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Minor surgery

C Wetterauer, D J Winkel, J R Federer-Gsponer, A Halla, S Subotic, A Deckart, H H Seifert, D T Boll, J Ebbing
BACKGROUND: Effective interdisciplinary communication of imaging findings is vital for patient care, as referring physicians depend on the contained information for the decision-making and subsequent treatment. Traditional radiology reports contain non-structured free text and potentially tangled information in narrative language, which can hamper the information transfer and diminish the clarity of the report. Therefore, this study investigates whether newly developed structured reports (SRs) of prostate magnetic resonance imaging (MRI) can improve interdisciplinary communication, as compared to non-structured reports (NSRs)...
2019: PloS One
Alfred C Kuo, Karthik Raghunathan, Alain M Lartigue, William E Bryan, Marc J Pepin, Steven Takemoto, Arthur W Wallace
BACKGROUND: In the United States, opioids are commonly prescribed to treat knee pain after total knee arthroplasty (TKA). While surgery leads to decreased pain in most patients, a sizable minority continue to experience severe pain and consume opioids chronically after TKA. We sought to determine the population-level effect of TKA on opioid consumption by detailing the pattern of opioid prescriptions before and after surgery. METHODS: We retrospectively identified US Veterans Health Administration TKA patients from 2010 to 2015...
January 29, 2019: Journal of Arthroplasty
Masaru Miyazaki, Mikiko Aoki, Kaori Koga, Makoto Hamasaki, Yoshikazu Sugiyama, Kensuke Midorikawa, Daisuke Hamatake, Michio Masaki, Yasushi Takamatsu, Akinori Iwasaki, Toshifumi Sakata, Toshitaka Nagao, Kazuki Nabeshima
Adenoid cystic carcinoma (AdCC) with high-grade transformation (AdCC-HGT) is rare, and AdCC-HGT with spindle cell component is particularly rare. The patient was a 65-year-old man with a 5 cm sized swelling of the right submandibular gland. Submandibular sialoadenectomy was performed. Histopathological findings mainly showed conventional AdCC, and minorly showed two other components: (1) the pleomorphic component, a proliferation of atypical pleomorphic epithelial cells forming solid or small clusters and accompanied by necrosis; (2) the spindle cell component, containing atypical spindle cells invading the stroma...
February 15, 2019: Auris, Nasus, Larynx
Daniel Rodger, Bruce P Blackshaw
BACKGROUND: Animal-derived constituents are frequently used in anaesthesia and surgery, and patients are seldom informed of this. This is problematic for a growing minority of patients who may have religious or secular concerns about their use in their care. It is not currently common practice to inform patients about the use of animal-derived constituents, yet what little empirical data does exist indicates that many patients want the opportunity to give their informed consent. DISCUSSION: First we review the nature and scale of the problem by looking at the groups who may have concerns about the use of animal-derived constituents in their care...
February 18, 2019: BMC Medical Ethics
Sara J S Wallace, Richard A Berger
BACKGROUND: Patients commonly report difficulty kneeling after total knee arthroplasty (TKA). The purpose of this study was to retrospectively assess patients' ability to kneel after TKA and to prospectively determine whether patients with reported difficulty can be taught to kneel. METHODS: Attempts were made to reach 307 consecutive TKAs in 255 adult patients who were 18-24 months after surgery. Patients were surveyed for their ability to kneel. Those who reported difficulty kneeling were offered participation in a kneeling protocol...
January 29, 2019: Journal of Arthroplasty
M Benedetti, P Ciano, I Pergolini, S Ciotti, G Guercioni, G Ruffo, F Borghi, A Patriti, P Del Rio, M Scatizzi, S Mancini, G Garulli, A Carrara, F Pirozzi, S Scabini, A Liverani, G Baiocchi, R Campagnacci, A Muratore, G Longo, M Caricato, R Macarone Palmieri, N Vettoretto, M Ceccaroni, S Guadagni, E Bertocchi, D Cianflocca, M Lambertini, U Pace, M Baraghini, L Pandolfini, R Angeloni, A Lucchi, G Martorelli, G Tirone, M Motter, A Sciuto, A Martino, A P Luzzi, T Di Cesare, S Molfino, A Maurizi, P Marsanic, F Tomassini, S Santoni, G T Capolupo, P Amodio, E Arici, M Clementi, B Ruggeri, M Catarci
BACKGROUND: Anastomotic leakage (AL) is a dreaded major complication after colorectal surgery. There is no uniform definition of anastomotic dehiscence and leak. Over the years many risk factors have been identified (distance of anastomosis from anal verge, gender, BMI, ASA score) but none of these allows an early diagnosis of AL. The DUtch LeaKage (DULK) score, C reactive protein (CRP) and procalcitonin (PCT) have been identified as early predictors for anastomotic leakage starting from postoperative day (POD) 2-3...
January 2019: Il Giornale di Chirurgia
Fahriye Groen-Hakan, Suzanne van de Laar, Annemiek A van der Eijk-Baltissen, Ninette Ten Dam van Loon, Joke de Boer, Aniki Rothova
PURPOSE: To assess the clinical and laboratory manifestations and vaccination status of uveitis patients positive for Rubella virus (RV) in aqueous humor and investigate its relationship to Fuchs Uveitis Syndrome (FUS). METHODS: Retrospective study of all uveitis patients, positive for RV in aqueous humor analysis (polymerase chain reaction (PCR) and/or Goldmann-Witmer coefficient (GWC)) between January 2010 and October 2016 at the ophthalmology departments in the Erasmus Medical Center (Rotterdam) and University Medical Center Utrecht...
February 13, 2019: American Journal of Ophthalmology
Xiao-Long Wu, Zhi-Yu Li, Yong Jiang, Xinyu Bi, Hong Zhao, Jian-Jun Zhao, Zhen Huang, Ye-Fan Zhang, Jian-Qiang Cai
BACKGROUND: In predicting the risk for posthepatectomy complications, hepatectomy is traditionally classified into minor or major resection based on the number of resected segments. Recently, a new hepatectomy complexity classification was proposed. This study aimed to compare the value of the traditional and that of the new classification in perioperative outcomes prediction. METHODS: Demographics, perioperative laboratory tests, intraoperative and postoperative outcomes, and follow-up data of patients with hepatocellular carcinoma who underwent liver resection were retrospectively analyzed...
February 15, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Tae-Hwan Yoon, Sung-Jae Kim, Chong-Hyuk Choi, Soon-Phil Yoon, Yong-Min Chun
PURPOSE: To investigate whether subscapularis integrity and compensatory teres, minor hypertrophy is associated with maintaining relatively good function and tolerable pain levels during non-operative treatment. METHODS: This study included 108 patients with irreparable, massive rotator cuff tears involving at least two tendons and stage III or IV muscle hypotrophy and fatty infiltration on oblique sagittal magnetic resonance imaging, in which even a partial repair does not seem feasible...
February 15, 2019: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Benjamin Thomas, Emre Gazyakan, Florian Falkner, Volker J Schmidt, Christoph Hirche, Ulrich Kneser, Amir K Bigdeli
BACKGROUND: Though technically feasible, free tissue transfer carries the risk of perioperative morbidity and mortality in elderly patients. To minimize the operative treatment time and complication rates, we choose the rectus abdominis muscle (RAM) flap. METHODS: Between 2012 and 2017, 34 patients (mean age: 74±7 years, range: 65-89 years) with comorbidities underwent defect reconstruction with a free RAM flap. Recipient-sites were: lower extremity (65%), trunk (18%), upper extremity (12%), and head and neck (6%)...
January 11, 2019: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Anusha Jegatheeswaran, Marshall L Jacobs, Christopher A Caldarone, Paul M Kirshbom, William G Williams, Eugene H Blackstone, William M DeCampli, Kim F Duncan, Linda M Lambert, Henry L Walters, Christo I Tchervenkov, Brian W McCrindle
OBJECTIVES: Improved survival after congenital heart surgery has led to interest in functional health status. We sought to identify factors associated with self-reported functional health status in adolescents and young adults with repaired interrupted aortic arch. METHODS: Follow-up of survivors (aged 13-24 years) from a 1987 to 1997 inception cohort of neonates included completion of functional health status questionnaires (Child Health Questionnaire-CF87 [age <18 years, n = 51] or the Short Form [SF]-36 [age ≥18 years, n = 66]) and another about 22q11 deletion syndrome (22q11DS) features (n = 141)...
January 11, 2019: Journal of Thoracic and Cardiovascular Surgery
Fouad Chouairi, Michael R Mercier, J Scott Persing, Kyle S Gabrick, James Clune, Michael Alperovich
PURPOSE: Being one of the most common congenital hand malformations, syndactyly is repaired by orthopedic, plastic, and fellowship-trained general surgeons. Limited multi-institutional outcomes analyses regarding incidence, timing, and type of repair exist. METHODS: All syndactyly cases performed over a 5-year period from 2012-2016 were isolated from the National Surgical Quality Improvement Program Pediatric database. Patient demographics, surgical factors, perioperative outcomes, and risk factors were analyzed using χ2 , Fisher exact, and t-test analysis...
February 15, 2019: Hand: Official Journal of the American Association for Hand Surgery
Roser M Magriñá-Mercado, Claudia Ramírez-Rentería, Eduardo Almeida-Gutiérrez, Victoria Mendoza-Zubieta, Aldo Ferreira-Hermosillo
Introduction: Primary hyperparathyroidism (PHPT) is the leading cause of outpatient hypercalcemia associated with increased cardiovascular risk. The flow-mediated vasodilation (FMV) has been proposed as a non-invasive method for assessing endothelial function. Objective: To compare the endothelial dysfunction measured by FMV and diastolic dysfunction in patients with PHPT before and after parathyroidectomy. Method: We performed a quasi-experimental (before-after) study to evaluate diastolic function and FMV in patients with PHPT before and six months after parathyroidectomy...
2019: Cirugia y Cirujanos
Rie Wakamiya, Hiroyuki Seki, Satoshi Ideno, Naho Ihara, Rie Minoshima, Kota Watanabe, Yasunori Sato, Hiroshi Morisaki
Dexamethasone is widely used for postoperative nausea and vomiting (PONV) prophylaxis, but its effect on PONV prevention in paediatric patients is validated only in short minor surgical procedures. In this study, we aimed to determine whether a single dose of dexamethasone reduces PONV in highly invasive surgeries that require opioid-based postoperative analgesia. One hundred adolescents undergoing scoliosis correction surgery were randomized to receive intravenous dexamethasone 0.15 mg/kg (dexamethasone group) or saline (control group) at induction of anaesthesia...
February 14, 2019: Scientific Reports
Jonathan DeAntonio, Hannah Cockrell, Hae Sung Kang, Melanie K Bean, Nancy Thompson, Matthew Brengman, Claudio Oiticica, Edmond Wickham, David Lanning
BACKGROUND: Metabolic and bariatric surgery in adolescents with severe obesity has been demonstrated to be safe and have long-term treatment efficacy. However, less than 0.1% of adolescents meeting criteria undergo surgery. METHODS: A prospective pilot study of adolescents who underwent laparoscopic gastric plication (LGP) was conducted to evaluate safety and effects on anthropometrics and weight-related medical and psychological comorbidities. RESULTS: Four adolescents enrolled and underwent LGP; two withdrew 90 days postoperatively and two were followed through 36 months...
January 23, 2019: Journal of Pediatric Surgery
Dominique Musselman, Neeta Shenvi, Amita Manatunga, Andrew H Miller, Edward Lin, Nana Gletsu-Miller
BACKGROUND: Neurobehavioral symptoms and cognitive dysfunction related to mood disorders are present in individuals with severe obesity. We sought to determine acute improvements in these symptoms and relationships with adiposity, inflammation, and insulin sensitivity after roux-en-y gastric bypass (RYGB) surgery. METHODS: The self-report Zung Depression Rating (ZDRS) and Neurotoxicity Rating (NRS) scales were administered before, and at 6-months after RYGB surgery in severely obese women (body mass index > 35 kg/m2 ; N = 19)...
February 11, 2019: Physiology & Behavior
Eva Huysmans, Karen Pien, Lieselot Callens, Lesley Van Loon, Kelly Ickmans, Jo Nijs, Ronald Buyl, Maarten Moens, Lisa Goudman, Griet Van Belleghem, Koen Putman
STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of this study was to determine hospital costs related to surgery for lumbar radiculopathy and identify determinants of intramural costs based on minimal hospital and claims data. SUMMARY OF BACKGROUND DATA: Costs related to the initial hospitalization of patients undergoing surgery for lumbar radiculopathy make up the major part of direct health care expenditure in this population. Identifying factors influencing intramural costs can be beneficial for health care policy makers, and clinicians working with patients with lumbar radiculopathy...
March 1, 2019: Spine
Alena Gerlinde Thiele, Maren Heckenmüller, Heike Bartelt, Sabine Klamt, Wieland Kiess, Thomas Michael Kapellen
OBJECTIVE: Continuous intravenous (IV) insulin infusion therapy minimizes blood glucose (BG) fluctuations and prevents metabolic deterioration in pediatric patients with type 1 diabetes (T1D) during intercurrent illness and surgery. However, data on the adequate fluid and insulin substitution in this situation is rare. We evaluated the effectiveness and safety of IV insulin therapy according to our local protocol. RESEARCH DESIGN AND METHODS: Retrospective study of 124 cases of hospitalization with IV insulin therapy due to intercurrent illness (n=78) or minor surgery (n=46) in 62 patients with T1D (mean age: 9...
February 13, 2019: Pediatric Diabetes
Annabel Spek, B Szabados, J Casuscelli, C Stief, M Staehler
BACKGROUND: Until recently, there was no approved adjuvant therapy (AT) for renal cell carcinoma (RCC) unless sunitinib was approved in the US. We evaluated clinical opinion and estimated use regarding different treatment options and patient selection of AT in RCC patients based on current scientific data and individual experience in Germany. METHODS: We conducted an anonymous survey during a national urology conference in 01/2017. Answers of 157 urologists treating RCC patients could be included...
February 13, 2019: International Journal of Clinical Oncology
Shereen Nabhani-Gebara, Simon Fletcher, Atif Shamim, Leanne May, Nabiha Butt, Sunita Chagger, Thuy Mason, Kunal Patel, Finlay Royle, Scott Reeves
BACKGROUND: A number of key publications in recent years have advocated a more integrated vision of UK primary care involving increased multi-professional communication and understanding. This has resulted in a marked change in the roles being undertaken by pharmacists. Community pharmacists have traditionally provided a medicine supply function and treated minor ailments in addition to delivering a suite of locally commissioned services; however these functions have not necessarily been part of a programme of care involving the other clinicians associated with the patient...
February 1, 2019: Research in Social & Administrative Pharmacy: RSAP
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