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Monitoring surgical patient

Claudia L Craven, Roshini Ramkumar, Linda D'Antona, Simon D Thompson, Lewis Thorne, Laurence D Watkins, Ahmed K Toma
OBJECTIVEChronic ventriculomegaly in the absence of raised intracranial pressure (ICP) is a known entity in adult hydrocephalus practice. The natural history and indication for treatment is, however, poorly defined. A highly heterogeneous group, some adults with ventriculomegaly are asymptomatic, while others have life-threatening deteriorations. The authors hypothesized that the various presentations can be subtyped and represent different stages of decompensation. A cluster analysis was performed on a cohort of patients with chronic ventriculomegaly with the aim of elucidating typical clinical characteristics and outcomes in chronic ventriculomegaly in adults...
February 8, 2019: Journal of Neurosurgery
Thomas Guiho, Christine Azevedo-Coste, David Guiraud, Claire Delleci, Grégoire Capon, Natalia Delgado-Piccoli, Luc Bauchet, Jean-Rodolphe Vignes
OBJECTIVESpinal cord injuries (SCIs) result in loss of movement and sensory feedback, but also organ dysfunction. Nearly all patients with complete SCI lose bladder control and are prone to kidney failure if intermittent catheterization is not performed. Electrical stimulation of sacral spinal roots was initially considered to be a promising approach for restoring continence and micturition control, but many patients are discouraged by the need for surgical deafferentation as it could lead to a loss of sensory functions and reflexes...
February 15, 2019: Journal of Neurosurgery. Spine
María Jesús Muniesa Royo, Juan Ezpeleta Campaña, Iván Benítez Iglesias
PURPOSE: To compare fluctuations in intraocular pressure (IOP) in medically versus surgically treated glaucoma patients. DESIGN: Prospective, non-randomized case series. METHODS: IOP-related fluctuations were measured for 24 hours using a contact lens sensor (CLS). SUBJECTS: We perform monitoring with CLS in 91 eyes of 77 patients; 59 eyes were receiving ocular hypotensive medication and had no previous history of glaucoma surgery (medical group), while 32 eyes with open angle glaucoma (OAG) had previously undergone glaucoma surgery (surgical group)...
February 13, 2019: American Journal of Ophthalmology
Yina Lan, Jinhao Lyu, Xiaoxiao Ma, Lin Ma, Xin Lou
BACKGROUND: Carotid artery stenting (CAS) and endarterectomy (CEA) are major treatment strategies for patients with internal carotid artery (ICA) stenosis; however, the dynamic cerebral blood flow (CBF) changes after CAS and CEA remain unclear. PURPOSE: This study aimed to monitor consecutive CBF changes at 24-h intervals in patients who underwent CAS and CEA to explore the potential pattern of CBF alternation and compare the effect on CBF changes of different surgical methods...
February 15, 2019: La Radiologia Medica
Ryo Kato, Kiyokazu Nakajima, Tsuyoshi Takahashi, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Masaki Mori, Yuichiro Doki
BACKGROUND: The fourth edition of New Japanese classification system for esophageal achalasia was revised after a long interval of 30 years in 2012. In this new system, achalasia is morphologically classified into 3 types, based on its X-ray findings. However, the system has been limitedly used in Japan and has not been fully validated in terms of its predictive capability of postoperative outcomes. The purpose of this study was to clarify the validity of new Japanese classification system for esophageal achalasia, as an index of patient characteristics and as a predictor of operative and mid/long-term postoperative outcomes...
February 15, 2019: Esophagus: Official Journal of the Japan Esophageal Society
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
Benjamin Vojnar, Martin Zoremba
With focused transthoracic echocardiography (TTE) we rapidly and non-invasively receive up-to-date information on a patient's hemodynamic status. These can subsequently influence our therapy and thus our risk management. Postoperatively, TTE has proved its worth as an examination method in the recovery room and in the intensive care unit to promptly diagnose life-threatening causes of circulatory depression. Acute pathology such as a pericardial tamponade or fulminant pulmonary artery embolism can be detected quickly and thus possibly time-consuming transport to a CT can be avoided...
February 2019: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Melanie A McWade, Giju Thomas, John Q Nguyen, Melinda E Sanders, Carmen C Solórzano, Anita Mahadevan-Jansen
BACKGROUND: Misidentifying parathyroid glands (PGs) during thyroidectomies or parathyroidectomies, could significantly increase post-operative morbidity. Imaging systems based on near-infrared autofluorescence (NIRAF) detection can localize PGs with high accuracy. These devices however depict NIRAF images on remote display monitors, where images lack spatial context and comparability with actual surgical field-of-view (FOV). In this study, we designed an Overlay Tissue Imaging System (OTIS) that detects tissue NIRAF and back-projects the collected signal as a visible image directly onto the surgical FOV instead of a display monitor, and tested its ability for enhancing parathyroid visualization...
February 12, 2019: Journal of the American College of Surgeons
Eugene A Woltering, Brianne A Voros, David T Beyer, Ramcharan Thiagarajan, Robert A Ramirez, Gregg Mamikunian, J Philip Boudreaux
OBJECTIVES: Elevated pancreastatin (PST) levels have been shown to be associated with poor prognosis in small bowel neuroendocrine tumors (NETs). We hypothesized that plasma PST levels that remain elevated following surgical cytoreduction portend a poor prognosis in well-differentiated small bowel NETs. METHODS: Patients diagnosed with small bowel NETs who underwent surgical cytoreduction at our institution were identified. Demographics, histopathologic characteristics, and biochemical data were collected...
February 14, 2019: Pancreas
Philip A Sosa, Phillip Matar, Isabel T Gross
BACKGROUND: Extracranial carotid aneurysms in children are extremely rare but carry a high mortality and morbidity. For pediatric patients, they are often complications of pharyngeal infections and surgical trauma but can also arise from congenital and inflammatory diseases. They have a wide range of presentation from an asymptomatic mass to a rapidly fatal hemorrhage. CASE: A 10-year-old boy presented to the emergency department with complaints of a neck mass and residual cough from a recent upper respiratory infection...
February 13, 2019: Pediatric Emergency Care
Lei Zhang, Zahid Hussain, Zhuanqin Ren
BACKGROUND: Normal pressure hydrocephalus (NPH) is a critical brain disorder in which excess cerebrospinal fluid (CSF) is accumulated in the brain's ventricles causing damage or disruption of the brain tissues. Amongst various signs and symptoms, difficulty in walking, blurred speech, impaired decision making and critical thinking, and loss of bladder and bowl control are considered the hallmark features of NPH. OBJECTIVE: The current review was aimed to present a comprehensive overview and critical appraisal of majorly employed neuroimaging techniques for rational diagnosis and effective monitoring of effectiveness of employed therapeutic intervention for NPH...
February 14, 2019: Current Drug Targets
Zahid Hussain, Lei Zhang, Zhuanqin Ren
BACKGROUND: Normal pressure hydrocephalus (NPH) is a critical brain disorder in which excess cerebrospinal fluid (CSF) is accumulated in the brain's ventricles causing damage or disruption of the brain tissues. Amongst various signs and symptoms, difficulty in walking, blurred speech, impaired decision making and critical thinking, and loss of bladder and bowl control are considered the hallmark features of NPH. OBJECTIVE: The current review was aimed to present a comprehensive overview and critical appraisal of majorly employed neuroimaging techniques for rational diagnosis and effective monitoring of effectiveness of employed therapeutic intervention for NPH...
February 14, 2019: Current Drug Targets
Stefano Olmi, Alberto Oldani, Matteo Uccelli, Bruno Scotto, Giovanni Cesana, Francesca Ciccarese, Roberta Villa, Riccardo Giorgi
PURPOSE: Although the modified Sugarbaker technique gives good results for the treatment of parastomal hernia (PH), there are other valid options for the treatment of this frequent complication. In our practice, the laparoscopic keyhole (KH) technique, with some specific modifications, can give similar results. MATERIALS AND METHODS: We collected data on all the patients with symptomatic PHs who underwent surgical repair between January 2002 and December 2017 in our surgical department...
February 15, 2019: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
O D Persa, C Loquai, M Wobser, M Baltaci, S Dengler, A Kreuter, A Volz, M Laimer, M Emberger, M Doerler, C Mauch, D Helbig
BACKGROUND: Pleomorphic dermal sarcomas (PDS) are frequent UV-induced sarcomas of the skin of intermediate grade malignant potential. Despite the fact that PDS have a noteworthy potential to recur (up to 28%) as well as to metastasize (up to 20%), there are no specific clinical guidelines with respect to follow-up these patients. Moreover, little is known about clinical, histological or molecular prognostic factors in PDS. OBJECTIVE: The aim of the present study was to identify risk factors to predict relapse in a large multicenter sample cohort of PDS which could aid to optimize personalized treatment recommendations regarding surgical safety margins and adjuvant radiotherapy...
February 14, 2019: Journal of the European Academy of Dermatology and Venereology: JEADV
Aura A Sanchez Mejia, Nathan J Rodgers
PURPOSE OF REVIEW: This review aims to describe the assessment of pulmonary hypertension and ventricular function in neonates with congenital diaphragmatic hernia and the long-term follow-up of their pulmonary vascular disease. RECENT FINDINGS: In 2015, the pediatric pulmonary hypertension guidelines from the American Heart Association and American Thoracic Society suggested class I level of evidence B guidelines for routine evaluation of patients with congenital diaphragmatic hernia, including longitudinal care in an interdisciplinary pulmonary hypertension program and following the recommendations offered for all children with pulmonary hypertension...
February 15, 2019: Current Treatment Options in Cardiovascular Medicine
Ken Matsushima, Michihiro Kohno, Nobuyuki Nakajima, Hitoshi Izawa, Norio Ichimasu, Yujiro Tanaka, Shigeo Sora
OBJECTIVE: The intraforaminal component of jugular foramen tumors is difficult to access surgically, as it requires complex approaches for radical removal and leads to a high recurrence due to residual tumor. The retrosigmoid suprajugular approach, intradural drilling of the roof of the jugular foramen, has been recently proposed for removal of such intraforaminal component without sacrificing the sigmoid-jugular venous system or requiring additional approaches. This study presents our experience with this approach and introduces the utility of intraoperative continuous vagus nerve monitoring...
February 11, 2019: World Neurosurgery
Sandeep Kumar, Reinier A Boon, Lars Maegdefessel, Stefanie Dimmeler, Hanjoong Jo
Abdominal aortic aneurysm (AAA) is a local dilatation of the abdominal aortic vessel wall and is among the most challenging cardiovascular diseases as without urgent surgical intervention, ruptured AAA has a mortality rate of >80%. Most patients present acutely after aneurysm rupture or dissection from a previously asymptomatic condition and are managed by either surgery or endovascular repair. Patients usually are old and have other concurrent diseases and conditions, such as diabetes mellitus, obesity, and hypercholesterolemia making surgical intervention more difficult...
February 15, 2019: Circulation Research
Georges Matar, Jean-Marc Lina, Georges Kaddoum
Pressure ulcer prevention is a vital procedure for patients undergoing long-term hospitalization. A human body lying posture (HBLP) monitoring system is essential to reschedule posture change for patients. Video-surveillance, the conventional method of HBLP monitoring, suffers from various limitations, such as subject's privacy, and field-of view obstruction. We propose an autonomous method for classifying the four state-of-art HBLPs in healthy adult subjects: supine, prone, left and right lateral, with no sensors or cables attached on the body and no constraints imposed on the subject...
February 13, 2019: IEEE Journal of Biomedical and Health Informatics
Stefan Greiner, Matthias Koch, Maximilian Kerschbaum, Pushkar P Bhide
PURPOSE: Most elbow dislocations can be treated conservatively, with surgery indicated in special circumstances. Surgical options, apart from fracture fixation, range from repair or reconstruction of the damaged ligaments to static external fixation, usually entailing either a long period of immobilization followed by carefully monitored initiation of movement or dynamic external fixation. In general, no consensus regarding surgical treatment has been reached. A new method of open ligament repair and augmentation of the lateral ulnar collateral ligament using a non-absorbable suture tape in cases of acute and subacute elbow instability following dislocations has been described here, which allows an early, brace-free initiation of the full range of motion...
February 14, 2019: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Ahmed A Albayar, Abigail Roche, Przemyslaw Swiatkowski, Sarah Antar, Nouran Ouda, Eman Emara, Douglas H Smith, Ali K Ozturk, Basem I Awad
Spinal Cord Injury (SCI) is a major challenge in Neurotrauma research. Complex pathophysiological processes take place immediately after the injury and later on as the chronic injury develops. Moreover, SCI is usually accompanied by traumatic injuries because the most common modality of injury is road traffic accidents and falls. Patients develop significant permanent neurological deficits that depend on the extent and the location of the injury itself and in time they develop further neurological and body changes that may risk their mere survival...
2019: Frontiers in Neurology
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