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https://www.readbyqxmd.com/read/28106782/from-clinical-standards-to-translating-next-generation-sequencing-research-into-patient-care-improvement-for-hepatobiliary-and-pancreatic-cancers
#1
REVIEW
Ioannis D Kyrochristos, Georgios K Glantzounis, Demosthenes E Ziogas, Ioannis Gizas, Dimitrios Schizas, Efstathios G Lykoudis, Evangelos Felekouras, Anastasios Machairas, Christos Katsios, Theodoros Liakakos, William C Cho, Dimitrios H Roukos
Hepatobiliary and pancreatic (HBP) cancers are associated with high cancer-related death rates. Surgery aiming for complete tumor resection (R0) remains the cornerstone of the treatment for HBP cancers. The current progress in the adjuvant treatment is quite slow, with gemcitabine chemotherapy available only for pancreatic ductal adenocarcinoma (PDA). In the advanced and metastatic setting, only two targeted drugs have been approved by the Food & Drug Administration (FDA), which are sorafenib for hepatocellular carcinoma and erlotinib for PDA...
January 18, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28105610/antithyroid-drug-induced-agranulocytosis-state-of-the-art-on-diagnosis-and-management
#2
Nuno Vicente, Luís Cardoso, Luísa Barros, Francisco Carrilho
Agranulocytosis is a rare but serious complication of antithyroid drug therapy, and an up-to-date understanding of this topic is important. Both direct toxicity and immune-mediated responses have been described as possible mechanisms. Some major susceptibility loci have recently been identified, which may lead the diagnosis of agranulocytosis into a genomic era. Onset is acute and patients present with symptoms and signs of infection together with high fever. Clinical suspicion is pivotal and should prompt blood sampling...
January 19, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28100941/outcomes-of-laparoscopy-combined-with-enhanced-recovery-pathway-for-reversal-of-hartmann-s-procedure
#3
Liang Zhang, Yong Zhong, Hao Lin, Lv Xiao-Peng
The objective of this study is to discuss the security and feasibility of the laparoscopic reversal of Hartmann's procedure (LRHP) on the concept of enhanced recovery after surgery (ERAS). The clinical data of 42 patients who underwent laparoscopic reversal of Hartmann's procedure was retrospectively analyzed, and the operative time, blood loss, intraoperative and postoperative complications, conversion to open surgery, postoperative hospital stay, and so on were observed. Twenty-nine patients (69.00 % of the study pool) received complete postoperative recovery courses as prescribed by enhanced recovery program (ERP)...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28098563/aortic-surgery-and-laparoscopy-still-a-future-in-the-endovascular-surgery-era
#4
Pierfrancesco Veroux, Vincenzo Ardita, Alessia Giaquinta, Alberto Davì, Giusi Basile, Massimiliano Veroux
: Laparoscopic surgery (LS) is the minimally invasive alternative to open surgery and endovascular approach for treating major aortic diseases. Only few reports in the literature describe the long-term outcomes of the laparoscopic approach for major vascular diseases. Furthermore, the widespread use of endovascular techniques has limited the use of LS to wellselected patients. This review evaluated the results of LS for aortic disease and compared the clinical outcomes of laparoscopic technique with those of open and endovascular surgery...
September 30, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#5
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28095385/early-cholecystectomy-for-acute-cholecystitis-in-the-elderly-population-a-systematic-review-and-meta-analysis
#6
Charlotte S Loozen, Bert van Ramshorst, Hjalmar C van Santvoort, Djamila Boerma
BACKGROUND: In the era of advanced surgical techniques and improved perioperative care, the willingness to perform emergency operations in elderly patients continues to increase. This systematic review aimed at assessing the clinical outcomes of early cholecystectomy in elderly patients with acute cholecystitis. METHODS: Medline, Embase, and Cochrane Library databases were systematically searched for studies reporting on early cholecystectomy for acute cholecystitis in patients aged ≥70 years...
January 18, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28093901/does-hospital-readmission-following-colorectal-cancer-resection-and-enhanced-recovery-after-surgery-impact-on-long-term-survival
#7
Nathan J Curtis, Emma Noble, Emad Salib, Rob Hipkiss, Emily Meachim, Richard Dalton, Andrew Allison, Jonathan Ockrim, Nader K Francis
BACKGROUND: Hospital readmission is undesirable for patients and care providers as this can impact short-term recovery and carries financial consequences. It is unknown if readmission has long term implications. AIM: To investigate the impact of thirty day readmission on long term overall survival following colorectal cancer resection within enhanced recovery after surgery (ERAS) care and explore the reasons, severity and details of readmission episodes. METHODS: A dedicated, prospectively populated database was reviewed...
January 17, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#8
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28076474/growth-factors-and-cox2-in-wound-healing-an-experimental-study-with-ehrlich-tumors
#9
Flávio L L Salgado, Ricardo Artigiani-Neto, Gaspar de Jesus Lopes-Filho
Background: Healing is an innate biological phenomenon, and carcinogenesis acquired, but with common humoral and cellular elements. Carcinogenesis interferes negatively in healing. Aim: To evaluate the histological changes in laparotomy scars of healthy Balb/c mice and with an Ehrlich tumor in its various forms of presentation. Methods: Fifty-four mice were divided into three groups of 18 animals. First group was the control; the second had Ehrlich tumor with ascites; and the third had the subcutaneous form of this tumor...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28070592/therapeutic-genome-editing-with-engineered-nucleases
#10
Simone A Haas, Viviane Dettmer, Toni Cathomen
Targeted genome editing with designer nucleases, such as zinc finger nucleases, TALE nucleases, and CRISPR-Cas nucleases, has heralded a new era in gene therapy. Genetic disorders, which have not been amenable to conventional gene-addition-type gene therapy approaches, such as disorders with dominant inheritance or diseases caused by mutations in tightly regulated genes, can now be treated by precise genome surgery. Moreover, engineered nucleases enable novel genetic interventions to fight infectious diseases or to improve cancer immunotherapies...
January 10, 2017: Hämostaseologie
https://www.readbyqxmd.com/read/28062937/protocol-for-enhanced-recovery-after-surgery-improves-short-term-outcomes-for-patients-with-gastric-cancer-a-randomized-clinical-trial
#11
Ryo Tanaka, Sang-Woong Lee, Masaru Kawai, Keitaro Tashiro, Satoshi Kawashima, Syuji Kagota, Kotaro Honda, Kazuhisa Uchiyama
BACKGROUND: The feasibility of the use of the enhanced recovery after surgery (ERAS) protocol in patients with gastric cancer remains unclear. METHODS: This study was a single-center, prospective randomized trial involving patients with gastric cancer undergoing curative gastrectomy. The primary end point was the length of postoperative hospital stay. Secondary end points were the postoperative complication rate, admission costs, weight loss, and amount of physical activity...
January 6, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28061895/initial-experience-with-laparoscopic-radical-antegrade-modular-pancreatosplenectomy-for-left-sided-pancreatic-cancer-in-a-single-institution-technical-aspects-and-oncological-outcomes
#12
Eun Young Kim, Tae Ho Hong
BACKGROUND: Laparoscopic surgery has been performed less frequently in the era of pancreatic cancer due to technical difficulties and concerns about oncological safety. Radical antegrade modular pancreatosplenectomy (RAMPS) is expected to be helpful to obtain a negative margin during radical lymph node dissection. We hypothesized that it would also be favorable as a laparoscopic application due to unique features. METHODS: Fifteen laparoscopic RAMPS for well-selected patients with left-sided pancreatic cancer were performed from July 2011 to April 2016...
January 7, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28056244/-trend-of-development-and-prospect-of-gastrointestinal-surgery-in-era-of-minimally-invasive
#13
X Y Qin
The development and popularization of minimally invasive treatment is gradually evolving in the course of human fighting against disease. Minimally invasive surgery has been widely accepted and carried out because of the advantages of smaller trauma, less pain, little impact on the body and physiological metabolism of the body. The evidence-based medicine makes it important to conduct clinical trials to confirm the technical and oncological safety. With the development of minimally invasive technologies, including three-dimensional laparoscopic, natural orifice transluminal endoscopic surgery, robotic surgery system, minimally invasive surgery are providing more opportunities and challenges for gastrointestinal diseases...
January 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28054356/impact-of-a-peri-operative-quality-improvement-programme-on-postoperative-pulmonary-complications
#14
J A Moore, D H Conway, N Thomas, D Cummings, D Atkinson
Postoperative pulmonary complications are common, with a reported incidence of 2-40%, and are associated with adverse outcomes that include death, longer hospital stay and reduced long-term survival. Enhanced recovery is now a standard of care for patients undergoing elective major surgery. Despite the high prevalence of pulmonary complications in this population, few elements of enhanced recovery specifically address reducing these complications. In 2013, a prevalence audit confirmed a postoperative pulmonary complication rate of 16/83 (19...
January 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28051291/biobanking-in-carotid-artery-disease-translation-to-clinical-practice
#15
Ian D VAN Koeverden, Joyce E Vrijenhoek, Gert J DE Borst, Hester M DEN Ruijter, Gerard Pasterkamp
Biobanking of atherosclerotic tissue samples has contributed to our understanding of vascular occlusive disease. The careful examination of atherosclerotic plaques derived during vascular surgery or autopsies helped shape our minds in understanding the underlying substrate of arterial thrombosis. This review will outline concepts of progression of atherosclerotic disease that have been based on descriptions of human plaque pathology. In addition, we will discuss the current shift in clinical presentation and underlying pathology of acute cerebral and coronary events that asks for a careful consideration of the currently widely applied description of the "vulnerable plaque"...
January 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28044948/surgical-stress-reduction-in-elderly-patients-undergoing-elective-colorectal-laparoscopic-surgery-within-an-eras-protocol
#16
Giulio Mari, Andrea Costanzi, Jacopo Crippa, Rosanna Falbo, Angelo Miranda, Michele Rossi, Valter Berardi, Dario Maggioni
ERAS program applied to colorectal laparoscopic surgery is well known to reduce hospitalization improving short terms outcomes and minimizing the Surgical Stress Response. However its effectiveness in elderly population is yet to be demonstrated. The primary aim of this study is to compare the level of immune and nutritional serum indexes across surgery in patients aged over 70 years old undergoing elective colorectal laparoscopic surgery within an ERAS protocol or according to a Standard program. 83 patients undergoing colorectal laparoscopic surgery were enrolled and randomized in two groups (ERAS Group 40, Standard Group 43) within a larger randomized trial on a general population...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28040858/multicenter-analysis-of-neoadjuvant-docetaxel-carboplatin-and-trastuzumab-in-her2-positive-breast-cancer
#17
Isabel Echavarria, Mónica Granja, Coralia Bueno, Sara Lopez-Tarruella, Paloma Peinado, Miguel Sotelo, Yolanda Jerez, Fernando Moreno, Gabriela Torres, Miriam Lobo, Ivan Marquez-Rodas, Maria Del Monte-Millan, Miguel Martín, Jose Angel García-Saenz
PURPOSE: In an era where neoadjuvant dual blockade is emerging as the standard of care for early and locally advanced HER2-positive breast cancer, we aimed to identify predictors of response to single-blockade chemotherapy. METHODS: This retrospective analysis reviewed all the incident stage I-III HER2-positive breast cancer patients who received neoadjuvant docetaxel, carboplatin, and trastuzumab (TCH) in three institutions. pCR was defined as the absence of invasive tumor in breast and axillary nodes (ypT0/isypN0)...
December 31, 2016: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28018759/could-the-use-of-an-enhanced-recovery-protocol-in-laparoscopic-donor-nephrectomy-be-an-incentive-for-live-kidney-donation
#18
Aparna Rege, Harold Leraas, Deepak Vikraman, Kadiyala Ravindra, Todd Brennan, Tim Miller, Julie Thacker, Debra Sudan
INTRODUCTION AND BACKGROUND: Gastrointestinal (GI) recovery after major abdominal surgery can be delayed from an ongoing need for narcotic analgesia thereby prolonging hospitalization. Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to facilitate early recovery after major surgery by maintaining preoperative body composition and physiological organ function and modifying the stress response induced by surgical exposure. Enhanced recovery programs (ERPs) in colorectal surgery have decreased the duration of postoperative ileus and the hospital stay while showing equivalent morbidity, mortality, and readmission rates in comparison to the traditional standard of care...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/28018536/computer-modeling-to-evaluate-the-impact-of-technology-changes-on-resident-procedural-volume
#19
Tyler R Grenda, Tiffany N S Ballard, Andrea T Obi, William Pozehl, F Jacob Seagull, Ryan Chen, Amy M Cohn, Mark S Daskin, Rishindra M Reddy
BACKGROUND : As resident "index" procedures change in volume due to advances in technology or reliance on simulation, it may be difficult to ensure trainees meet case requirements. Training programs are in need of metrics to determine how many residents their institutional volume can support. OBJECTIVE : As a case study of how such metrics can be applied, we evaluated a case distribution simulation model to examine program-level mediastinoscopy and endobronchial ultrasound (EBUS) volumes needed to train thoracic surgery residents...
December 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28012330/synchronous-hepatic-metastasis-and-metachronous-krukenberg-tumor-from-advanced-colon-cancer-a-case-report-with-an-unexpected-disease-free-survival
#20
Giovanni Li Destri, Lidia Puzzo, Alessia Erika Russo, Francesco Ferraù, Antonio Di Cataldo, Stefano Puleo
BACKGROUND: In the international literature we have never found a long survival in patients treated for a colon cancer with synchronous hepatic metastases and for a metachronous Krukenberg tumor. PRESENTATION OF CASE: A 46-year old woman for an advanced colon cancer with a synchronous hepatic metastases was subjected to a left hemicolectomy and a resection of liver segment V (R0 resection; T4N2bM1; stage IVa according AJCC 2010). After one year a CT of the abdomen revealed an expansive formation of the left ovary...
November 23, 2016: International Journal of Surgery Case Reports
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