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    8416 results match your criteria Preoperative Evaluation and Management

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    Preanesthesia concerns in a patient with a thyroid mass.
    JAAPA 2018 Mar;31(3):1-3
    Gayle B. Bodner and Ashley L. Talbott practice in the Department of Anesthesiology at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. The authors have disclosed no potential conflicts of interest, financial or otherwise.
    Preoperative evaluation helps identify patient comorbidities and surgical characteristics that increase perioperative risk, and also can help identify patients with potentially difficult airways. Identifying patients with difficult airways before surgery lets clinicians plan appropriate perioperative management and prepare for potential complications. This article focuses on management of a difficult airway in a patient undergoing surgery for a thyroid mass. Read More

    Technical Aspects of Awake Craniotomy With Mapping for Brain Tumors in a Limited Resource Setting.
    World Neurosurg 2018 Feb 13. Epub 2018 Feb 13.
    Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Department of Neurosurgey , Niterói, Rio de Janeiro, Brazil.
    Background: Brain tumor surgery near or within eloquent regions is increasingly common and is associated with a high risk of neurological injury. Awake craniotomy with mapping has been shown to be a valid method to preserve neurological function while increasing the extent of resection. However, the technique used varies greatly among centers. Read More

    [Intraoperative optical coherence tomography in explorative vitrectomy in patients with vitreous haemorrhage-a case series].
    Ophthalmologe 2018 Feb 15. Epub 2018 Feb 15.
    Augenklinik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
    Background: High-resolution spectral domain optical coherence tomography (SD-OCT) is a gold standard technique for diagnosis, management and monitoring of patients with vitreoretinal diseases. Preoperative diagnostics for evaluation of intraocular and retinal status in patients with vitreous haemorrhage are limited, thus final therapeutic decisions can only be made during explorative vitrectomy. We evaluated the use of intraoperative SD-OCT (iSD-OCT) as a real-time additional diagnostic tool during explorative vitrectomy in patients with vitreous haemorrhage. Read More

    Cardiac surgery in adult patients with remitted or active malignancies: a review of preoperative screening, surgical management and short- and long-term postoperative results.
    Eur J Cardiothorac Surg 2018 Feb 13. Epub 2018 Feb 13.
    Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands.
    Candidate patients for cardiac surgery procedures with a history of malignancies and antitumour therapy or with an active cancer and on antineoplastic treatment are increasingly common in daily practice. Oncological therapy can lead to cardiovascular injury and, therefore, has the potential for impacting operative risks and surgical strategies. This means that a number of considerations are essential to take into account prior to cardiac surgery. Read More

    Preoperative evaluation of the elderly surgical patient and anesthesia challenges in the XXI century.
    Aging Clin Exp Res 2018 Feb 14. Epub 2018 Feb 14.
    Perioperative Geriatric Medicine, University of San Marino, Contrada Omerelli, 20, 47890, San Marino, San Marino.
    Universally recognized goals of preoperative anesthesia assessment are the evaluation of patient's health status to define the entity of the surgical risk, and the anticipation of possible complications while optimizing and planning preventive strategies. Data obtained by Comprehensive Geriatric Assessment (CGA) and frailty evaluation are of extreme usefulness in surgical risk evaluation in older patients and in the decision about surgery. It is from the team-based discussion of such results that the most appropriate treatment can be individuated, surgery invasiveness and duration critically analyzed and if needed modified, and the best perioperative strategy carefully tailored. Read More

    Anesthesia and analgesia: how does the role of anesthetists changes in the ERAS program for VATS lobectomy.
    J Vis Surg 2018 11;4. Epub 2018 Jan 11.
    Department of Morphology, Surgery and Experimental Medicine, Azienda Ospedaliero-Universitaria Sant'Anna, Ferrara, Italy.
    Enhanced recovery after surgery (ERAS) programs are developed to prevent factors that delay postoperative recovery as well as issues that cause complications. The development of video-assist thoracoscopic surgery (VATS) techniques favors the fast recovery after thoracic procedures. ERAS strategies are based on multidisciplinary approach in which the anesthetist plays an important role from the preoperative to the postoperative phase with several goals. Read More

    High-resolution esophageal manometry in a Mexican population: diagnostic outcome.
    Dis Esophagus 2018 Feb 9. Epub 2018 Feb 9.
    Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA.
    High-resolution esophageal manometry (HREM) has become the method of choice for evaluation of esophageal motility disorders. There is a paucity of data with this technique from Hispanic countries. This study aims to characterize the diagnostic outcome of HREM in a large cohort of consecutive patients in Mexico. Read More

    Three groups of dissatisfied patients exist after total knee arthroplasty: early, persistent, and late.
    Bone Joint J 2018 Feb;100-B(2):161-169
    Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne NE7 7DD, UK.
    Aims: The primary aim of this study was to assess whether patient satisfaction one year after total knee arthroplasty (TKA) changed with longer follow-up. The secondary aims were to identify predictors of satisfaction at one year, persistence of patient dissatisfaction, and late onset dissatisfaction in patients that were originally satisfied at one year.

    Patients And Methods: A retrospective cohort consisting of 1369 patients undergoing a primary TKA for osteoarthritis that had not undergone revision were identified from an established arthroplasty database. Read More

    Evaluation and surgical outcome of acquired nonaccommodative esotropia among older children.
    Can J Ophthalmol 2018 Feb 25;53(1):45-48. Epub 2017 Sep 25.
    Ivey Eye Institute, Department of Ophthalmology, Western University, London, Ont.
    Objective: To describe the presentation, clinical evaluation, work-up, surgical management, and surgical outcomes in children older than 8 years with spontaneous, comitant, acquired nonaccommodative esotropia (ANAET).

    Design: Retrospective chart review.

    Participants: Children who underwent bilateral medial rectus recession surgery for ANAET with initial esotropia onset later than 8 years of age. Read More

    The results of Scarf osteotomy combined with distal soft tissue procedure are mostly satisfactory in surgical management of moderate to severe hallux valgus.
    Foot Ankle Surg 2017 May 29. Epub 2017 May 29.
    Yeditepe University, School of Medicine, Department of Orthopaedic Surgery and Traumatology, İstanbul, Turkey. Electronic address:
    Background: Intrinsically stable diaphyseal osteotomy gained popularity in recent years for symptomatic hallux valgus deformities. In this study, Scarf osteotomy results, in surgical management of moderate to severe hallux valgus, are presented.

    Methods And Patients: Study group consisted of 40 feet of 32 (28 females, four males) patients surgically managed by Scarf osteotomy between September 2009 and 2011, with a mean age of 52,98 (range, 31-75) years at the time of surgery. Read More

    Acute right ventricular failure after orthotopic liver transplantation.
    Ann Transl Med 2018 Jan;6(1):19
    Department of Cardiovascular Medicine, University of Tennessee Health Science Center, Memphis, TN 38136, USA.
    The interdependence between the heart and liver in maintaining hemodynamic stability during the perioperative period of either orthotopic heart (OHT) or liver (OLT) transplantation is important. The pre-transplant hemodynamic changes that occur in patients with end-stage liver disease (ESLD) can include decreased systemic vascular resistance, poor ventricular response to stress and increased cardiac output (CO). Concomitant pulmonary disorders are often present in ESLD. Read More

    Chronic Obstructive Pulmonary Disease Is Associated With Short-Term Complications Following Total Hip Arthroplasty.
    J Arthroplasty 2018 Jan 9. Epub 2018 Jan 9.
    Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
    Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Furthermore, COPD patients are at increased risk of complications following surgery. The purpose of this study was to evaluate the postoperative total hip arthroplasty (THA) outcomes of COPD patients. Read More

    Innovative Use Of Electronic Consultations In Preoperative Anesthesiology Evaluation At VA Medical Centers In New England.
    Health Aff (Millwood) 2018 Feb;37(2):275-282
    Jay D. Orlander is a professor of medicine, Section of General Medicine, at Boston University School of Medicine and associate chief of Medical Service, VA Boston Healthcare System.
    Electronic consultations (e-consults) improve access to specialty care without requiring face-to-face patient visits. We conducted a mixed-methods descriptive study to understand the variability in e-consult use across anesthesiology departments in the Veterans Affairs New England Healthcare System (VANEHS). In the period 2012-15, the system experienced a rapid increase in the use of anesthesiology e-consults: 5,023 were sent in 2015, compared with 103 in 2012. Read More

    [The consensus on nutritional and multi-disciplinary management for bariatric surgery].
    • Authors:
    • ,
    Zhonghua Wai Ke Za Zhi 2018 Feb;56(2):81-90
    Obesity is associated with many chronic diseases and has become a major public health problem all over the world. Although weight loss includes lifestyle modification, psychological and medical treatment, bariatric surgery remains an effective treatment for morbidly obese patients. Due to the lack of multidisciplinary management and long-term nutrition monitoring, some patients are suffering from malnutrition, functional impairment and other issues after bariatric surgery. Read More

    The Growing Utilization of Laparoscopy in Emergent Colonic Disease.
    Am Surg 2017 Oct;83(10):1068-1073
    Department of Surgery, University of California, Irvine School of Medicine, Irvine, California, USA.
    Emergent colonic disease has traditionally been managed with open procedures. Evaluation of recent trends suggests a shift toward minimally invasive techniques in this disease setting. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) targeted colectomy database from 2012 to 2014 was used to examine clinical data from patients who emergently underwent open colectomy (OC) and laparoscopic colectomy (LC). Read More

    Early myocardial surgical revascularization after ST-segment elevation myocardial infarction in multivessel coronary disease: bridge therapy is the solution?
    J Cardiovasc Med (Hagerstown) 2018 Mar;19(3):120-125
    Department of Medicine and Surgery, University of Salerno.
    Background: Many ST-segment elevation myocardial infarction (STEMI) patients have a multivessel disease that initially require percutaneous coronary intervention (PCI) of the culprit vessel but subsequently may require coronary artery bypass graft (CABG) of nonculprit vessels. Evidence supports staged revascularization, but the identification of optimal strategies (percutaneous or surgical), the timing and the management of antiplatelet therapy after recent PCI with stenting are matters of great controversies.

    Methods: In our retrospective registry, we have enrolled 21 patients presenting with STEMI and multivessel disease, who underwent PCI of the culprit vessel only and then CABG of nonculprit vessels. Read More

    Multiloculated Cystic Renal Tumors of Childhood: Has the Final Word Been Spoken.
    J Indian Assoc Pediatr Surg 2018 Jan-Mar;23(1):22-26
    Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India.
    Background: Multicystic renal tumors which include cystic nephroma, cystic partially differentiated nephroblastoma (CPDN) and cystic Wilms tumor has been a diagnostic and therapeutic challenge. Histopathological examination has been the only reliable differentiating method. Management of these tumors is still riddled with controversy as a definitive preoperative differentiation between the three has not been possible. Read More

    Road to recovery after transvaginal surgery for urethral mesh perforation: evaluation of outcomes and subsequent procedures.
    Int Urogynecol J 2018 Jan 29. Epub 2018 Jan 29.
    Department of Urologic Surgery, Vanderbilt University Medical Center, A1302 Medical Center North, Nashville, TN, 37232-2765, USA.
    Introduction And Hypothesis: Urethral injury resulting from transvaginal mesh slings is a rare complication with an estimated incidence of <1%. Our objective was to review the surgical management and functional outcomes of women presenting with urethral mesh perforation following midurethral sling (MUS) placement.

    Methods: This was a retrospective multicenter review of women who from January 2011 to March 2016 at two institutions underwent mesh sling excision for urethral perforation with Female Pelvic Medicine and Reconstructive Surgery fellowship-trained surgeons. Read More

    Approach to the Diagnostic Workup and Management of Small Bowel Lesions at a Tertiary Care Center.
    J Gastrointest Surg 2018 Jan 25. Epub 2018 Jan 25.
    Department of Surgery, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA, 01655, USA.
    Background: Small bowel lesions (SBL) are rare, representing diagnostic and management challenges. The purpose of this cross-sectional study was to evaluate diagnostic modalities used and management practices of patients with SBL at an advanced endoscopic referral center.

    Methods: We analyzed patients undergoing surgical management for SBL from 2005 to 2015 at a single tertiary care center. Read More

    Factors related to subjective satisfaction following microendoscopic foraminotomy for cervical radiculopathy.
    BMC Musculoskelet Disord 2018 01 24;19(1):30. Epub 2018 Jan 24.
    Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan.
    Background: Microendoscopic foraminotomy has been reported to be effective for the treatment of cervical radiculopathy, using outcome measurement scores such as the neck disability index (NDI) and numerical rating scale (NRS). However, the scores for spine surgery do not always reflect the true subjective satisfaction of the patient. The purpose of this study was to evaluate factors related to subjective satisfaction following microendoscopic foraminotomy for cervical radiculopathy. Read More

    Histopathological evaluation of aortic coarctation after conventional balloon angioplasty in neonates.
    Cardiol Young 2018 Jan 18:1-5. Epub 2018 Jan 18.
    1Department of Cardiovascular Surgery,Turkiye Yuksek İhtisas Training and Research Hospital,Ankara,Turkey.
    Background: Optimal management strategy for native aortic coarctation in neonates and young infants is still a matter of debate. The surgical procedure, histopathologic research, and clinical outcome in 15 neonates who underwent surgery after successful balloon angioplasty is the basis of this study.

    Method: Between 01 October, 2014 and 01 August, 2017, we enrolled 15 patients with native aortic coarctation for this study. Read More

    Paediatric physeal sparing posterior cruciate ligament (PCL) reconstruction with parental donation allograft: Rationale and operative approach.
    Knee 2018 Jan 17;25(1):203-209. Epub 2018 Jan 17.
    University of Winchester, Department of Sports and Exercise Medicine, Sparkford Road, Winchester SO22 4NR, United Kingdom.
    Background: Paediatric PCL injuries are rare but constitute a significant management challenge. We describe a novel approach to the surgical management of an 11-year-old boy who presented with persisting symptomatic instability following 18months of failed conservative therapy.

    Methods: PCL reconstruction was performed using a physeal sparing, all-inside technique under fluoroscopic control. Read More

    Patient-Reported Outcome Measures (PROM) as A Preoperative Assessment Tool.
    J Anesth Perioper Med 2017 Nov 2;4(6):274-281. Epub 2017 Nov 2.
    Department of Internal Medicine, Winston-Salem, NC, USA.
    Aim Of Review: Patient-reported outcomes (PRO) on functional, social, and behavioral factors might be important preoperative predictors of postoperative outcomes. We conducted a literature review to explore associations of preoperative depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, and nutritional status with surgical outcomes.

    Methods: Two electronic data bases, including PubMed and Google Scholar, were searched linking either depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, or nutritional status with surgery, postoperative complications, or perioperative period within the past 2 decades. Read More

    International guidelines for groin hernia management.
    • Authors:
    Hernia 2018 Feb 12;22(1):1-165. Epub 2018 Jan 12.
    Introduction: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. Read More

    Outcomes After Dermal Allograft Reconstruction of Chronic or Subacute Pectoralis Major Tendon Ruptures.
    Orthop J Sports Med 2018 Jan 2;6(1):2325967117745834. Epub 2018 Jan 2.
    Kerlan-Jobe Orthopaedic Clinic at White Memorial Medical Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
    Background: Avoiding delay in the surgical management of pectoralis major (PM) ruptures optimizes outcomes. However, this is not always possible, and when a tear becomes chronic or when a subacute tear has poor tissue quality, a graft can facilitate reconstruction.

    Purpose: The primary aim was to evaluate the clinical outcomes of PM reconstruction with dermal allograft augmentation for chronic tears or for subacute tears with poor tissue quality. Read More

    Ankylosing spondylitis kyphosis surgical correction postoperative evaluation via SRS-22 domain investigation.
    J Orthop Surg Res 2018 Jan 9;13(1). Epub 2018 Jan 9.
    The Department of Orthopaedics, Chinese PLA General Hospital, Beijing, People's Republic of China.
    Background: The SRS-22 is used to evaluate clinical outcomes in ankylosing spondylitis kyphosis patients. This study aimed to investigate the relationship between Scoliosis Research Society-22 (SRS-22) domains and satisfaction with management in patients who underwent surgical correction for ankylosing spondylitis kyphosis. The relationship between patient satisfaction and SRS-22 domain scores will feedback abundant information of therapeutic effect and significance for treatment guidance. Read More

    Peripheral Nerve Injury associated with a Subdermal Contraceptive Implant: Illustrative Cases and Systematic Review of Literature.
    World Neurosurg 2018 Jan 5. Epub 2018 Jan 5.
    Background: Despite the demonstrable safety and efficacy of subdermal contraceptive implants (SCI), both insertion and removal of SCI in the arm have been associated with neurovascular complications. The primary aim of this study is to investigate the type and prognosis of nerve injuries associated with SCI.

    Methods: The authors performed a comprehensive search of 4 electronic databases for studies pertaining to patients with nerve injury and concurrent SCI. Read More

    Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Role of Imaging in the Diagnosis and Management of Patients With Vestibular Schwannomas.
    Neurosurgery 2018 Feb;82(2):E32-E34
    Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia.
    Question 1: What sequences should be obtained on magnetic resonance imaging (MRI) to evaluate vestibular schwannomas before and after surgery?

    Target Population: Adults with vestibular schwannomas.

    Recommendations: Initial Preoperative Evaluation Level 3: Imaging used to detect vestibular schwannomas should use high-resolution T2-weighted and contrast-enhanced T1-weighted MRI. Level 3: Standard T1, T2, fluid attenuated inversion recovery, and diffusion weighted imaging MR sequences obtained in axial, coronal, and sagittal plane may be used for detection of vestibular schwannomas. Read More

    Reducing Overutilization of Preoperative Medical Referrals Among Patients Undergoing Radical Cystectomy Using an Evidence-based Algorithm.
    Urology 2018 Jan 2. Epub 2018 Jan 2.
    Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH. Electronic address:
    Objective: To evaluate the frequency with which preoperative medical evaluations lead to changes in perioperative management of patients undergoing radical cystectomy and to examine the impact of an evidence-based algorithm on referral utilization.

    Materials And Methods: A retrospective review of 176 patients undergoing radical cystectomy in 2013-2014 was conducted. Patients referred for additional preoperative medical or cardiology evaluation were identified and the incidence of diagnostic testing or management changes resulting from such evaluations were determined. Read More

    Use of Intraoperative Computed Tomography in Craniomaxillofacial Trauma Surgery.
    J Oral Maxillofac Surg 2017 Dec 13. Epub 2017 Dec 13.
    Attending Oral and Maxillofacial Surgeon, Legacy Emanuel Medical Center, Head and Neck Institute, Portland, OR.
    Purpose: The use of technology to aid in assessment, planning, and management of complex craniomaxillofacial injuries is increasingly common. Preoperative computed tomography (CT) evaluation is considered the standard of care, and intraoperative imaging is becoming increasingly accessible. Limited data exist regarding the implication of intraoperative CT on decision making in the management of all sites of facial fractures. Read More

    Postoperative ERAS Interventions Have the Greatest Impact on Optimal Recovery: Experience With Implementation of ERAS Across Multiple Hospitals.
    Ann Surg 2018 Jan 4. Epub 2018 Jan 4.
    Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
    Background: Enhanced recovery after surgery (ERAS) programs incorporate evidence-based practices to minimize perioperative stress, gut dysfunction, and promote early recovery. However, it is unknown which components have the greatest impact.

    Objective: This study aims to determine which components of ERAS programs have the largest impact on recovery for patients undergoing colorectal surgery. Read More

    Medial patellofemoral ligament reconstruction in children: do osseous abnormalities matter?
    Int Orthop 2018 Jan 4. Epub 2018 Jan 4.
    Paediatric Orthopaedics, Timone Children's Hospital, Aix-Marseille University, 264, rue Saint Pierre, 13005, Marseille, France.
    Purpose: Management of post-traumatic patellar instability in children with osseous abnormalities is challenging because of the presence of an open physis. The aim of our study was to compare the rate of recurrence after isolated reconstruction of the medial patellofemoral ligament (MPFL) in children with or without osseous abnormalities.

    Methods: The medical records of 25 children (27 knees) with recurrent patellar dislocation were reviewed. Read More

    Head and neck paragangliomas: A two-decade institutional experience and algorithm for management.
    Laryngoscope Investig Otolaryngol 2017 Dec 11;2(6):380-389. Epub 2017 Nov 11.
    Department of Otolaryngology-Head and Neck SurgeryKresge Hearing Research InstituteAnn ArborMichiganU.S.A.
    Objectives: Paragangliomas of the head and neck and cranial base are typically benign, slow-growing tumors arising within the jugular foramen, middle ear, carotid bifurcation, or vagus nerve proper. The objective of this study was to provide a comprehensive characterization of our institutional experience with clinical management of these tumors and posit an algorithm for diagnostic evaluation and treatment.

    Methods: This was a retrospective cohort study of patients undergoing treatment for paragangliomas of the head and neck and cranial base at our institution from 2000-2017. Read More

    Evaluation of Preoperative Flupirtine in Ambulatory Functional Endoscopic Sinus Surgery: A Prospective, Double-Blind, Randomized Controlled Trial.
    Anesth Essays Res 2017 Oct-Dec;11(4):902-908
    Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
    Background: Functional endoscopic sinus surgery (FESS) is the mainstay therapeutic management for nasal pathologies. We evaluated flupirtine, a centrally acting analgesic, for producing perfect perioperative conditions in FESS for adults in a day-care setting.

    Materials And Methods: Sixty-two patients (25-40 years) scheduled for FESS under general anesthesia were randomly divided into Group F (= 31) receiving preoperative flupirtine (100 mg) and Group C (= 31) receiving identical-looking placebo capsule per oral 60 min before induction of anesthesia. Read More

    The incidence of malignancy in clinically benign cystic lesions of the lateral neck: our experience and proposed diagnostic algorithm.
    Eur Arch Otorhinolaryngol 2018 Mar 27;275(3):767-773. Epub 2017 Dec 27.
    Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel.
    Aim: Solitary cystic masses of the lateral neck in an adult patient can pose a diagnostic dilemma. Malignancy must be ruled out since metastases arising from H&N cancers may mimic the presentation of benign cystic masses. Only a small number of studies have investigated the diagnostic management and malignancy rate of clinically benign solitary cervical cystic lesions. Read More

    Transfusion Requirements in Cardiac Surgery III (TRICS III): Study Design of a Randomized Controlled Trial.
    J Cardiothorac Vasc Anesth 2018 Feb 3;32(1):121-129. Epub 2017 Nov 3.
    Department of Anesthesia, University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada. Electronic address:
    Objectives: To determine if a restrictive transfusion threshold is noninferior to a higher threshold as measured by a composite outcome of mortality and serious morbidity.

    Design: Transfusion Requirements in Cardiac Surgery (TRICS) III was a multicenter, international, open-label randomized controlled trial of two commonly used transfusion strategies in patients having cardiac surgery using a noninferiority trial design ( number, NCT02042898). Read More

    Efficacy of corneal cooling on postoperative pain management after photorefractive keratectomy: A contralateral eye randomized clinical trial.
    J Curr Ophthalmol 2017 Dec 11;29(4):264-269. Epub 2017 May 11.
    Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
    Purpose: To compare chilled and room temperature balanced salt solution (BSS) and bandage contact lens (BCL) on post photorefractive keratectomy (PRK) pain.

    Methods: In a prospective, single-masked, controlled eye study, one hundred eyes of fifty patients were divided into two groups which received room temperature or chilled BSS and BCL in each eye, and compared for post-PRK pain. Three different pain evaluation systems were used to evaluate pain between the groups at 1 and 6 h and days 1, 2, 3, 5, and 7, postoperatively. Read More

    Reverse shoulder arthroplasty patient personalized rehabilitation protocol. Preliminary results according to prognostic groups.
    Muscles Ligaments Tendons J 2017 Apr-Jun;7(2):263-270. Epub 2017 Sep 18.
    I Orthopedic and Traumatology Unit, Università della Campania "L. Vanvitelli", Napoli, Italy.
    Background: Rehabilitation after Reverse Shoulder Arthroplasty (RSA) is still object of discussion with no based evidence guidelines. The aim of this study was to test a personalized rehabilitation protocol for three different patients groups according to clinical and intraoperative parameters that can affect final outcomes after RSA.

    Patients And Methods: We retrospectively evaluated a consecutive series of 112 patients who underwent to RSA between 2013 and 2015. Read More

    Hormone secreting gastro-entero-pancreatic neuroendocrine neoplasias (GEP-NEN): When to consider, how to diagnose?
    Rev Endocr Metab Disord 2017 Dec 19. Epub 2017 Dec 19.
    Schwerpunkt Endokrinologie und Stoffwechselerkrankungen, I. Medizinischen Klinik und Poliklinik; ENETS center of excellence, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstrasse 1, 55101, Mainz, Germany.
    Neuroendocrine neoplasms of the digestive system (GEP-NEN) represent a heterogeneous group of malignancies with various clinical presentation and prognosis. GEP-NENs can potentially affect all organs of the gastrointestinal tract; characteristically they share the biological property to produce and secrete peptides and neuroamines. About 30% of GEP-NENs are hormonally active and can cause specific clinical syndromes. Read More

    Preoperative evaluation and surgical technique of functional and cosmetic aspects in zygomatic complex fracture patients.
    J Biol Regul Homeost Agents 2017 Oct-Dec;31(4):1005-1012
    Department of Plastic and Reconstructive Surgery, the First Hospital of Jilin University, Changchun, China.
    The zygomatico-maxillary complex functions as the principle buttress of the face and is the cornerstone to an individual’s aesthetic appearance. Its fracture not only creates cosmetic deformities owing to its position and facial contour, but can also cause disruption of ocular and mandibular functions. The aim of this study was to evaluate the quality, efficacy and impact of internal fixation of zygomatic complex fractures on functional and cosmetic outcomes. Read More

    Stereotactic EEG via multiple single-path omnidirectional trajectories within a single platform: institutional experience with a novel technique.
    J Neurosurg 2017 Dec 15:1-9. Epub 2017 Dec 15.
    Department of Neurological Surgery, Vanderbilt University Medical Center.
    OBJECTIVE Stereotactic electroencephalography (SEEG) is being used with increasing frequency to interrogate subcortical, cortical, and multifocal epileptic foci. The authors describe a novel technique for SEEG in patients with suspected epileptic foci refractory to medical management. METHODS In the authors' technique, standard epilepsy evaluation and neuroimaging are used to create a hypothesis-driven SEEG plan, which informs the 3D printing of a novel single-path, multiple-trajectory, omnidirectional platform. Read More

    Multidisciplinary management of a giant cervico-mediastinal liposarcoma: A case report and literature review.
    Ear Nose Throat J 2017 Dec;96(12):E10-E13
    Department of Otorhinolaryngology, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
    Liposarcomas are rare mesenchymal tumors that usually develop in lower extremities or retroperitoneum; cervico-mediastinal presentation is quite uncommon. These neoplasms are commonly diagnosed at a late stage because they remain asymptomatic until nearby structures are compressed. This makes radical excision particularly challenging. Read More

    The role of preoperative high resolution manometry in predicting dysphagia after laparoscopic Nissen fundoplication.
    Surg Endosc 2017 Dec 12. Epub 2017 Dec 12.
    Dept of General Surgery, University of Vermont Medical Center, Burlington, VT, USA.
    Background: Laparoscopic fundoplication is an accepted surgical management of refractory gastro-esophageal reflux disease (GERD). The use of high resolution esophageal manometry (HRM) in preoperative evaluation is often applied to determine the degree of fundoplication to optimize reflux control while minimizing adverse sequela of postoperative dysphagia.

    Objective: Assess the role of preoperative HRM in predicting surgical outcomes, specifically risk assessment of postoperative dysphagia and quality of life, among patients receiving laparoscopic Nissen fundoplication for GERD with immediate postoperative (< 4 weeks clinic), short-term (3-month clinic), and long-term (34 ± 10. Read More

    Association of Atrial Fibrillation and Oral Anticoagulant Use With Perioperative Outcomes After Major Noncardiac Surgery.
    J Am Heart Assoc 2017 Dec 12;6(12). Epub 2017 Dec 12.
    Division of Cardiology, University of Toronto, Canada
    Background: We examined the association of atrial fibrillation (AF) and oral anticoagulant use with perioperative death and bleeding among patients undergoing major noncardiac surgery.

    Methods And Results: A population-based study of patients aged 66 years and older who underwent elective (n=87 257) or urgent (n=35 930) noncardiac surgery in Ontario, Canada (April 2012 to March 2015) was performed. Outcomes were compared between AF groups using inverse probability of treatment weighting using the propensity score. Read More

    The effects of recreational ketamine cystitis on urinary tract reconstruction - a surgical challenge.
    BJU Int 2017 Dec 12. Epub 2017 Dec 12.
    Department of Urology, University College London Hospital, London, UK.
    Objectives: To identify the rate of postoperative complications in patients who require surgical reconstruction for ketamine-induced urinary tract dysfunction and to identify any predictors for poor postoperative outcome with subsequent management strategies.

    Patients And Methods: A retrospective review of data collected between 2007 and 2017 of all patients with ketamine-induced urinary tract disease was performed. Evaluation included computed tomography urogram, cystoscopy, and biopsy. Read More

    Procedure-based postoperative risk prediction using NSQIP data.
    J Surg Res 2018 Jan;221:322-327
    Department of Surgery, Maine Medical Center, Portland, Maine.
    Background: The National Surgical Quality Improvement Program (NSQIP) has proposed using procedure-based hierarchical models to predict adverse outcomes, but it is not clear whether this approach was used to develop the NSQIP "Surgical Risk Calculator". We therefore wished to demonstrate how procedure-based hierarchical models can be constructed and to describe their results.

    Methods: NSQIP data from 2015 were used to construct statistical models predicting 30-day postoperative mortality and morbidity, using two-level logistic regression with preoperative patient-level variables as fixed effects and procedure-specific codes as a random intercept. Read More

    Revision Arthroplasty of the Wrist in Patients With Rheumatoid Arthritis, Mean Follow-Up 6.6 Years.
    J Hand Surg Am 2017 Dec 7. Epub 2017 Dec 7.
    Department of Hand Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Purpose: Management of failed total wrist arthroplasty (TWA) can be challenging; surgical treatment options include salvage arthrodesis, revision arthroplasty, and resection arthroplasty. There are few studies regarding salvage arthrodesis, and revision arthroplasty has been infrequently investigated. The aim of the study was to report the outcome after revision arthroplasty of the wrist. Read More

    Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management.
    Tumori 2017 Dec 5. Epub 2017 Dec 5.
    Office of Improvement and Innovation at Lombardy Health Service Department, Lombardy - Italy.
    Purpose: Measurement and monitoring of the quality of care using a core set of quality measures are increasing in health service research. Although administrative databases include limited clinical data, they offer an attractive source for quality measurement. The purpose of this study, therefore, was to evaluate the completeness of different administrative data sources compared to a clinical survey in evaluating rectal cancer cases. Read More

    Clinical Evaluation of Efficacy and Performance of All-Poly Tibial FreedomTotal Knee System for Treating Osteoarthritis Patients: Three-Year Follow Up Study.
    J Clin Diagn Res 2017 Sep 1;11(9):RC01-RC05. Epub 2017 Sep 1.
    Senior Consultant, Department of Orthopaedic and Rheumatology, Amandeep Hospital, Amritsar, Punjab, India.
    Introduction: Advancement in technology in terms of design and building materials has made Total Knee Replacement (TKR) a highly effective, safe, and predictable orthopedic procedure.

    Aim: To review the clinical outcomes for efficacy and performance of Freedom Total Knee System for the management of Osteoarthritis (OA), at a minimum of three years follow up.

    Materials And Methods: For this retrospective, post-marketing study, clinical data of patients treated with Freedom Total Knee System was retrieved from the clinical records after approval from the Institutional Ethics Committee . Read More

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