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https://www.readbyqxmd.com/read/28444770/factors-associated-with-local-recurrence-in-operated-osteosarcomas-a-retrospective-evaluation-of-95-cases-from-a-tertiary-care-center-in-a-resource-challenged-environment
#1
Rishi R Poudel, Vivek Tiwari, Venkatesan S Kumar, Sameer Bakhshi, Shivanand Gamanagatti, Shah Alam Khan, Shishir Rastogi
BACKGROUND AND OBJECTIVES: Local control of disease is one of the main goals of osteosarcoma management. We conducted a retrospective evaluation of 95 operated cases of osteosarcoma over 7 years to know about the factors associated with local recurrence in resource-challenged environment of the developing world. METHODS: The factors which were evaluated and compared between local recurrence and non-local recurrence groups included demographic profile, site of tumor, whether biopsy done outside, type of surgery (limb salvage or amputation), presence of pathological fracture, vicinity of neurovascular bundle, tumor volume, histological subtype, chemotherapy induced necrosis, surgical margins, and delay in surgery...
April 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28444764/prospective-unbiased-experience-with-three-acellular-dermal-matrices-in-breast-reconstruction
#2
Edward I Chang, Jun Liu
BACKGROUND: The use of acellular dermal matrix (ADM) has become the standard of care in breast reconstruction. However, the majority of current studies are biased or combine large databases introducing inherent flaws. Here, we present a prospective single surgeon experience comparing three ADM. METHODS: All expander based breast reconstructions between 2014 and 2015 using ADM were included. RESULTS: Eighteen patients (32 breasts) underwent reconstruction using Flex Pliable, 15 patients (22 breasts) used Alloderm, and 14 patients (20 breasts) had Dermacell...
April 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28444558/evolution-of-surgical-treatment-for-rectal-cancer-a-review
#3
Sanjeev Dayal, Nick Battersby, Tom Cecil
Surgery that produces an optimal total mesorectal excision (TME) resection specimen remains the cornerstone of curative rectal cancer management. In the modern era, despite the results of recent randomised trials, laparoscopic TME is a crucial technique in the TME surgery armamentarium. Laparoscopic surgery offers the benefit of magnified views that aid sharp and precise dissection. However operating in the confines of a narrow pelvis, particularly when the mesorectum is bulky, requires significant technical skill...
April 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28444463/cost-effectiveness-of-craniotomy-for-epidural-hematomas-at-a-major-government-hospital-in-cambodia
#4
Dane Moran, Mark G Shrime, Sam Nang, Iv Vycheth, Din Vuthy, Raksmey Hong, William V Padula, Kee B Park
BACKGROUND: Epidural hematoma (EDH) is a common and potentially deadly occurrence following a severe traumatic brain injury. Our aim was to determine whether craniotomy is cost-effective when indicated for the treatment of EDH when a trained neurosurgeon is available. METHODS: A decision tree was used to model the cost-effectiveness of craniotomy available versus craniotomy unavailable for the management of traumatic EDH from a Cambodian societal and provider perspective...
April 25, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28444404/velmahos-gc-degiannis-e-doll-d-eds-penetrating-trauma-a-practical-guide-on-operative-technique-and-peri-operative-management-springer-verlag-berlin-heidelberg-2017-isbn-978-3-662-49857-6-print-978-3-662-49859-0-online
#5
F J Turégano
No abstract text is available yet for this article.
April 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28444129/return-to-sport-following-stress-fractures-of-the-great-toe-sesamoids-a-systematic-review
#6
G A J Robertson, J S Goffin, A M Wood
Introduction: This review aims to provide information on return rates and times to sport following stress fractures of the great toe sesamoids (SFGTSs). Sources of data: A systematic search of CINAHAL, Cochrane, EMBASE, Google Scholar, Medline, PEDro, Scopus, SPORTDiscus and Web of Science was performed using the keywords 'stress', 'fractures', 'great', 'toe', 'sesamoid', 'athletes', 'sports', 'non-operative', 'conservative', 'operative' and 'return to sport'. Areas of agreement: Fourteen studies were included: three studies reported on the outcome of conservatively-managed SFGTSs; thirteen studies reported on the outcome of surgically-managed SFGTSs...
April 24, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28444048/state-health-managers-perceptions-of-the-public-health-action-organizational-contract-in-the-state-of-cear%C3%A3-brazil
#7
Neusa Goya, Luiz Odorico Monteiro de Andrade, Ricardo José Soares Pontes, Fábio Solon Tajra, Ivana Cristina de Holanda Cunha Barreto
The Public Health Action Organizational Contract (COAP) / Decree 7.508/2011 aimed to seal health agreements made between federated entities to promote the cooperative governance and management of Health Regions. A qualitative study was carried out adopting a hermeneutic approach to understand state health managers' perceptions of the elaboration and effects of the COAP in the State of Ceará. Open-ended interviewees and documental analysis were conducted. It was observed that the COAP led to the strengthening of regionalization in the government sphere; institutional gains through the implementation of ombudsmen and the National System of Pharmaceutical Care Management; increased information about the state health system's workforce; and health budget transparency...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444047/health-regionalization-in-amazonas-progress-and-challenges
#8
Luiza Garnelo, Amandia Braga Lima Sousa, Clayton de Oliveira da Silva
This paper analyses the health services regionalization process in the State of Amazonas through a case study covering the health sub-region Manaus Surroundings. This is a qualitative, descriptive and analytical research, which data were collected using interviews, documents and Internet reviews, oriented by the guiding concept of health regionalization. Study findings revealed a social setting dominated by asymmetry, verticality, competitiveness and fragile multilateral relations among municipalities, associated to a bureaucratic profile of local institutions operating in the region under study...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444040/the-prominent-role-of-councils-of-municipal-health-secretariats-in-the-regional-governance-process
#9
Helena Eri Shimizu, Mariana Sodário Cruz, Nilo Bretas, Sergio Ricardo Schierholt, Walter Massa Ramalho, Maíra Catharina Ramos, Monique Santos Mesquita, Everton Nunes Silva
This study aims to analyze the perception of managers of the Councils of Municipal Health Secretariats (COSEMS) and their contributions to the health regionalization process. We conducted thorough interviews with presidents of COSEMS of the states of Mato Grosso do Sul, Paraná, Ceará, Tocantins and Minas Gerais. Data were analyzed with Iramuteq software, which generated a dendrogram with three themes: The first thematic axis: the prominent role of COSEMS in the regional governance process, which includes class 1 - COSEMS' leadership in the process of regionalization, and class 3 - The strategic experience of the regional agreement process...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444039/the-health-regionalization-process-from-the-perspective-of-the-transation-cost-theory
#10
Leyla Gomes Sancho, Daniela Savi Geremia, Sulamis Dain, Fabiano Geremia, Cláudio José Silva Leão
This study analyzes the incidence of transaction costs in the regionalization process of health policies in the Brazilian federal system. In this work, regionalized health actions contracted and agreed between federal agencies have assumed a transactional nature. A conceptual theoretical essay of reflective nature was prepared with the purpose of questioning and proposing new approaches to improve the health regionalization process. The main considerations suggest that institutional management tools proposed by the standards and regulations of the Unified Health System have a low potential to reduce transaction costs, especially due to hardships in reconciling common goals among the entities, environment surrounded by uncertainty, asymmetries and incomplete information, bounded rationality and conflict of interest...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28443977/contributions-of-paulo-freire-to-understanding-the-dialogic-leadership-exercise-of-nurses-in-the-hospital-setting
#11
Simone Coelho Amestoy, Anelise Freitas Lins de Oliveira, Maira Buss Thofehrn, Letícia de Lima Trindade, Bianca Pozza Dos Santos, Ana Cristina Pretto Bao
Objective: To know the understanding of nurses regarding the exercise of dialogic leadership in the hospital setting, and the challenges of leadership. Methods: Qualitative and exploratory-descriptive study Thirty-five nurses of a mid-sized hospital in the city of Pelotas/RS participated in this study. Data were collected by means of semi-structured interviews, subsequently analysed using the operative proposal of Minayo. Results: The results led to the following categories: exercise of dialogic leadership and challenges in the exercise of dialogic leadership...
April 4, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28443816/segmental-volvulus-in-the-neonate-a-particular-clinical-entity
#12
Naziha Khen-Dunlop, Sylvie Beaudoin, Blandine Marion, Véronique Rousseau, Agnes Giuseppi, Muriel Nicloux, David Grevent, Laurent J Salomon, Yves Aigrain, Alexandre Lapillonne, Sabine Sarnacki
BACKGROUND: Complete intestinal volvulus is mainly related to congenital anomalies of the so-called intestinal malrotation, whereas segmental volvulus appears as a distinct entity, mostly observed during the perinatal period. Because these two situations are still lumped together, the aim of this study was to describe the particular condition of neonatal segmental volvulus. STUDY DESIGN: We analyzed the circumstances of diagnosis and management of 17 consecutives neonates operated for segmental volvulus more than a 10-year period in a single institution...
March 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28443676/pre-operative-nomograms-for-predicting-renal-function-at-1-year-after-partial-nephrectomy
#13
Cheuk Fan Shum, Clinton D Bahler, Clint Cary, Timothy A Masterson, Ronald S Boris, Thomas A Gardner, Hristos Z Kaimakliotis, Rick Foster, Richard Bihrle, Michael Koch, James E Slaven, Chandru P Sundaram
INTRODUCTION: Partial nephrectomy (PN) reduces the risk of post-operative chronic renal insufficiency (CRI). However, some patients still develop CRI after PN, and may eventually require dialysis. Being able to predict renal function before PN helps in counseling patients and managing expectations. We aimed to construct nomograms that predict estimated glomerular filtration rate (eGFR), defined by the Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulae, at one year after PN, using only pre-operative covariates as predictors...
April 26, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28442849/operative-management-of-enteroatmospheric-fistula-in-bj%C3%A3-rck-4-open-abdomen-patients-by-the-help-of-laparoscopic-lateral-approach
#14
Fahri Yetişir, A Ebru Sarer
As the open abdomen (OA) management increases, the number of fistula formation has also been increasing during the last two decades. These fistulas in OA have been defined as enteroatmospheric fistula (EAF). EAF occurring in a frozen OA is classified as Björck 4 OA. Management of Björck 4 OA patient is not easy and mortality of these patients is very high in spite of the presence of modern treatment modalities. There are a few surgical approaches for treatment of Björck 4 OA patients. One of them is excising the hostile segment by lateral abdominal approach from the healthy side or entering from lateral border of OA wound after enough time intervals for subsiding of the edematous intestine in acute inflammatory reaction in the hostile environment...
April 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28442687/postoperative-management-of-penetrating-and-nonpenetrating-external-filtering-procedures
#15
Paolo Bettin, Federico Di Matteo
Correct postoperative management is fundamental to prevent and treat complications and to optimize the success of filtering surgery. Timely control visits and appropriate actions and prescriptions ensure the best outcomes, allow recovery from a number of untoward events, and can reestablish filtration when failure seems imminent. In contrast, a slack follow-up and wrong interventions or prescriptions can lead to the failure of any surgery, no matter how accurately it was carried out, sometimes jeopardizing vision and even the anatomy of the globe...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28442660/anatomic-feasibility-of-next-generation-stent-grafts-for-the-management-of-type-a-aortic-dissection-in-japanese-patients
#16
Naoki Fujimura, Shinji Kawaguchi, Hideaki Obara, Akihiro Yoshitake, Masanori Inoue, Satoshi Otsubo, Yuko Kitagawa, Hideyuki Shimizu
BACKGROUND: The aims of the present study were to analyze the anatomical characteristics of type A aortic dissections (TAAD) in Japanese patients and evaluate the feasibility of 3 next-generation stent grafts dedicated to ascending/arch aortic lesions.Methods and Results:We analyzed 172 consecutive patients surgically treated for TAAD at 2 institutions between 2007 and 2015. Computed tomography (CT) images and operative records were used to identify the location of entry tear (ET)...
April 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28442330/symptomatic-carotid-artery-disease-revascularization
#17
REVIEW
Piero Montorsi, Stefano Galli, Paolo M Ravagnani, Marco Roffi
Patients with symptomatic carotid artery disease should be managed by a multidisciplinary team including neurologists, vascular surgeons and interventionalists. Duplex ultrasound is the most widely used diagnostic modality to assess carotid disease, followed by additional imaging tests (CT- or MR-angiography) to confirm the severity of the stenosis, detect brain lesions, and assess intracranial circulation as well as the supra-aortic anatomy. Although overall randomized trial results favored (CEA) over carotid artery stenting (CAS) in symptomatic patients, this was likely related to the insufficient expertise of the endovascular specialists in several of the trials...
April 22, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28442135/-anesthetic-management-of-late-pressure-angioedema
#18
Inês Furtado, Filipe Linda, Sílvia Pica, Marco Monteiro
BACKGROUND AND OBJECTIVES: Late pressure angioedema is a rare form of angioedema in which light pressure stimulus can lead to edema after 1-12h. This uncommon and unreported entity is especially important in patients who undergo general anesthesia, for whom the usual harmless supine position, intravenous catheter insertion, standard monitoring, airway management and ventilation can lead to life threatening consequences as the trigger is a physical stimulus. CASE REPORT: In this report, we describe a successful perioperative anesthetic management of a 30 year old patient, proposed for intra-ocular lens insertion, with a severe form of the disease with peri-oral, tongue and limb edema presentation...
April 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28441990/high-mobility-group-box-1-biomarker-of-inhaled-corticosteroid-treatment-response-in-children-with-moderate-severe-asthma
#19
Sara Manti, Salvatore Leonardi, Giuseppe F Parisi, Dominique De Vivo, Annamaria Salpietro, Antonietta Spinuzza, Teresa Arrigo, Carmelo Salpietro, Caterina Cuppari
BACKGROUND: High mobility group box 1 (HMGB1) is abnormally expressed in serum and sputum of patients with allergic asthma. OBJECTIVE: The aim of this study was to investigate the role of HMGB1 as guidance for treatment management of children with asthma. METHODS: Thirty children with asthma and 44 healthy children were enrolled. The patients were classified according to Global Initiative for Asthma Guideline disease severity criteria. Sputum HMGB1 levels and lung function index (percentage forced expiratory volume in 1 second [FEV1%]) were recorded in the cohort study at baseline (T0) and after 3 (T3) and 6 (T6) months of inhaled corticosteroids (ICS) treatment...
May 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28441963/in-hospital-airway-management-training-for-non-anesthesiologist-ems-physicians-a-descriptive-quality-control-study
#20
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Pre-hospital airway management is a major challenge for emergency medical service (EMS) personnel. Despite convincing evidence that the rescuer's qualifications determine efficacy of tracheal intubation, in-hospital airway management training is not mandatory in Austria, and often neglected. Thus we sought to prove that airway management competence of EMS physicians can be established and maintained by a tailored training program. METHODS: In this descriptive quality control study we retrospectively evaluated all in- and pre-hospital airway cases managed by EMS physicians who underwent a structured in-hospital training program in anesthesia at General Hospital Wiener Neustadt...
April 26, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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