 1138 patients with symptomatic peripheral artery disease (PAD) who underwent 1017 endovascular procedures, 86 open surgeries, and 35 major amputations between 2013 and 2016. A cost-mix analysis was performed on individual patient data generated for selected diagnosis-related groups...
May 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29753669/does-the-weekend-effect-for-postoperative-mortality-stand-up-to-scrutiny-association-for-cardiothoracic-anesthesia-and-critical-care-cohort-study-of-110-728-cardiac-surgical-patients
#20
Olympia Papachristofi, Andrew A Klein, John Mackay, Samer Nashef, Nick S Fletcher, Linda D Sharples
OBJECTIVE: Ongoing debate focuses on whether patients admitted to the hospital on weekends have higher mortality than those admitted on weekdays. Whether this apparent "weekend effect" reflects differing patient risk, care quality differences, or inadequate adjustment for risk during analysis remains unclear. This study aimed to examine the existence of a "weekend effect" for risk-adjusted in-hospital mortality after cardiac surgery. DESIGN: Retrospective analysis of prospectively collected cardiac registry data...
April 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
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