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Rachid Madkouri, David Brauge, Anthony Vidon-Buthion, Elie Fahed, Klaus-Luc Mourier, Jacques Beaurain, Mickael Grelat
OBJECTIVE: The aim of this study was to evaluate modifications in static spinal status after posterior decompression surgery without fusion in patients with symptomatic central canal stenosis. MATERIAL & METHODS: From November 2014 to May 2016, 72 patients who underwent isolated decompression for lumbar spinal stenosis were prospectively enrolled in this monocentric study. All of the patients had lateral full-body x-rays using the EOS system (EOS Imaging, Paris, France) before surgery and after 12 months of follow-up...
March 9, 2018: World Neurosurgery
Sarinnapha M Vasunilashorn, Long H Ngo, Noel Y Chan, Wenxiao Zhou, Simon T Dillon, Hasan H Otu, Sharon K Inouye, Iris Wyrobnik, George A Kuchel, Janet E McElhaney, Zhongcong Xie, David C Alsop, Richard N Jones, Towia A Libermann, Edward R Marcantonio
Background: Delirium is common, morbid, and costly, yet its biology is poorly understood. We aimed to develop a multi-protein signature of delirium by identifying proteins associated with delirium from unbiased proteomics and combining them with delirium biomarkers identified in our prior work (interleukin [IL]-6 and IL-2). Methods: We used the Successful Aging after Elective Surgery (SAGES) Study of adults age ≥70 undergoing major non-cardiac surgery (N=560; 24% delirium)...
February 24, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Daniel Gilsdorf, Jake Henrichsen, Katie Liljestrand, Allison Staheli, Griffin Olsen, Prem Narayanan, Mark Ott, David S Morris, Raymond Price
BACKGROUND: The ideal management of common bile duct (CBD) stones remains controversial, whether with single-stage management using laparoscopic CBD exploration (LCBDE) during laparoscopic cholecystectomy, or with two-stage management using preoperative or postoperative endoscopic retrograde cholangiopancreatography (ERCP). We wished to elucidate the practice patterns within our health system, which includes both large urban referral centers and small rural critical access hospitals. STUDY DESIGN: Retrospective data analysis from our 22-hospital, not-for-profit, integrated healthcare system...
March 5, 2018: Journal of the American College of Surgeons
Niklas Pircher, Jan Lammer, Stephan Holzer, Andreas Gschließer, Ruth Donner, Stefan Pieh, Gerald Schmidinger
PURPOSE: A stromal demarcation line (DL) after corneal cross-linking (CXL) has lately been suggested as a surrogate parameter for the success of CXL. The aim of this study was to investigate the correlation between depth of the central DL 1 month and the change in K values 12 months after CXL. METHODS: Treatment-naive subjects with keratoconus were treated using an accelerated CXL protocol [A-CXL(9*10)]. Depth of the DL/relative depth of the DL (DL%) was measured using Visante OCT imaging 1 month postoperatively (OP)...
February 23, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
H M C Shantha Kumara, Elli Sutton, Geoffrey A Bellini, Xiaohong Yan, Vesna Cekic Rn, Nipa Dilip Gandhi, Richard L Whelan
Minimally invasive colorectal resection (MICR) for colorectal cancer (CRC) is associated with elevated levels of seven proangiogenic proteins that persist for 2-4 weeks after surgery. The proangiogenic plasma may promote tumor growth postoperatively in patients with residual cancer. To the best of our knowledge, the impact of surgery on interleukin 8 (IL-8) levels is unknown. The aim of the present study was to evaluate plasma IL-8 levels after MICR for CRC. Patients with CRC enrolled in an institutional review board-approved plasma/data bank who underwent MICR were eligible...
March 2018: Molecular and Clinical Oncology
Nilanjana Tewari, Sherif Awad, František Duška, Julian P Williams, Andrew Bennett, Ian A Macdonald, Dileep N Lobo
BACKGROUND & AIMS: The aims of this study were to identify whether differences in distribution of adipose tissue and skeletal muscle in obese and non-obese individuals contribute to the magnitude of the postoperative inflammatory response and insulin resistance, with and without preoperative treatment with carbohydrate drinks. METHODS: Thirty-two adults (16 obese/16 non-obese) undergoing elective major open abdominal surgery participated in this 2 × 2 factorial, randomised, double-blind, placebo-controlled study...
February 14, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Jennifer Franklin, Kathleen Turner, John S Hudson, Kimberly Guest, Ellen D Dillavou
Postoperative infections can complicate patient care and increase health care costs. A vascular preventative bundle was implemented at a large teaching/research intensive hospital to decrease surgical site infections (SSIs) with vascular surgery patients. The aim of this study was to measure fidelity to the bundle and determine if implementation of the vascular SSI bundle reduced the rate of SSIs. Three periods of data were collected, and they are identified as preimplementation (period 1), early implementation (period 2), and postimplementation (period 3)...
March 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
Annette Pascual Marrero, Alvaro Gracia, William Méndez
Thyroid cancer management has moved to less extensive surgery in lesions with favorable criteria. Our study evaluated if the sonographic (US) size of thyroid nodules is a reliable criterion to determine the extent of surgery in patients with papillary thyroid carcinoma (PTC). A retrospective study was performed to evaluate thyroid nodules measuring <10 mm in the preop sonogram with a permanent pathology of PTC. Patients were subdivided into two groups based on the US size: A (1-5 mm) and B (6-10 mm). Statistical correlations were made for the presence of the following unfavorable criteria: multifocality, capsular invasion, angio/lymphatic invasion, extrathyroidal invasion, and presence of metastases...
January 1, 2018: American Surgeon
Frederick Galla, Dirk Wähnert, Ulf Liljenqvist
INTRODUCTION: A balanced ratio of the main parameters of lumbar lordosis (LL) and pelvic incidence (PI) has high clinical relevance. A postoperative mismatch of LL and PI has been described in the literature to be associated with an inferior clinical outcome and higher postoperative revision rates. The aim of this retrospective, radiological study is to evaluate the magnitude of relordosing in mono-/bisegmental TLIF spondylodesis affecting the spino-pelvic alignment and the main contributing factors...
February 7, 2018: European Spine Journal
D Dammerer, M C Liebensteiner, U M Kujala, K Emmanuel, S Kopf, F Dirisamer, J M Giesinger
INTRODUCTION: The Kujala score is the most frequently used questionnaire for patellofemoral disorders like pain, instability or osteoarthritis. Unfortunately, we are not aware of a validated German version of the Kujala score. The aim of our study was the translation and linguistic validation of the Kujala score in German-speaking patients with patella instability and the assessment of its measurement characteristics. MATERIALS AND METHODS: The German Kujala score was developed in several steps of translation...
January 25, 2018: Archives of Orthopaedic and Trauma Surgery
Hans-Georg Palm, Mario Steinbach, Patricia Lang, Carsten Hackenbroch, Benedikt Friemert, Hans-Joachim Riesner
BACKGROUND: Kyphoplasty is used to alleviate pain and to restore the initial height of osteoporotic vertebral fractures (OVF). One of the most recent procedures is radiofrequency-targeted vertebral augmentation (RFTVA). We investigated whether restoration with this method is similar and as adequate as with the established procedure of balloon kyphoplasty (BKP), as assessed by the anatomical height of the vertebral body. The aim of our study was to compare the intravertebral angles (base-endplate) post- and preoperatively with these two procedures...
January 25, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Robert G Henry, Ted P Raybould, Kelli Romond, Dimitrios E Kouzoukas, Sandra D Challman
The purpose of this study was to -examine the use of oral clonidine as a preoperative sedative prior to parenteral moderate sedation. Initially, four patients were given 0.2 mg oral clonidine but reduced to 0.1 mg clonidine due to -significant drops in blood pressure. Oral clonidine doses of 0.1 mg were then given to 19 patients preoperatively. In all these patients, blood pressure measurements decreased, but there were no significant differences in amounts of sedative agents needed in the clonidine group and the control group (N = 80)...
January 24, 2018: Special Care in Dentistry
Kellen Worhacz, Marc C Jacofsky, David J Jacofsky, Sarim Ahmed
Obesity is associated with increased surgical complications that may lead to suboptimal total knee arthroplasty (TKA) outcomes. Additionally, females exhibit increased rates of severe, clinical osteoarthritis OA, along with increased ligamentous laxity. Therefore, obese females present a particularly challenging case for TKA with increased joint loads coupled with a propensity for instability. This study retrospectively analyzed knee range of motion and stability of one TKA designs with two different degrees of polyethylene conformity in the obese female population...
January 22, 2018: Journal of Knee Surgery
Bi O Jeong, Tae Yong Kim, Jong Hun Baek, Hyuk Jung, Seung Hyun Song
PURPOSE: This study aimed to assess radiological changes of the ankle joint, subtalar joint and foot following the correction of varus deformity of the knee with total knee arthroplasty (TKA). It was hypothesized that following the correction of varus deformity by TKA, compensatory reactions would occur at the subtalar joint in accordance with the extent of the correction. METHODS: For this prospective study, 375 knees of patients who underwent TKA between 2011 and 2012 were enrolled...
January 18, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Katherine A Morgan, William P Lancaster, Stefanie M Owczarski, Hongjun Wang, Jeffrey Borckardt, David B Adams
BACKGROUND: Best practice to select patients with chronic pancreatitis for surgical management with total pancreatectomy with islet autotransplantation (TPIAT) is in evolution as new discoveries are made in the pathogenesis of chronic pancreatitis. METHODS: A prospectively maintained database of patients undergoing TPIAT is reviewed. Islet function is inferred from daily insulin requirement. Pain relief is evaluated by healthcare utilization and narcotic use. Quality of life (QOL) is measured with SF-12...
December 28, 2017: Journal of the American College of Surgeons
Thuss Sanguansak, Katharine E Morley, Michael G Morley, Kavin Thinkhamrop, Jaruwan Thuanman, Isha Agarwal
BACKGROUND: Social media offers a new way to provide education, reminders, and support for patients with a variety of health conditions. Most of these interventions use one-way, provider-patient communication. Incorporating social media tools to improve postoperative (postop) education and follow-up care has only been used in limited situations. OBJECTIVE: The aim of this study was to determine the feasibility and efficacy of two-way social media messaging to deliver reminders and educational information about postop care to cataract patients...
December 19, 2017: Journal of Medical Internet Research
Antonio A Faundez, Jonathon Richards, Philippe Maxy, Rachel Price, Amélie Léglise, Jean-Charles Le Huec
PURPOSE: To identify risk factors, in 12 patients with junctional breakdown (JBD) after thoraco-sacral fusions and to test a software locating maximal bending moment on full spine EOS images. METHODS: Twelve patients underwent long fusions for lumbar degenerative pathologies. Preop EOS images were compared to first postop EOS showing JBD. Parameters analyzed were: spinopelvic parameters [pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical axis (SVA), spinosacral angle (SSA), lordosis, and kyphosis], proximal junctional angle (PJA), odontoid-hip axis angle (ODHA), and CIA...
December 15, 2017: European Spine Journal
Zhen Zhang, Zhen Liu, Zezhang Zhu, Yong Qiu
This is a retrospective study. The aim of this study was to access sagittal compensatory mechanism of the cervical spine in thoracic adolescent idiopathic scoliosis (T-AIS) before and after posterior spinal fusion and to identify preoperative or immediate postoperative radiographic parameters that can predict the ultimate cervical sagittal alignment (CSA) after long-term follow-up.A retrospective study was performed on 44 T-AIS patients treated with posterior spinal fusion and with at least 5 years of follow-up...
December 2017: Medicine (Baltimore)
R P Gruber, M G Galvez, D D Ulvila
BACKGROUND: Over the years there have been numerous anecdotal reports of nasal tip enlargement and loss of tip definition post rhinoplasty. Subsequent revisionary procedures not only failed to reduce the tip size but aggravated the problem causing an even larger and less defined nasal tip. The final result was often worse than the preop condition and uncorrectable. METHOD/RESULTS: Six patients who demonstrated an aggravation of the postop result with subsequent revisionary or secondary surgeries were evaluated to find common causes or circumstances...
December 12, 2017: HNO
Themistocles S Protopsaltis, Subaraman Ramchandran, Kojo Hamilton, Daniel Sciubba, Peter G Passias, Virginie Lafage, Renaud Lafage, Justin S Smith, Robert A Hart, Munish Gupta, Doug Burton, Shay Bess, Christopher Shaffrey, Christopher P Ames
STUDY DESIGN: Prospective multi-center cohort study with consecutive enrollment OBJECTIVE.: To evaluate pre-operative alignment and surgical factors associated with sub-optimal early post-operative radiographic outcomes following surgery for cervical deformity. SUMMARY OF BACKGROUND DATA: Recent studies have demonstrated correlation between cervical sagittal alignment and patient reported outcomes. Few studies have explored cervical deformity correction prospectively, and the factors that result in successful vs...
December 8, 2017: Spine
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