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https://www.readbyqxmd.com/read/28727719/intercostal-neuralgia-occurring-as-a-complication-of-splanchnic-nerve-radiofrequency-ablation-in-a-patient-with-chronic-pancreatitis
#1
Saipriya Tewari, Anil Agarwal, Sujeet K Gautam, Rajashree Madabushi
Our intent is to report a case of intercostal neuralgia occuring as a complication of splanchnic radiofreqency ablation (RFA), due to a breach in the integrity of the insulating sheath of the RFA needle.A 48-year-old man presented to our pain clinic with upper abdominal pain due to chronic pancreatitis, recalcitrant to medical management. We decided to perform bilateral splanchnic nerve RFA in this patient. After confirmation of bilateral correct needle placement under fluoroscopic guidance and sensorimotor testing, RFA was performed on the right side uneventfully...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727386/retroperitoneal-access-for-robotic-renal-surgery
#2
Barrett G Anderson, Alec J Wright, Aaron M Potretzke, R Sherburne Figenshau
INTRODUCTION AND OBJECTIVE: Retroperitoneal access for robotic renal surgery is an effective alternative to the commonly used transperitoneal approach. We describe our contemporary experience and technique for attaining retroperitoneal access. MATERIALS AND METHODS: We outline our institutional approach to retroperitoneal access for the instruction of urologists at the beginning of the learning curve. The patient is placed in the lateral decubitus position. The first incision is made just inferior to the tip of the twelfth rib as described by Hsu, et al...
July 20, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28717570/chip-on-the-tip-compact-flexible-endoscopic-epifluorescence-video-microscope-for-in-vivo-imaging-in-medicine-and-biomedical-research
#3
Gregor Matz, Bernhard Messerschmidt, Werner Göbel, Severin Filser, Christian S Betz, Matthias Kirsch, Ortrud Uckermann, Marcel Kunze, Sven Flämig, André Ehrhardt, Klaus-Martin Irion, Mareike Haack, Mario M Dorostkar, Jochen Herms, Herbert Gross
We demonstrate a 60 mg light video-endomicroscope with a cylindrical shape of the rigid tip of only 1.6 mm diameter and 6.7 mm length. A novel implementation method of the illumination unit in the endomicroscope is presented. It allows for the illumination of the biological sample with fiber-coupled LED light at 455 nm and the imaging of the red-shifted fluorescence light above 500 nm in epi-direction. A large numerical aperture of 0.7 leads to a sub-cellular resolution and yields to high-contrast images within a field of view of 160 μm...
July 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28701200/assessing-colonoscopic-inspection-skill-using-a-virtual-withdrawal-simulation-a-preliminary-validation-of-performance-metrics
#4
Christine M Zupanc, Guy M Wallis, Andrew Hill, Robin Burgess-Limerick, Stephan Riek, Annaliese M Plooy, Mark S Horswill, Marcus O Watson, Hans de Visser, David Conlan, David G Hewett
BACKGROUND: The effectiveness of colonoscopy for diagnosing and preventing colon cancer is largely dependent on the ability of endoscopists to fully inspect the colonic mucosa, which they achieve primarily through skilled manipulation of the colonoscope during withdrawal. Performance assessment during live procedures is problematic. However, a virtual withdrawal simulation can help identify and parameterise actions linked to successful inspection, and offer standardised assessments for trainees...
July 12, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28692450/advances-in-midface-reconstruction-beyond-the-reconstructive-ladder
#5
Antoine Eskander, Stephen Y Kang, Theodoros N Teknos, Matthew O Old
PURPOSE OF REVIEW: This article reviews the anatomy and function of the midface, defect classifications and the breadth of common and novel reconstructive techniques including medical modeling, dental splints, and dental rehabilitation. RECENT FINDINGS: Historically many classification systems for midface and maxillary defects exist but most defects are unique and an individualized approach is required. There has been an increased interest in using regional pedicled flaps with bone for reconstruction...
July 7, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28690297/successful-complete-revascularization-with-pci-using-super-low-volume-of-contrast-medium-in-a-patient-with-three-vessel-disease-including-2-chronic-total-occlusions-with-severe-renal-dysfunction
#6
Masahiro Koide, Masayuki Kato, Kimihito Usui, Kayoko Mera, Yoshinori Tsubakimoto, Koji Isodono, Tomohiko Sakatani, Akiko Matsuo, Keiji Inoue, Hiroshi Fujita
The most important factor for preventing contrast-induced nephropathy (CIN) during percutaneous coronary intervention (PCI) in patients with severe renal dysfunction is to minimize the contrast volume. Herein, we report a successful case of complete revascularization after 3 separate PCI procedures using a super-low volume of contrast medium in a patient with 3-vessel disease, including two chronic total occlusions (CTOs). A 70-year-old man having exertional angina despite maximal medical therapy was referred to our hospital...
July 10, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28685257/budd-chiari-syndrome-hepatic-venous-outflow-tract-obstruction
#7
REVIEW
Dominique-Charles Valla
BACKGROUND: Budd-Chiari syndrome (BCS) is a rare disease characterized by hepatic venous outflow tract obstruction (HVOTO). METHODS: Recent literature has been analyzed for this narrative review. RESULTS: Primary BCS/HVOTO is a result of thrombosis. The same patient often has multiple risk factors for venous thrombosis and most have at least one. Presentation and etiology may differ between Western and certain Eastern countries. Myeloproliferative neoplasms are present in 40% of patients and are usually associated with the V617F-JAK2 mutation in myeloid cells, in particular peripheral blood granulocytes...
July 6, 2017: Hepatology International
https://www.readbyqxmd.com/read/28677472/how-to-set-up-and-administer-an-enteral-feed-via-a-nasogastric-tube
#8
Carolyn Best
Rationale and key points Nasogastric tube feeding is a method of enteral feeding commonly administered by nurses. Feed can be administered either using a volumetric enteral feeding pump (pump feeding) or via an enteral syringe (bolus feeding). This article explains how nurses can safely undertake these two methods of nasogastric tube feed administration at the patient's bedside. » Nasogastric tube feeding can be used to provide some or all of the patient's nutrition, fluid or medication. » Nurses should be equipped with the relevant knowledge to flush a nasogastric tube before the administration of feed or medication; set up and administer an enteral feed via a volumetric enteral feeding pump; and set up and administer a feed using a bolus method...
July 5, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28673653/not-just-guess-work-tips-for-observation-brainstorming-and-prototyping
#9
Ryan Krone
Much has been written about brainstorming and prototyping in medical devices. These 2 topics are the crucial ingredients to innovation; which, if well seeded by organized and structured forays into each, will net much higher quality and more valuable results. Structure and process, although slightly counterintuitive as applied to brainstorming and prototyping, can greatly improve the value proposition of the innovation itself.
June 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28673647/regulation-and-device-development-tips-for-optimizing-your-experience-with-the-food-and-drug-administration
#10
Steven S Brooks
Physician-inventors are in a unique position to identify unserved patient needs, and innovate solutions to clinical problems. These solutions may also have associated commercial opportunities. The logistics of developing these medical products, however, can seem a daunting task. One of the primary barriers in the United States is the regulatory process of the Food and Drug Administration (FDA). In this article, we will explore the risk-based approach used by the FDA which forms a framework to consider the regulatory pathway and the process to gain regulatory clearance or approval for medical devices...
June 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28672072/the-blue-bubble-technique-an-ab-interno-approach-for-descemet-separation-in-deep-anterior-lamellar-keratoplasty-dalk-using-trypan-blue-stained-viscoelastic-device
#11
Eitan Livny, Irit Bahar, Naama Hammel, Yoav Nahum
BACKGROUND: In this study we examined a novel variant of "Big-Bubble" Deep Anterior Lamellar Keratoplasty (DALK) using trypan-blue-stained viscoelastic device for the creation of a pre-Descemetic bubble. METHODS: Ten corneoscleral rims were mounted on an artificial anterior chamber (AC). The anterior chamber was filled with air through a limbal paracentesis. A Melles' triangulated spatula was inserted through the paracentesis, with its tip penetrating the AC, was then slightly retracted and pushed into the deep stroma above the roof of the paracentesis...
July 3, 2017: Clinical & Experimental Ophthalmology
https://www.readbyqxmd.com/read/28670943/high-rates-of-secondary-non-adherence-causes-decreased-efficacy-of-0-1-topical-tacrolimus-in-adult-eczema-patients-results-from-a-multicenter-clinical-trial
#12
Min-Young Yang, Hyunju Jin, Woo-Haing Shim, Gun-Wook Kim, Hoon-Soo Kim, Hyun-Chang Ko, Hyo-Jin Kim, Ho-Seok Suh, Sook-Kyung Lee, So-Young Jung, Hye-Sook Kim, Kyung-Min Lim, Moon-Bum Kim, Byung-Soo Kim
BACKGROUND: Patients tend to apply topical medications less frequently, in improper amounts. Not only frequency but also application amount may influence treatment outcome. However, studies on relationship between application amount and objective treatment outcome have rarely been conducted. OBJECTIVE: To assess efficacy of topical agent according to application amount in adult patients, using the finger-tip unit method Methods: The efficacy of 0.1% topical tacrolimus in adult patients with localised atopic dermatitis was assessed using EASI, TIS, IGA, and PGA scores at baseline, follow-up...
July 3, 2017: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/28664187/design-of-a-compact-actuation-and-control-system-for-flexible-medical-robots
#13
Tania K Morimoto, Elliot Wright Hawkes, Allison M Okamura
Flexible medical robots can improve surgical procedures by decreasing invasiveness and increasing accessibility within the body. Using preoperative images, these robots can be designed to optimize a procedure for a particular patient. To minimize invasiveness and maximize biocompatibility, the actuation units of flexible medical robots should be placed fully outside the patient's body. In this letter, we present a novel, compact, lightweight, modular actuation, and control system for driving a class of these flexible robots, known as concentric tube robots...
July 2017: IEEE Robotics and Automation Letters
https://www.readbyqxmd.com/read/28640176/ultrasound-guided-percutaneous-radiofrequency-ablation-of-liver-metastasis-from-ovarian-cancer-a-single-center-initial-experience
#14
Baoxian Liu, Guangliang Huang, Chunlin Jiang, Ming Xu, Bowen Zhuang, Manxia Lin, Wenshuo Tian, Xiaohua Xie, Ming Kuang, Xiaoyan Xie
OBJECTIVE: The aim of this study was to evaluate the feasibility, effectiveness, and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) for the treatment of liver metastasis from ovarian cancer (OC). METHODS: A retrospective review was performed on 11 patients (mean age, 53.0 ± 10.1 years) with 22 liver metastases (mean diameter, 2.0 ± 0.8 cm) from OC undergone RFA. Radiofrequency ablation was carried out with Starburst XL electrodes (RITA Medical System, Mountain View, CA) or Cool-tip electrodes (Cool-tip Systems; Valleylab, Boulder, CO)...
July 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28634973/the-role-of-a-surveillance-programme-for-intro-ducing-peripherally-inserted-central-catheters-a-2-year-observational-study-in-an-academic-hospital
#15
Elia Lo Priore, Monika Fliedner, Johannes T Heverhagen, Urban Novak, Jonas Marschall
AIMS OF THE STUDY: In our hospital, a previous attempt to introduce peripherally inserted central catheters (PICC) was aborted after a nonsystematic approach, seemingly accompanied by high rates of complications. The goal of this new interdisciplinary project was to introduce PICCs in an academic hospital, with an embedded interdisciplinary surveillance programme for both infectious and noninfectious outcomes. METHODS: We prospectively collected data for this surveillance study from all patients who underwent PICC insertion from 1 January 2014 and had the catheter removed by 31 December 2015 in our 950-bed academic hospital (Bern University Hospital, Switzerland)...
June 21, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28631331/missing-data-in-clinical-trials-control-based-mean-imputation-and-sensitivity-analysis
#16
Devan V Mehrotra, Fang Liu, Thomas Permutt
In some randomized (drug versus placebo) clinical trials, the estimand of interest is the between-treatment difference in population means of a clinical endpoint that is free from the confounding effects of "rescue" medication (e.g., HbA1c change from baseline at 24 weeks that would be observed without rescue medication regardless of whether or when the assigned treatment was discontinued). In such settings, a missing data problem arises if some patients prematurely discontinue from the trial or initiate rescue medication while in the trial, the latter necessitating the discarding of post-rescue data...
June 20, 2017: Pharmaceutical Statistics
https://www.readbyqxmd.com/read/28630750/tips-and-tricks-for-using-the-internet-for-professional-purposes
#17
Hasan Huseyin Ceylan, Nurdan Güngören, Fatih Küçükdurmaz
Online resources provide access to large amounts of information which is expanding every day. Using search engines for reaching the relevant, updated and complete literature that is indexed in various bibliographical databases has already become part of the medical professionals' everyday life.However, most researchers often fail to conduct a efficient literature search on the internet. The right techniques in literature search save time and improve the quality of the retrieved data.Efficient literature search is not a talent but a learnable skill, which should be a formal part of medical education...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28623369/looking-beyond-the-imaging-plane-3d-needle-tracking-with-a-linear-array-ultrasound-probe
#18
Wenfeng Xia, Simeon J West, Malcolm C Finlay, Jean-Martial Mari, Sebastien Ourselin, Anna L David, Adrien E Desjardins
Ultrasound is well suited for guiding many minimally invasive procedures, but its use is often precluded by the poor visibility of medical devices. When devices are not visible, they can damage critical structures, with life-threatening complications. Here, we developed the first ultrasound probe that comprises both focused and unfocused transducer elements to provide both 2D B-mode ultrasound imaging and 3D ultrasonic needle tracking. A fibre-optic hydrophone was integrated into a needle to receive Golay-coded transmissions from the probe and these data were processed to obtain tracking images of the needle tip...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28614995/ease-of-use-of-tobramycin-inhalation-powder-compared-with-nebulized-tobramycin-and-colistimethate-sodium-a-crossover-study-in-cystic-fibrosis-patients-with-pulmonary-pseudomonas-aeruginosa-infection
#19
James Greenwood, Carsten Schwarz, Urte Sommerwerck, Edward F Nash, Michael Tamm, Weihua Cao, Paul Mastoridis, Laurie Debonnett, Kamal Hamed
BACKGROUND: This study assessed the ease of use of tobramycin inhalation powder (TIP) administered via T-326 inhaler versus tobramycin inhalation solution (TIS) and colistimethate sodium (COLI), both administered via nebulizers, for the treatment of chronic pulmonary Pseudomonas aeruginosa infection in patients with cystic fibrosis (CF). METHODS: A real-world, open-label, crossover, interventional phase IV study was conducted in CF patients aged ⩾6 years with forced expiratory volume in 1 second (FEV1) ⩾25% to ⩽90% predicted...
July 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28614170/implications-of-left-sided-gallbladder-in-the-emergency-setting-retrospective-review-and-top-tips-for-safe-laparoscopic-cholecystectomy
#20
Hariscine K Abongwa, Belinda De Simone, Laura Alberici, Maurizio Iaria, Gennaro Perrone, Antonio Tarasconi, Gianluca Baiocchi, Nazario Portolani, Salomone Di Saverio, Massimo Sartelli, Federico Coccolini, Jennifer E Manegold, Luca Ansaloni, Fausto Catena
BACKGROUND: Left-sided gallbladder without situs viscerum inversus (LSG-woSVI) is a rare congenital anomaly. Clinical features and routine presurgical imaging could miss the anomalous position, thereby producing complications during surgery. Laparoscopic cholecystectomy can be performed safely, but the risk of bile duct injury (BDI) is greater than in cholecystectomy of the orthotopic gallbladder. We present a retrospective review of all scientific literature for diagnosed cases of LSG-woSVI undergoing cholecystectomy from 1996 to 2014...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
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