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Arpandeep Randhawa, Tulika Gupta, Parmod Singh, Anjali Aggarwal, Daisy Sahni
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) has emerged as a less invasive treatment than surgical aortic valve replacement in patients with aortic stenosis. Understanding the anatomy of aortic valve complex may help in optimal positioning of prosthetic valve and circumvent complications that can arise during its implantation. MATERIAL AND METHODS: The anatomy of aortic root was studied in 30 formalin-fixed cadavers. Aortic root and left ventricular cavity was opened to measure the diameter at the base of aortic root and sinotubular junction (STJ); distance of coronary ostia from base of aortic root and STJ; height and width of aortic valve leaflets; length and thickness of membranous septum (MS)...
January 21, 2019: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Alexandra Higgins, Zaraq Khan, Charles C Coddington, Shahrukh K Hashmi, Mehrdad Hefazi, Hassan Alkhateeb, Mark R Litzow, William J Hogan, Elizabeth Cathcart-Rake, Carrie A Thompson, Mrinal M Patnaik
Iatrogenic menopause with consequent infertility is a major complication in reproductive aged women undergoing hematopoietic cell transplantation (HCT). Recent guidelines recommend a discussion of the possibility of infertility and the options for fertility preservation as part of informed consent before initiation of any cancer-directed therapy, including HCT. Women aged 15-49 years at the time of allogeneic HCT, between the years 2001 and 2017, were identified from the Mayo Clinic Rochester institutional HCT database...
February 14, 2019: Biology of Blood and Marrow Transplantation
Goji Fushihara, Tomoya Kamide, Tatsuki Kimura, Ririko Takeda, Toshiki Ikeda, Yuichiro Kikkawa, Ryuichiro Araki, Hiroki Kurita
OBJECTIVE: The aim of the study was to better define the incidence of and risk factors for early seizures after repair of unruptured intracranial aneurysms in modern microsurgical techniques. PATIENTS AND METHODS: The medical records of 414 consecutive patients who underwent neck clipping of unruptured intracranial aneurysms in our institution over a 5-year period were retrospectively reviewed. Clinical and neuroimaging variables were analyzed to investigate putative predictors of perioperative seizures using multivariate logistic regression analysis...
February 8, 2019: Clinical Neurology and Neurosurgery
L Mata-Moret, C Chiarri-Toumit, L Hernández-Bel, E Cervera-Taulet
Digital subtraction angiography (DSA) is a technique used in interventional radiology for the diagnosis of vascular cerebral conditions. Central retinal artery occlusion (CRAO) is a complication of endovascular procedures that involve atherosclerotic plaque removal with subsequent embolisation. The case is presented on a patient who noticed a sudden vision loss during a DSA. Funduscopy showed retinal pallor and a cherry red spot. The angiography showed a structure suggesting the presence of an embolus in the central retinal artery...
February 12, 2019: Archivos de la Sociedad Española de Oftalmología
Tyler Bm Hickey, Asaf Honig, Avrum J Ostry, Jason B Chew, James Caldwell, Michael A Seidman, Hamid Masoudi, John A Maguire
INTRODUCTION: Iatrogenic embolization following cardiac investigative procedures may result from hydrophilic polymer emboli (HPE) from catheter valve and vessel wall calcifications, and air embolism from open heart surgery. This retrospective clinical pathologic analysis was undertaken to ascertain the frequency and extent of these potentially fatal complications. METHODS: This retrospective clinical pathologic autopsy analysis with premortem diagnostic imaging correlation identified 110 individuals who had undergone endovascular procedures between 2010 and 2016 within 90 days of death and followed by hospital autopsy...
January 19, 2019: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
David A Edwards, Traci L Hedrick, Jennifer Jayaram, Charles Argoff, Padma Gulur, Stefan D Holubar, Tong J Gan, Michael G Mythen, Timothy E Miller, Andrew D Shaw, Julie K M Thacker, Matthew D McEvoy
Enhanced recovery pathways have quickly become part of the standard of care for patients undergoing elective surgery, especially in North America and Europe. One of the central tenets of this multidisciplinary approach is the use of multimodal analgesia with opioid-sparing and even opioid-free anesthesia and analgesia. However, the current state is a historically high use of opioids for both appropriate and inappropriate reasons, and patients with chronic opioid use before their surgery represent a common, often difficult-to-manage population for the enhanced recovery providers and health care team at large...
February 12, 2019: Anesthesia and Analgesia
Sahil Jain, Aniruddha Agarwal, Kanika Aggarwal, Vishali Gupta
BACKGROUND AND OBJECTIVE: To discuss the role of proportional reflux hydrodissection (PRH) during pars plana vitrectomy (PPV) in eyes with diabetic tractional retinal detachment (TRD). PATIENTS AND METHODS: In this retrospective study, records of patients with diabetic TRD involving the fovea undergoing PPV with the help of PRH between January 2015 to March 2017 were noted. PRH relies on the Constellation system's proportional reflux feature. The mean age, gender, and pre- and postoperative best-corrected visual acuity (BCVA) were noted...
February 1, 2019: Ophthalmic Surgery, Lasers & Imaging Retina
Neha Kumar, Hesham Abboud
The number of reported cases of iatrogenic demyelination of the central nervous system (CNS) is on the rise. This is, in part, related to the recent expansion in the use of biologics. Review of literature from the past decade suggests that in addition to vaccines, tumor necrosis factor (TNF)-alpha inhibitors and checkpoint inhibitors are the most frequently cited inducers of central inflammation. About one-third of demyelinating cases in the setting of TNF-alpha inhibitors evolve into full-blown multiple sclerosis...
February 15, 2019: Multiple Sclerosis: Clinical and Laboratory Research
Osamah Hasan, Grant S Johnson, James J Siegert, Francisco Garcini, Thai T Nguyen
Ureteral injury is an uncommon but potentially morbid complication following any open or endoscopic pelvic procedure. Gynecologic surgeries alone make up 50 percent of nonurologic ureteral injuries leading to prolonged hospital stays, secondary interventions, and potential loss of renal function. The use of AmnioFix ® a processed dehydrated, immunologically privileged cellular amniotic membrane allograft has been well established in urologic and gynecologic procedures. These allografts contain human extracellular matrix components, growth factors, and cytokines that mediate inflammation and facilitate would healing...
2019: Case Reports in Obstetrics and Gynecology
Gregory Scott Troutman, Jason Salamon, Matthew Scharf, Jeremy A Mazurek
Osborn waves, or J waves, initially described by John Osborn in 1953 in hypothermic dog experiments, are highly sensitive and specific for hypothermia. Initially thought to be secondary to a hypothermia-induced "injury current," they have more recently been attributed to a voltage differential between epicardial and endocardial potassium (Ito ) currents. While the exact conditions required to induce such waves have been debated, numerous clinical scenarios of environmental and iatrogenic hypothermia have been described...
2019: Case Reports in Cardiology
Federica Guicciardi, Laura Atzori, Angelo Valerio Marzano, Simona Tavecchio, Giampiero Girolomoni, Chiara Colato, Axel Patrice Villani, Jean Kanitakis, Christina Mitteldorf, Rosanna Satta, Bernard Cribier, Laurence Gusdorf, Maria Teresa Rossi, Piergiacomo Calzavara-Pinton, Isabel Bielsa, Maria Teresa Fernandez-Figueras, Werner Kempf, Giorgio Filosa, Luca Pilloni, Franco Rongioletti
BACKGROUND: Clinical and pathological criteria to distinguish drug-induced subacute lupus erythematosus (DI-SCLE) from idiopathic (I-SCLE) are controversial. OBJECTIVE: Aim of the survey was a retrospective analysis of a consistent number of iatrogenous and idiopathic SCLE cases, by means of clinical and histopathological investigation. METHODS: Eleven European University Dermatology Units collected all diagnosed cases from January 2000 to December 2016...
February 11, 2019: Journal of the American Academy of Dermatology
Sarah N Bowe, C Alessandra Colaianni, Alisa Yamasaki, Brian M Cummings, Christopher J Hartnick
Importance: Health care organizations are complex and evolving systems. To date, longitudinal evaluation to ensure the sustainability of quality improvement (QI) initiatives has been missing from the otolaryngology literature. We sought to reassess perioperative management of laryngotracheal reconstruction, which requires adequate sedation. Objective: Using principles of continuous QI, the objectives of this study were to (1) describe step-by-step methods to sustain QI efforts and (2) revisit a series of process, outcome, and balance measures for sedation weaning management following implementation of a new electronic health record (EHR)...
February 14, 2019: JAMA Otolaryngology—Head & Neck Surgery
Michael T Milone, Christopher S Klifto, Z-Hye Lee, Vishal Thanik, Jacques H Hacquebord
BACKGROUND: The general teaching is that increased number of vein repairs in digit replantation leads to improved venous outflow, resulting in lower need for iatrogenic bleeding, lower postoperative transfusion requirements, and better survival rates. The purpose of this study was to determine whether the traditional teaching that emphasizes the repair of multiple veins per arterial anastomosis results in superior survival rates. METHODS: A retrospective review of a single urban replant center's single-digit replants distal to the mid-metacarpal level in adult patients from 2007 to 2017 was performed...
February 14, 2019: Hand: Official Journal of the American Association for Hand Surgery
Gilda Cinnella, Marco Pavesi, Andrea De Gasperi, Marco Ranucci, Lucia Mirabella
Patient blood management is currently defined as the application of evidence based medical and surgical concepts designed to maintain hemoglobin (Hb), optimize hemostasis and minimize blood loss to improve patient outcome. Blood management focus on the perioperative management of patients undergoing surgery or other invasive procedures in which significant blood loss occurs or is expected. Preventive strategies are emphasized to identify and manage anemia, reduce iatrogenic blood losses, optimize hemostasis (e...
February 13, 2019: Minerva Anestesiologica
Anca Pantalon, Martin Pfister, Valentin Aranha Dos Santos, Sabina Sapeta, Angelika Unterhuber, Niklas Pircher, Gerald Schmidinger, Gerhard Garhöfer, Doreen Schmidl, Leopold Schmetterer, René M Werkmeister
PURPOSE: To employ ultrahigh-resolution (UHR) optical coherence tomography (OCT) for investigation of the early wound healing process in corneal epithelium. METHODS: A custom-built UHR-OCT system assessed epithelial healing in human keratoconic cornea after epi-off crosslinking (CXL) procedure and a wound healing model in rabbits with iatrogenic corneal injury. 3D OCT data sets enhanced obtaining epithelial thickness maps and evaluation of reepithelization stage...
February 14, 2019: Acta Ophthalmologica
P S Kyzlasov, A G Martov, M V Zabelin, A I Bokov, A A Kazhera
Urethral strictures are one of the most common reasons to see a urologist and are considered a socially significant disease. Management of urethral strictures is one of the challenging issues in urology. The article presents a case of a patient with extensive iatrogenic stricture of the penile urethra. The patient underwent penile augmentation urethroplasty using buccal mucosa resulting in the restoration of the whole length of the urethral lumen and non-obstructive urination according to uroflowmetry findings...
October 2018: Urologii︠a︡
S V Kotov, S V Belomyttsev, R I Guspanov, M K Semenov, M M Iritsyan, A M Ugurchiev
INTRODUCTION: Iatrogenic urethral damage is the leading etiologic factor for urethral stricture in men in developed countries and second after traumatic injury in developing ones. This study aimed to evaluate the frequency of iatrogenic strictures of the urethra and the results of their treatment. MATERIALS AND METHODS: This retrospective analysis comprised 133 patients who were treated for iatrogenic urethral stricture from 2011to 2016. Group I included 72 (54%) patients after trans(intra)urethral interventions (transurethral resection of the prostate or urinary bladder), urethral dilation, traumatic catheterization, etc...
October 2018: Urologii︠a︡
Benjamin Pirotte, Kenji Inaba, Morgan Schellenberg, Gustavo Recinos, Lydia Lam, Elizabeth Benjamin, Kazuhide Matsushima, Demetrios Demetriades
Intraoperative consultations are an important component of acute care surgery (ACS). The nature of these consultations is incompletely characterized by the existing literature. The study objective was to define the characteristics of intraoperative consults managed by a mature ACS program at a Level I trauma center. All intraoperative consultations requested from the ACS service at LAC+USC Medical Center (January 2011-July 2016) were identified. Demographics, date/time of consultation, referring service, procedure data, and outcomes were abstracted...
January 1, 2019: American Surgeon
Heather L Covey, Yu-Mei Chang, Jonathan Elliott, Harriet M Syme
BACKGROUND: Iatrogenic hypothyroidism might worsen the prognosis of cats with azotemic CKD after thyroidectomy. Varying thyroxine concentrations influence utility of creatinine in assessing renal function. Symmetric dimethylarginine (SDMA) has limited studies in cats with changing thyroid status. OBJECTIVES: Thyroid status is stable 6 months post-thyroidectomy. Symmetric dimethylarginine and creatinine are linearly associated without influence from total thyroxine concentration (tT4)...
February 13, 2019: Journal of Veterinary Internal Medicine
Wei Sun, Cheng Xue, Xian-Ye Tang, Hu Feng, Feng Yuan, Kai-Jin Guo, Jie Zhao
BACKGROUND: Lumbar spinal stenosis, often accompanied by degenerative spondylolisthesis, is one of the most common conditions in the elderly. Decompression and fusion is a well-accepted treatment for single-segment lumbar spinal stenosis with degenerative spondylolisthesis; however, the treatment for multi-segment lumbar spinal stenosis with single-segment degenerative spondylolisthesis (MLSS) remains controversial. The objective of this study is to compare the effectiveness of selective decompression and fusion to multi-segmental decompression and fusion for MLSS...
February 12, 2019: Journal of Orthopaedic Surgery and Research
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