9,084 results match your criteria Preoperative Evaluation and Management


The evaluation of monocyte lymphocyte ratio as a preoperative predictor in urothelial malignancies: a pooled analysis based on comparative studies.

Sci Rep 2019 Apr 18;9(1):6280. Epub 2019 Apr 18.

Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People's Republic of China.

In recent years, several studies have reported monocyte lymphocyte ratio (MLR) to predict prognosis in various tumors. Our study was performed to evaluate the association between preoperative MLR between prognostic variables in urothelial carcinoma patients. Systematic literature search was conducted in PubMed, Embase, Web of science. Read More

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http://dx.doi.org/10.1038/s41598-019-42781-yDOI Listing

Distal Outflow-related Anterior Inferior Cerebellar Artery Aneurysm in Hemangioblastoma.

World Neurosurg 2019 Apr 12. Epub 2019 Apr 12.

Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University. Electronic address:

Anterior inferior cerebellar artery (AICA) aneurysm is a rare cerebral entity and its presentation in association with a hyper-vascularized tumor is even more exceptional. In this study, we presented a patient with rare coexistent pathologies in combination of a cerebellar hypervascularized tumor with an outflow related AICA aneurysm. A one-stage procedure to remove both lesions was carried out following meticulous discussion with patient. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.04.023DOI Listing

Management of Recalcitrant Carpal Tunnel Syndrome.

J Am Acad Orthop Surg 2019 Apr 9. Epub 2019 Apr 9.

From the Department of Orthopaedic Surgery (Dr. Lauder, Dr. Mithani, and Dr. Leversedge), and the Department of Surgery (Dr. Mithani and Dr. Leversedge), Division of Plastic Surgery, Duke University Medical Center, Durham, NC.

Recalcitrant carpal tunnel syndrome presents a clinical challenge. Potential etiologies of persistent or recurrent symptoms after primary carpal tunnel release include incomplete nerve decompression, secondary sites of nerve compression, unrecognized anatomic variations, irreversible nerve pathology associated with chronic compression neuropathy, perineural adhesions, conditions associated with secondary nerve compression, iatrogenic nerve injury, or inaccurate preoperative diagnosis. Understanding the pertinent surgical anatomy and pathophysiology is essential toward developing an effective diagnostic and treatment strategy. Read More

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http://dx.doi.org/10.5435/JAAOS-D-18-00004DOI Listing
April 2019
1 Read

Management of Acquired Compressive Myelopathy due to Spinal Fluorosis.

Indian J Orthop 2019 Mar-Apr;53(2):324-332

Department of Orthopaedics, B J Medical College, Civil Hospital, Ahmedabad, Gujarat, India.

Background: Fluorosis is an endemic disease of India which causes compressive cervical and/or dorsal myelopathy. This study aims to evaluate the role of surgical management in the crippling fluorosis along with evaluation of radiological imaging as screening/diagnosing tool for the disease.

Materials And Methods: This is a prospective cohort study of 33 patients operated at tertiary care center having nontraumatic involvement of spinal cord affecting neurology with history, clinical and radiological features (Ossified Posterior Longitudinal Ligament-, Ossified Ligamentum flavum) suggesting fluorosis as the cause of compression. Read More

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http://dx.doi.org/10.4103/ortho.IJOrtho_570_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415559PMC
April 2019
2 Reads

Evaluation of Challenges in Diagnosis of Spontaneous Subacute Pyogenic Spondylodiscitis in Immunocompetent Patients: Experiences from a Tertiary Care Center.

Asian Spine J 2019 Apr 2. Epub 2019 Apr 2.

Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India.

Study Design: Prospective clinical study.

Purpose: We evaluated the challenges faced during diagnosis and management of patients with subacute pyogenic discitis and discussed various clues in clinical history, radiologic and hematologic parameters of these patients that helped in establishing their diagnosis.

Overview Of Literature: Present literature available shows that in patients with subacute spondylodiscitis and infection with less virulent organisms, the clinical picture often is confusing and the initial radiologic and hematologic studies do not contribute much toward establishing the diagnosis. Read More

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http://dx.doi.org/10.31616/asj.2018.0220DOI Listing
April 2019
1 Read

Fine-needle cytology of intraglandular parotid lymph node: A useful procedure in the management of salivary gland nodules.

Diagn Cytopathol 2019 Apr 8. Epub 2019 Apr 8.

Dipartimento di Medicina e Chirurgia, Università di Salerno, Salerno, Italy.

Background: Enlarged intra-parotid lymph nodes (pLNs) may be misdiagnosed at ultrasound (US) being rare entities and because of their similarities to parotid nodules. Fine-needle cytology (FNC) is used in the preoperative diagnosis of parotid nodules, and may be used on pLNs to assess their nature and the underlying pathological processes.

Methods: Twenty consecutive pLNs underwent US-guided FNC and rapid on-site evaluation (ROSE). Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1002/dc.24177
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http://dx.doi.org/10.1002/dc.24177DOI Listing
April 2019
3 Reads

"Pop in a scope": attempt to decrease the rate of unnecessary nontherapeutic laparotomies in hemodynamically stable patients with thoracoabdominal penetrating injuries.

Surg Endosc 2019 Apr 8. Epub 2019 Apr 8.

Division of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas, University of Sao Paulo, São Paulo, Brazil.

Background: Management of patients with thoracoabdominal penetrating injuries is challenging. Thoracoabdominal penetrating trauma may harbor hollow viscus injuries in both thoracic and abdominal cavities and occult diaphragmatic lesions. While radiological tests show poor diagnostic performance in these situations, evaluation by laparoscopy is highly sensitive and specific. Read More

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http://dx.doi.org/10.1007/s00464-019-06761-7DOI Listing

Preoperative Pulmonary Evaluation.

Med Clin North Am 2019 May;103(3):585-599

Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 409, Houston, TX 77030, USA. Electronic address:

The preanesthesia evaluation is an opportunity to elucidate a patient's underlying medical disease, determine if the patient is optimized, treat modifiable conditions, screen for potentially unrecognized disorders, and present the clear picture of the patient's overall risk for perioperative complications. This article presents the preoperative assessment of pulmonary patients in 2 sections. First, the components of a thorough assessment of patients presenting for preanesthesia evaluation, which should occur for all patients, regardless of the presence of pulmonary pathology, are discussed. Read More

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http://dx.doi.org/10.1016/j.mcna.2018.12.016DOI Listing
May 2019
2 Reads

Preoperative risk evaluation for pancreatic fistula after pancreaticoduodenectomy.

J Surg Oncol 2019 Apr 5. Epub 2019 Apr 5.

Department of Surgery, Surgical Outcomes and Quality Improvement Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Background: Pancreatic fistula remains common, with limited ability to risk stratify patients preoperatively. The objective of this study was to identify risk factors for clinically-relevant postoperative pancreatic fistula (CR-POPF) that are routinely available in the preoperative setting.

Methods: Preoperatively available variables for all pancreaticoduodenectomies from 2014-2017 were examined using a national clinical registry. Read More

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http://dx.doi.org/10.1002/jso.25464DOI Listing
April 2019
1 Read

Uterine-preserving pelvic organ prolapse surgery using the UPHOLD LITE vaginal support system: The outcomes of 291 patients.

Medicine (Baltimore) 2019 Apr;98(14):e15086

Department of Obstetrics and Gynecology.

This article aims to evaluate the safety and outcome of women with pelvic organ prolapse (POP) treated by a minimally invasive bilateral sacrospinous hysteropexy (UPHOLD LITE Vaginal Support System, Boston Scientific) without concomittent anti-incontinence surgery.This retrospective study was conducted between 2014 and 2016. Evaluated items included surgical parameter and postoperative outcome. Read More

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http://dx.doi.org/10.1097/MD.0000000000015086DOI Listing
April 2019
1 Read

Evaluation of a Patient-Facing Digital Prototype for Perioperative Risk Assessment.

Stud Health Technol Inform 2019 ;258:201-205

Chair of Medical Informatics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany.

Preparations for anesthesiological management of patients build on preoperative patient self-reports concerning risk factors and comorbidities. In this setting, electronic documentation could facilitate innovative computerized functions, although patient-facing digital questionnaires require appropriate tools that patients can access effectively. To explore the feasibility of an electronic application for preoperative data acquisition directly from patients, a digital, tablet-based prototypical application has been developed within a user-centered design process in order to replace a previously used paper-based anamnesis sheet for perioperative risk evaluation. Read More

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January 2019

Decision-Making Factors for Ulnar Nerve Transposition in Cubital Tunnel Surgery.

J Wrist Surg 2019 Apr 2;8(2):168-174. Epub 2018 Jul 2.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

 We designed a survey to ascertain the current perspectives of hand surgeons on the evaluation and management of ulnar nerve instability at the elbow. The secondary aim was to assess the concordance of hand surgeons on definitions of the terms "subluxated" and "dislocated" for classification of ulnar nerve instability.  A questionnaire, including demographic practice variables, cubital tunnel practice patterns, preoperative imaging and electrodiagnostic evaluation, and a series of standardized intraoperative photographs of ulnar nerve instability at the elbow were developed and distributed to the current American Society for Surgery of the Hand (ASSH) membership. Read More

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http://dx.doi.org/10.1055/s-0038-1665548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443386PMC
April 2019
6 Reads

Feasibility of a Preoperative Anemia Protocol in a Large Integrated Health Care System.

Perm J 2019 ;23

Kaiser Permanente San Jose Medical Center, CA.

Background: Optimizing preoperative anemia is a required component of the Joint Commission Patient Blood Management Certification and an important component of Enhanced Recovery After Surgery.

Objective: To describe a preoperative anemia protocol developed and implemented at the Kaiser Permanente San Jose Medical Center in California to facilitate preoperative identification and treatment of anemia.

Methods: The protocol included all operations at risk of causing substantial blood loss. Read More

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http://dx.doi.org/10.7812/TPP/17-200DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380480PMC
January 2019
2 Reads

Anatomic Basis and Clinical Effect of Selective Dorsal Neurectomy for Patients with Lifelong Premature Ejaculation: A Randomized Controlled Trial.

J Sex Med 2019 Apr;16(4):522-530

Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address:

Introduction: Although guidelines from the American Urological Association and European Association of Urology do not consider surgical treatment for premature ejaculation (PE), the use of selective dorsal neurectomy (SDN) has increased for many years in Asian countries.

Aim: To evaluate anatomic basis and clinical effect of SDN in patients with PE in mainland China.

Methods: All of the patients included in the study had redundant foreskin, and they were assigned to 2 groups: group 1, composed of 46 patients with redundant foreskin, and group 2, composed of 96 patients with redundant foreskin and PE. Read More

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http://dx.doi.org/10.1016/j.jsxm.2019.01.319DOI Listing
April 2019
3 Reads

A meta-analysis exploring the role of PET and PET-CT in the management of potentially resectable colorectal cancer liver metastases.

Eur J Surg Oncol 2019 Mar 21. Epub 2019 Mar 21.

Department of Surgery, McMaster University, Hamilton, ON, Canada; Ontario Clinical Oncology Group, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. Electronic address:

Background: Positron emission tomography (PET), alone or combined with computed tomography (CT), potentially enhances detection of occult metastatic colorectal cancer.

Methods: We compared the impact of PET/PET-CT with conventional imaging, versus conventional imaging alone, in patients with potentially resectable colorectal cancer liver metastases. MEDLINE, EMBASE, and CENTRAL were searched for studies investigating PET/PET-CT to determine resectability. Read More

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http://dx.doi.org/10.1016/j.ejso.2019.03.025DOI Listing
March 2019
1 Read

Should Utilization of Lymphadenectomy Vary According to Morphologic Subtype of Intrahepatic Cholangiocarcinoma?

Ann Surg Oncol 2019 Mar 29. Epub 2019 Mar 29.

Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Objective: We sought to evaluate the utilization of lymphadenectomy (LND) and the incidence of lymph node metastasis (LNM) among different morphologic types of intrahepatic cholangiocarcinoma (ICC).

Methods: Clinical data of patients undergoing curative-intent resection for ICC between 1990 and 2017 were collected and analyzed. The preoperative nodal status was evaluated by imaging studies, and the morphologic and lymph node (LN) status was collected on final pathology report. Read More

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http://dx.doi.org/10.1245/s10434-019-07336-5DOI Listing
March 2019
1 Read

Dynamic Contrast-Enhanced Magnetic Resonance Imaging as a Diagnostic Tool in the Assessment of Tumour Angiogenesis in Urinary Bladder Cancer.

Can Assoc Radiol J 2019 Mar 25. Epub 2019 Mar 25.

Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Governorate, Egypt.

Purpose: The aim of study is to assess the role of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and correlation with tumour angiogenesis in evaluation of urinary bladder cancer.

Material And Methods: The study included 81 patients with recent presumed diagnosis of bladder tumour or who came for follow up after management of histopathologically proven bladder cancer. All had DCE-MRI with time-signal intensity curve. Read More

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http://dx.doi.org/10.1016/j.carj.2018.11.004DOI Listing
March 2019
2 Reads
0.584 Impact Factor

[Non-cardiac surgery in adults with congenital heart defects : Most important parameters in anesthesia management].

Anaesthesist 2019 Apr;68(4):245-258

Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, A1, 48149, Münster, Deutschland.

Background: Adults with congenital heart disease (CHD) represent an increasing proportion of patients undergoing non-cardiac surgery.

Objective: To identify the most important parameters for management of anesthesia.

Material And Methods: Evaluation and discussion of the current original research and guideline recommendations. Read More

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http://link.springer.com/10.1007/s00101-019-0575-1
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http://dx.doi.org/10.1007/s00101-019-0575-1DOI Listing
April 2019
4 Reads

Evaluation of an Intervention to Reduce Low-Value Preoperative Care for Patients Undergoing Cataract Surgery at a Safety-Net Health System.

JAMA Intern Med 2019 Mar 25. Epub 2019 Mar 25.

Division of Geriatrics, David Geffen School of Medicine at UCLA, Los Angeles.

Importance: Preoperative testing for cataract surgery epitomizes low-value care and still occurs frequently, even at one of the nation's largest safety-net health systems.

Objective: To evaluate a multipronged intervention to reduce low-value preoperative care for patients undergoing cataract surgery and analyze costs from various fiscal perspectives.

Design, Setting, And Participants: This study took place at 2 academic safety-net medical centers, Los Angeles County and University of Southern California (LAC-USC) (intervention, n = 469) and Harbor-UCLA (University of California, Los Angeles) (control, n = 585), from April 13, 2015, through April 12, 2016, with 12 additional months (April 13, 2016, through April 13, 2017) to assess sustainability (intervention, n = 1002; control, n = 511). Read More

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http://dx.doi.org/10.1001/jamainternmed.2018.8358DOI Listing
March 2019
1 Read

Rare paraneoplastic erythroderma associated with ectopic neuron-specific enolase deposition in basal cells.

Ann Transl Med 2019 Feb;7(3):51

Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China.

The cutaneous symptom of the paraneoplastic erythroderma can be the only symptom of a malignancy. Although many cases associated with malignancies have been reported, the pathogenesis of cancer related erythroderma is still unclear. Herein we presented a patient with large cell neuroendocrine carcinoma (LCNEC) of the lung and contemporary severe erythroderma. Read More

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http://dx.doi.org/10.21037/atm.2018.12.04DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389566PMC
February 2019
2 Reads

Prevalence of Neuropathic Pain Symptoms in Foot and Ankle Patients.

Foot Ankle Int 2019 Mar 22:1071100719838302. Epub 2019 Mar 22.

1 Rothman Orthopaedic Institute, Philadelphia, PA, USA.

Background:: The management of pain in patients with foot and ankle pathology can be challenging. Cumulative data suggest that, in addition to nociceptive mechanisms, other neuropathic mechanisms can contribute to pain in a subset of people with orthopedic conditions, and can be found in 10.5% to 53% of patients with chronic pain, depending on the location of the pathology. Read More

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http://dx.doi.org/10.1177/1071100719838302DOI Listing
March 2019
2 Reads

Evaluating the Effect of Intravenous Acetaminophen in Multimodal Analgesia After Total Hip Arthroplasty: A Randomized Controlled Trial.

J Arthroplasty 2019 Feb 25. Epub 2019 Feb 25.

Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.

Background: Postoperative pain is a significant concern of patients before surgery. Multimodal pain management is an effective method of pain control after major orthopedic surgery. Acetaminophen is the most commonly used analgesic for the management of pain. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403193018
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http://dx.doi.org/10.1016/j.arth.2019.02.033DOI Listing
February 2019
2 Reads

Robotic-Assisted Total Knee Arthroplasty in the Presence of Extra-Articular Deformity.

Surg Technol Int 2019 Mar 18;34. Epub 2019 Mar 18.

Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, New York.

Introduction: Tibial or femoral extra-articular deformities complicate the goal achieving optimal mechanical axis alignment for successful total knee arthroplasty (TKA) outcomes. In the presence of these extra-articular deformities, standard operative techniques and instruments may not be reliable. Robotic-arm assisted technology was developed to help achieve a well-aligned and balanced knee in a variety of clinical scenarios. Read More

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Endoscopic posterior cricoid reduction: A surgical method to improve posterior glottic diastasis.

Laryngoscope 2019 Apr;129(S2):S1-S9

Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Objectives/hypothesis: Describe the preoperative evaluation of patients with glottic diastasis who are candidates for endoscopic posterior cricoid reduction (EPCR) and their perioperative and postoperative surgical and voice outcomes, and validate the aerodynamic benefit of EPCR using computation fluid dynamics (CFD)-based modeling from computed tomography (CT) scans.

Study Design: Retrospective case series.

Methods: Thirteen patients who underwent EPCR were followed from 2013 to 2017. Read More

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http://dx.doi.org/10.1002/lary.27833DOI Listing

The Utility of Whole Body Imaging in the Evaluation of Solitary Brain Tumors.

World Neurosurg 2019 Mar 15. Epub 2019 Mar 15.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address:

Background: Solitary brain tumors can propose a diagnostic dilemma owing to the difficulty in differentiating between primary brain tumors and metastatic disease. The similar radiologic appearance on routine magnetic resonance imaging will necessitate the need for additional noninvasive testing. We sought to determine the clinical utility of preoperative whole body screening with computed tomography (CT) to detect metastatic disease in patients with solitary brain tumors. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.02.228DOI Listing
March 2019
4 Reads

Development of a multi-institutional registry for children with operative congenital lung malformations.

J Pediatr Surg 2019 Feb 28. Epub 2019 Feb 28.

Section of Pediatric Surgery, Department of Surgery, University of Michigan and Michigan Medicine, C.S. Mott Children's and Von Voigtlander Women's Hospital, Ann Arbor, MI, USA.

Introduction: The purpose of this study was to develop a multi-institutional registry to characterize the demographics, management, and outcomes of a contemporary cohort of children undergoing congenital lung malformation (CLM) resection.

Methods: After central reliance IRB approval, a web-based, secure database was created to capture retrospective cohort data on pathologically-confirmed CLMs performed between 2009 and 2015 within a multi-institutional research collaborative.

Results: Eleven children's hospitals contributed 506 patients. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2019.01.058DOI Listing
February 2019
2 Reads

Diagnosis and management of a remnant of the original fistula (ROOF) in males following surgery for anorectal malformations.

J Pediatr Surg 2019 Feb 28. Epub 2019 Feb 28.

Center for Colorectal and Pelvic Reconstruction-Nationwide Children's Hospital, Columbus, OH 43205, USA.

Purpose: A complication of the surgical management of anorectal malformations (ARMs) is a retained remnant of the original fistula (ROOF) formerly called a posterior urethral diverticulum (PUD). A ROOF may have multiple presentations or may be incidentally discovered during the work-up of ARM after previous surgery. We sought to define the entity and the surgical indications for excision of a ROOF when found. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00223468193011
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http://dx.doi.org/10.1016/j.jpedsurg.2019.02.006DOI Listing
February 2019
8 Reads
1.311 Impact Factor

Provider Access to Legacy Electronic Anesthesia Records Following Implementation of an Electronic Health Record System.

J Med Syst 2019 Mar 16;43(5):105. Epub 2019 Mar 16.

Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.

Many hospitals are in the process of replacing their legacy anesthesia information management system (AIMS) with an Electronic Health Record (EHR) system, within which the AIMS is integrated. Using the legacy AIMS security access log table, we studied the extent to which anesthesia providers were accessing historical anesthesia records (January 2006 - March 2017) following implementation of an EHR (April 2017). Statistical analysis was by segmented regression. Read More

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http://dx.doi.org/10.1007/s10916-019-1232-6DOI Listing

Real-time Ultrasound-Guided Lumbar Epidural with Transverse Interlaminar View: Evaluation of an In-Plane Technique.

Pain Med 2019 Mar 13. Epub 2019 Mar 13.

Department of Pain Management, Firelands Regional Medical Center, Sandusky, Ohio, USA.

Objective: The anatomical landmarks method is currently the most widely used technique for epidural needle insertion and is faced with multiple difficulties in certain patient populations. Real-time ultrasound guidance has been recently used to aid in epidural needle insertion, with promising results. Our aim was to test the feasibility, success rate, and satisfaction associated with a novel real-time ultrasound-guided lumbar epidural needle insertion in the transverse interlaminar view. Read More

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http://dx.doi.org/10.1093/pm/pnz026DOI Listing
March 2019
2 Reads

Patient Blood Management: Recommendations From the 2018 Frankfurt Consensus Conference.

JAMA 2019 Mar;321(10):983-997

German Red Cross Blood Transfusion Service and Goethe University Clinics, Frankfurt/Main, Germany.

Importance: Blood transfusion is one of the most frequently used therapies worldwide and is associated with benefits, risks, and costs.

Objective: To develop a set of evidence-based recommendations for patient blood management (PBM) and for research.

Evidence Review: The scientific committee developed 17 Population/Intervention/Comparison/Outcome (PICO) questions for red blood cell (RBC) transfusion in adult patients in 3 areas: preoperative anemia (3 questions), RBC transfusion thresholds (11 questions), and implementation of PBM programs (3 questions). Read More

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http://dx.doi.org/10.1001/jama.2019.0554DOI Listing
March 2019
6 Reads

Multimodal imaging in an idiopathic spontaneously absorbed cataractous lens: A rare case report.

Eur J Ophthalmol 2019 Mar 6:1120672119833558. Epub 2019 Mar 6.

Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, India.

Purpose:: To report an unusual and rare case of idiopathic spontaneous absorption of the cataractous lens and its multimodal imaging features.

Methods:: A 56-year-old female presented with a complaint of diminution of vision in both eyes (OU). Slit lamp examination of the right eye (OD) revealed Morgagnian cataract with a normal anterior segment. Read More

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http://dx.doi.org/10.1177/1120672119833558DOI Listing

An evaluation of arytenoid prolapse following laryngotracheal reconstruction.

Laryngoscope 2019 Mar 5. Epub 2019 Mar 5.

Department of Otolaryngology, Children's National Health System, Washington, DC, U.S.A.

Objectives/hypothesis: Laryngotracheal reconstruction (LTR) is a collection of procedures used to treat pediatric laryngotracheal stenosis. Arytenoid prolapse is a potential postoperative complication that may lead to upper airway obstruction. This study investigates the incidence, risk factors, and need for surgical intervention for post-LTR arytenoid prolapse. Read More

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http://dx.doi.org/10.1002/lary.27864DOI Listing
March 2019
5 Reads

Development of a preoperative computed tomography score for the management of advanced epithelial ovarian cancer.

Int J Gynecol Cancer 2019 Mar 21;29(3):599-604. Epub 2018 Dec 21.

Gynaecology and Obstetrics Academic Department, University of Turin, A.O. Ordine Mauriziano, Turin, Italy.

Objective: The main objective is to develop a model based on computed tomographic features to predict surgical outcome and establish cut-offs to rationalize clinical management in advanced epithelial ovarian carcinoma. The secondary purpose is to identify parameters that should be reported by radiologists to allow a correct pre-operative evaluation.

Methods: This study evaluated the association between 17 radiologic parameters and surgical outcome through the review of 61 computed tomographic scans. Read More

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https://ijgc.bmj.com/lookup/doi/10.1136/ijgc-2018-000054
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http://dx.doi.org/10.1136/ijgc-2018-000054DOI Listing
March 2019
7 Reads

Microsurgical vasectomy reversal: contemporary techniques, intraoperative decision making, and surgical training for the next generation.

Fertil Steril 2019 Mar;111(3):444-453

Center for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, New York. Electronic address:

Men seeking fertility after elective sterilization can be treated with a wide array of interventions. Reconstruction of the reproductive tract remains the gold standard and most cost-effective option for the appropriately selected candidate. In the following review, the treatment algorithm for men desiring vasectomy reversal is outlined. Read More

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http://dx.doi.org/10.1016/j.fertnstert.2019.01.004DOI Listing
March 2019
2 Reads

Clinical Outcomes and Costs Following Unplanned Excisions of Soft Tissue Sarcomas in the Elderly.

J Surg Res 2019 Feb 27;239:125-135. Epub 2019 Feb 27.

Division of Surgical Oncology, Department of Surgery, University of California (UC), Davis Medical Center, Sacramento, California. Electronic address:

Background: Surgical guidelines for soft tissue sarcoma (STS) emphasize pretreatment evaluation and reports of the perils of unplanned excision exist. Given the paucity of population-based data on this topic, our objective was to analyze clinical outcomes and costs of planned versus unplanned STS excisions in the Medicare population.

Methods: We analyzed 3913 surgical patients with STS ≥66 y old from 1992 to 2011 using the Surveillance, Epidemiology, and End Results-Medicare datafiles. Read More

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http://dx.doi.org/10.1016/j.jss.2019.01.055DOI Listing
February 2019
2 Reads

Preoperative MRI for the Multiligament Knee Injury: What the Surgeon Needs to Know.

Curr Probl Diagn Radiol 2019 Feb 10. Epub 2019 Feb 10.

University of Washington, Department of Orthopaedics & Sports Medicine, Seattle, WA 98195. Electronic address:

The multiligament knee injury is devastating and potentially limb threatening. Preoperative magnetic resonance imaging for the evaluation of the multiligament knee injury is an invaluable clinical tool, and when the radiologist is familiar with how certain injury patterns influence management, optimal outcomes can be achieved. We provide a detailed description of the relationship between salient imaging features of the multiligament knee injury, focusing on the preoperative magnetic resonance imaging, and their influence on clinical decision-making. Read More

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http://dx.doi.org/10.1067/j.cpradiol.2019.02.004DOI Listing
February 2019
2 Reads

Preoperative cardiopulmonary evaluation in specific neonatal surgery.

Semin Pediatr Surg 2019 Feb 18;28(1):3-10. Epub 2019 Jan 18.

Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, 1001 Decarie Blvd, Room B04.2318, Montreal, QC, Canada. Electronic address:

Preoperative assessment of surgical neonates often relates to issues of prematurity, low birth weight, or associated malformations. This review explores the preoperative cardiopulmonary evaluation in specific newborn surgical populations, the role of echocardiography in congenital diaphragmatic hernia perioperative management, the impact of bronchopulmonary dysplasia in the ex-preterm surgical neonate and a brief discussion on the risk of general anesthesia and specific anesthetic considerations for any surgical neonate. Newborns with congenital anomalies requiring early general surgical intervention should have an assessment for congenital heart disease. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10558586193000
Publisher Site
http://dx.doi.org/10.1053/j.sempedsurg.2019.01.002DOI Listing
February 2019
8 Reads

Readmissions following ambulatory pediatric endoscopic sinus surgery.

Laryngoscope 2019 Mar 1. Epub 2019 Mar 1.

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts.

Objectives/hypothesis: Endoscopic sinus surgery (ESS) is indicated in select pediatric patients with medically refractory sinus disease. Our objectives were to examine indications and rates of readmission following ambulatory pediatric ESS and identify specific subgroups that may benefit from inpatient admission.

Study Design: Retrospective database review. Read More

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http://dx.doi.org/10.1002/lary.27898DOI Listing
March 2019
1 Read

Black Diaphragm Intraocular Lens Implantation in Patients with Aniridia.

J Ophthalmic Vis Res 2019 Jan-Mar;14(1):27-31

Department of Ophthalmology, College of Medicine, Qassim University, Buraidah, Al-Qassim, Saudi Arabia.

Purpose: To review the management outcomes of black diaphragm intraocular (BDI) lens implantation in Arab patients with aniridia.

Methods: Patients with aniridia undergone BDI lens implantation at our institution between 2013 and 2014 were included. Uncorrected visual acuity (UCVA), manifest refraction, and best-corrected visual acuity (BCVA) were evaluated before and 6 months and yearly after BDI lens implant surgery until the last visit. Read More

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http://dx.doi.org/10.4103/jovr.jovr_244_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388531PMC

Operative Considerations for the General Surgeon in Patients with Chronic Liver Disease.

Am Surg 2019 Feb;85(2):234-244

Chronic liver disease remains a prevalent and challenging comorbidity in the American population at large. Scarring and fibrosis cause physical and physiological changes that may prove challenging in both medical and surgical management. However, because there has been relevant improvements in preoperative diagnostic, perioperative hepatologic, and intensive care management, as well as in surgical techniques, patients with cirrhosis can safely be operated on but patient selection remains vital. Read More

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February 2019
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Evaluation of preoperative risk factors and postoperative indicators for anastomotic leak of minimally invasive McKeown esophagectomy: a single-center retrospective analysis.

J Cardiothorac Surg 2019 Feb 28;14(1):46. Epub 2019 Feb 28.

Department of Thoracic Surgery, Jinling Hospital, No.34 Yanggongjing, Qinhuai District, Nanjing, 210002, China.

Background: Minimally invasive McKeown esophagectomy is an important surgical approach for esophageal cancer. Anastomotic leak is one of its common and serious complications. We assumed that the preoperative risk factors and postoperative indicators would predict or detect anastomotic leak. Read More

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http://dx.doi.org/10.1186/s13019-019-0864-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394086PMC
February 2019

Breast Reconstruction Following Breast Implant-Associated Anaplastic Large Cell Lymphoma.

Plast Reconstr Surg 2019 03;143(3S A Review of Breast Implant-Associated Anaplastic Large Cell Lymphoma):51S-58S

Houston, Texas; Perth, Western Australia; Toronto, Canada; and Sydney, New South Wales, Australia From the Departments of Plastic and Reconstructive Plastic Surgery, Hematology, and Breast Surgery, The University of Texas MD Anderson Cancer Center; Department of Surgery, University of Toronto; Department of Plastic and Reconstructive Plastic Surgery, Macquarie University; and private practice.

Background: Standard of care treatment of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) involves surgical resection with implant removal and complete capsulectomy. We report a case series of BIA-ALCL reconstruction with proposals for timing and technique selection.

Methods: We retrospectively reviewed and prospectively enrolled all BIA-ALCL patients at 2 tertiary care centers and 1 private plastic surgery practice from 1998 to 2017. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005569DOI Listing

Anesthetic Management in an Adult Patient With Costello Syndrome: A Case Report.

A A Pract 2019 Feb 21. Epub 2019 Feb 21.

From the Department of Anesthesiology, Shimane University Faculty of Medicine, Shimane, Japan.

Costello syndrome is a rare genetic disorder characterized by mental and growth retardation and distinctive coarse facies. A significant proportion of patients with Costello syndrome have hypertrophic cardiomyopathy, papillomata, and malignant tumors. General anesthesia practice, especially airway and cardiac management, in patients with Costello syndrome may be complicated by anatomical features and cardiac abnormalities. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000983DOI Listing
February 2019
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Preoperative Frailty Evaluation: A Promising Risk-stratification Tool in Older Adults Undergoing General Surgery.

Authors:
Fred C Ko

Clin Ther 2019 Mar 22;41(3):387-399. Epub 2019 Feb 22.

Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Geriatric Research Education and Clinical Center (GRECC), James J. Peters VA Medical Center, Bronx, NY, USA. Electronic address:

Purpose: General surgical procedures are among the most commonly performed operations in the United States. Despite advances in surgical and anesthetic techniques and perioperative care, complications after general surgery in older adults remain a significant cause of increased morbidity, mortality, and health care costs. Frailty, a geriatric syndrome characterized by multisystem physiologic decline and increased vulnerability to stressors and adverse clinical outcomes, has emerged as a plausible predictor of adverse outcomes after surgery in older patients. Read More

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http://dx.doi.org/10.1016/j.clinthera.2019.01.014DOI Listing
March 2019
1 Read

Cancellations of elective surgical procedures due to inadequate management of chronic medications.

J Clin Pharm Ther 2019 Feb 21. Epub 2019 Feb 21.

Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

What Is Known And Objectives: Inadequate management of chronic medication puts patients at risk and causes unnecessary suspension of surgical procedures. The objective of the study was to calculate the rate of cancellation of elective surgical procedures due to inadequate management of chronic medications and to analyse the underlying causes of cancellation.

Methods: We designed an analytic, observational, retrospective study of all elective surgical procedures performed from July to October 2017 in a tertiary hospital. Read More

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http://dx.doi.org/10.1111/jcpt.12816DOI Listing
February 2019
8 Reads

Is the Mallampati Score Useful for Emergency Department Airway Management or Procedural Sedation?

Ann Emerg Med 2019 Feb 16. Epub 2019 Feb 16.

Departments of Pediatrics and Emergency Medicine, University of Minnesota, Minneapolis, MN.

We review the literature in regard to the accuracy, reliability, and feasibility of the Mallampati score as might be pertinent and applicable to emergency department (ED) airway management and procedural sedation. This 4-level pictorial tool was devised to predict difficult preoperative laryngoscopy and intubation, but is now also widely recommended as a routine screening element before procedural sedation. The literature evidence demonstrates that the Mallampati score is inadequately sensitive for the identification of difficult laryngoscopy, difficult intubation, and difficult bag-valve-mask ventilation, with likelihood ratios indicating a small and clinically insignificant effect on outcome prediction. Read More

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http://dx.doi.org/10.1016/j.annemergmed.2018.12.021DOI Listing
February 2019
2 Reads

Preoperative difficult airway prediction using suprahyoid and infrahyoid ultrasonography derived measurements in anesthesiology.

Med Ultrason 2019 Feb;21(1):83-88

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Airway management is one of the most important skills in everyday practice of anesthesia. Improper airway management might contribute to significant morbidity and mortality. In some patients, clinical parameters do not anticipate all difficulties related to airway management. Read More

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http://dx.doi.org/10.11152/mu-1764DOI Listing
February 2019

Revised management of advanced primary colon cancer: Case series of 2 patients.

Int J Surg Case Rep 2019 10;55:233-238. Epub 2019 Feb 10.

Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA.

Background: The resection of a primary colon cancer has the opportunity to cure the patient of cancer by complete clearance and absolute containment of disease. Alternatively, if the cancer resection does not provide clearance and containment it will eventuate in local recurrence and peritoneal dissemination.

Methods: Culpability of recurrence of colorectal cancer is difficult to determine. Read More

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http://dx.doi.org/10.1016/j.ijscr.2019.01.046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378842PMC
February 2019

Role of preoperative investigations in elderly patients undergoing oncosurgical procedures - A retrospective review audit.

J Anaesthesiol Clin Pharmacol 2018 Oct-Dec;34(4):535-539

Department of Epidemiology and Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.

Background And Aims: The aim of the study was to evaluate the efficacy and usefulness of the current practice of various investigations and consultations being done during preanesthetic evaluation in patients undergoing oncosurgical procedures in our hospital. We also evaluated the delay caused due to these and its value in predicting postoperative complications.

Material And Methods: The preanesthetic charts of 300 elderly patients >65 years of age were reviewed, and the incidence of abnormal investigations and number of consultations advised were noted. Read More

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http://dx.doi.org/10.4103/joacp.JOACP_147_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360897PMC
February 2019

Incidence and malignancy rates of indeterminate pediatric thyroid nodules.

Cancer Cytopathol 2019 Apr 15;127(4):231-239. Epub 2019 Feb 15.

Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee.

Background: The American Thyroid Association guidelines task force currently recommends definitive thyroidectomy or lobectomy after an indeterminate thyroid biopsy in children. This recommendation is based on evidence of a greater incidence and a higher risk of malignancy compared with adults in earlier pediatric studies. Such management may lead to overtreatment and unnecessary surgery for many children in the United States. Read More

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http://dx.doi.org/10.1002/cncy.22104DOI Listing
April 2019
1 Read