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Head and Neck Surgery During COVID-19 Pandemic: Experience from a Tertiary Care in India.

Indian J Surg Oncol 2021 Sep 12:1-11. Epub 2021 Sep 12.

Department of Otorhinolaryngology and,Head and Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi, India.

Head and neck pathologies requiring surgical intervention are considered a high-risk subsite in the context of COVID-19 pandemic by virtue of its close proximity to the mucosa of the upper aerodigestive tract. Retrospective review of all head and neck surgical procedures is undertaken during the pandemic from 23rd April 2020 to 30th September 2020. One hundred procedures were performed on 98 patients. Read More

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September 2021

A Rare Case of Xanthogranulomatous Pyelonephritis with Spontaneous Renocolic Fistula and IVC Thrombosis.

Case Rep Nephrol 2021 7;2021:3604017. Epub 2021 Sep 7.

Department of Surgery, Tor Vergata University of Rome, Rome, Italy.

Xanthogranulomatous pyelonephritis (XGPN) is a rare disorder affecting the kidney which can fistulise to the colon in exceptional cases. We herein report a case of XGPN with renocolic fistula and large vessel thrombosis presenting with sepsis and pulmonary embolism. Preoperative diagnosis and strategic planning resulted in successful management. Read More

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September 2021

Multidisciplinary management of temporomandibular joint ankylosis in an adult: journey from arthroplasty to oral rehabilitation.

BMJ Case Rep 2021 Sep 16;14(9). Epub 2021 Sep 16.

Oral & Maxillofacial Surgery, Aesthetica, Kolkatta, India.

Ankylosis of the temporomandibular joint is a debilitating condition resulting in progressive trismus and facial disfigurement. Common trigger factors include paediatric mandibular trauma, middle ear infection or traumatic childbirth. Although diminishing in incidence among urban population, it is still prevalent in the underprivileged world. Read More

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September 2021

[Study on heme oxygenase-1 and HAP model for the diagnosis of chronic hepatitis B-related liver fibrosis].

Zhonghua Gan Zang Bing Za Zhi 2021 Aug;29(8):743-747

Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang 050051, China.

To determine the diagnostic value of plasma heme oxygenase 1 (HO-1) in the occurrence, development, and pathological stages of chronic hepatitis B-related liver fibrosis. 211 outpatients and inpatients with chronic hepatitis B (CHB) and 57 healthy controls who visited the Third Hospital of Hebei Medical University were selected. Simultaneously, clinical data, peripheral blood routine and serum biochemical test results of the research subjects were collected. Read More

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Successful staged management of a spontaneous iliac vein rupture associated with May-Thurner syndrome: a case report.

Eur Heart J Case Rep 2021 Aug 4;5(8):ytab316. Epub 2021 Aug 4.

Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan.

Background: Spontaneous iliac vein ruptures have only been reported in approximately 50 cases. An accurate preoperative diagnosis is difficult even with contrast-enhanced computed tomography (CT), and the operative mortality and morbidity rates are quite high. The cause of spontaneous iliac vein ruptures and their optimal diagnosis and management remain unclear. Read More

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The Role of 3D Tractography in Skull Base Surgery: Technological Advances, Feasibility, and Early Clinical Assessment with Anterior Skull Base Meningiomas.

J Neurol Surg B Skull Base 2021 Oct 14;82(5):576-592. Epub 2020 Aug 14.

Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, United States.

 The aim of this study is to determine feasibility of incorporating three-dimensional (3D) tractography into routine skull base surgery planning and analyze our early clinical experience in a subset of anterior cranial base meningiomas (ACM).  Ninety-nine skull base endonasal and transcranial procedures were planned in 94 patients and retrospectively reviewed with a further analysis of the ACM subset.  (1) Automated generation of 3D tractography; (2) co-registration 3D tractography with computed tomography (CT), CT angiography (CTA), and magnetic resonance imaging (MRI); and (3) demonstration of real-time manipulation of 3D tractography intraoperatively. Read More

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October 2021

Volume-Staged Radiosurgery for Large Arteriovenous Malformation: Retrospective Analysis of 19 Cases.

Cureus 2021 Aug 5;13(8):e16901. Epub 2021 Aug 5.

Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, JPN.

Introduction The effectiveness of Gamma Knife surgery (GKS) for small arteriovenous malformations (AVMs) is well known. However, for large AVMs, the prescribed dose should be decreased to reduce the risk of radiation damage, but it leads to a decrease in nidus obliteration rates. Therefore, it is very difficult to achieve complete obliteration of large AVMs in a single treatment, and methods using multiple irradiation such as volume-staged stereotactic radiosurgery (VS-SRS) have been suggested. Read More

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Modeling and staged assessments of the controllability of spread for repeated outbreaks of COVID-19.

Nonlinear Dyn 2021 Sep 6:1-14. Epub 2021 Sep 6.

School of Mechanical Engineering, Tiangong University, Tianjin, 300387 China.

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has been causing an outbreak of a new type of pneumonia globally, and repeated outbreaks have already appeared. Among the studies on the spread of the COVID-19, few studies have investigated the repeated outbreaks in stages, and the quantitative condition of a controllable spread has not been revealed. In this paper, a brief compartmental model is developed. Read More

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September 2021

European Association of Urology Guidelines on Non-muscle-invasive Bladder Cancer (Ta, T1, and Carcinoma in Situ).

Eur Urol 2021 Sep 9. Epub 2021 Sep 9.

European Association of Urology, Arnhem, The Netherlands.

Context: The European Association of Urology (EAU) has released an updated version of the guidelines on non-muscle-invasive bladder cancer (NMIBC).

Objective: To present the 2021 EAU guidelines on NMIBC.

Evidence Acquisition: A broad and comprehensive scoping exercise covering all areas of the NMIBC guidelines since the 2020 version was performed. Read More

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September 2021

Minimal Uterine Serous Carcinoma and Endometrial Polyp: A Close Clinicopathological Relationship.

Hum Pathol 2021 Sep 8. Epub 2021 Sep 8.

Department of Pathology, Yale University School of Medicine, New Haven, CT 06520.

Frequently involving an endometrial polyp, minimal uterine serous carcinoma (MUSC) represents the earliest recognizable forms of endometrial serous carcinoma. The aim of this study was to provide a comprehensive morphological and clinical outcome assessment of MUSC involving endometrial polyp. 77 fully staged MUSCs involving endometrial polyp were identified including 53 MUSCs confined to polyp and 24 non-polyp confined tumors. Read More

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September 2021

The First Successful Endovascular Management of Posterior Fossa Arteriovenous Malformations in Nepal: Case Series.

JNMA J Nepal Med Assoc 2020 Dec 31;58(232):1089-1092. Epub 2020 Dec 31.

Department of Anaesthesiology, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal.

Posterior fossa arteriovenous malformations represent 7-15% of all intracranial AVMs. They carry a higher risk of rupture than supratentorial AVMs and are associated with considerable rates of morbidity and mortality. Available treatment options include conservative management, microsurgical resection, radiosurgery, endovascular embolization, or combinations of these modalities. Read More

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December 2020

Staged treatment for substantial bilateral calcium carbonate nephrolithiasis in vegan patient.

Urol Case Rep 2021 Nov 1;39:101831. Epub 2021 Sep 1.

N.E.O. Urology Associates, Boardman OH, 7430 Southern Blvd, Boardman, OH, 44512, USA.

Calcium carbonate (CaCO3), or calcite, stones average 0.15% of annual nephrolithiasis cases. The authors report a 53 year old female, following a 15 year vegan diet, presenting with left flank pain and later found to have bilateral extensive staghorn renal calculi requiring multiple procedures over the course of months. Read More

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November 2021

ALPPS Procedure. The New Frontier in Advanced Liver Surgery. Single Centre Experience and Literature Review.

Chirurgia (Bucur) 2021 Aug;116(4):409-423

Presentation of the first experience of a liver surgery center in applying an innovative procedure - ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) for massive liver tumors. This medod has been performed in the surgery clinic 2 since 2018 in patients with massive primary or metastatic liver tumors, whose future residual liver volume is considered too small to perform curative liver resection safely. Until recently, these conditions assigned large tumors occupying more than 75-90% of the liver to the group of unresectable tumors. Read More

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Irinel Popescu

Chirurgia (Bucur) 2021 Aug;116(4):385-386

Liver surgery continues to evolve, as knowledge of liver anatomy and physiology deepens, new technologies are introduced, and the experience of surgical teams increases. Internationally, liver surgery is part of a very well-defined subspecialty today, namely "hepato-biliary-pancreatic surgery". The United States has a two-year post-residency training system (Fellowship). Read More

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Sequential minimally invasive treatment of concomitant abdominal aortic aneurysm and colorectal cancer: a single-center experience.

Ann Vasc Surg 2021 Sep 4. Epub 2021 Sep 4.

Department of Public Health, Minimally Invasive General and Oncological Surgery Unit, University of Naples Federico II, Naples, Italy. Electronic address:

Background: The surgical management of concomitant occurrence of abdominal aortic aneurysm (AAA) and colorectal cancer (CCR) is still controversial. Conversely, benefits from a minimally invasive approach are well known concerning the treatment of both AAA and CCR. The aim of this study is to assess safety and feasibility of a sequential two-staged minimally invasive during the same recovery by EVAR technique and laparoscopic colorectal resection. Read More

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September 2021

Need to restage Korean melanoma patients following publication of the 8th edition of the American Joint Committee on Cancer staging manual.

Indian J Dermatol Venereol Leprol 2021 Aug 1:1-5. Epub 2021 Aug 1.

Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.

Background: The tumor, nodes and metastasis (TNM) classification and stage grouping have been updated in the 8th edition of the American Joint Committee on Cancer (AJCC) melanoma staging manual. However, restaging all the previous cases are not recommended.

Aims: The aims of the study were to investigate the necessity of restaging Korean melanoma patients staged by the previous edition of the AJCC manual. Read More

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Staged surgical management of sinus tarsi syndrome: our experience of 273 cases.

Ann Palliat Med 2021 Aug;10(8):8909-8918

Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Background: The sinus tarsi syndrome (STS) is a common foot and ankle disease with controversial pathogenesis and treatment procedures. This long-term study aimed to analyze the effect of a staged surgical strategy for STS.

Methods: Clinical data were retrospectively analyzed in 273 STS patients [129 men and 144 women; mean age: 36 years (10-60 years)] treated between 2006 and 2016. Read More

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Single-stage versus staged interposition urethroplasty for glandular hypospadias with severe penile curvature: 15-year experience.

World J Urol 2021 Sep 5. Epub 2021 Sep 5.

Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, People's Republic of China.

Purpose: Our study examined the benefit of an alternative interposition urethroplasty (IU) procedure for glandular hypospadias (GH) with severe penile curvature (SPC). The technique involved transecting and reconstructing the urethra to preserve the distal glandular and coronal urethra and correct the curvature. We compared procedural characteristics, outcomes, and surgical complications for the single-stage and staged IU techniques. Read More

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September 2021

Temporal and Spatial Characteristics of Cataract Surgery Rates in China.

Risk Manag Healthc Policy 2021 25;14:3551-3561. Epub 2021 Aug 25.

Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China.

Objective: The aim of the current study was to explore the spatial and temporal distribution characteristics of registered cases of cataract surgery in China from 2013 to 2017.

Methods: A database for spatial analysis of cataract surgery in China in 2013-2017 was established using ArcGIS10.0 software as a platform for data management and presentation. Read More

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National Cancer Information System Within the Framework of Health Insurance in Colombia: A Real-World Data Approach to Evaluate Access to Cancer Care.

JCO Glob Oncol 2021 Aug;7:1329-1340

Division of Medical Oncology at University of Miami Sylvester Comprehensive Cancer Center, Miami, FL.

Purpose: The National Cancer Information System (NCIS) has been operating since 2014, including information reported by health care insurers and providers on people with cancer diagnosed and treated within the Colombian health system. Its main purpose is to identify barriers to an effective access to cancer diagnosis and treatment across the country. We aimed to describe the methodology, scope and results in terms of access to health services with real-world data provided by the NCIS. Read More

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The use of free myocutaneous flap and implant reinsertion for staged cranial reconstruction in patients with titanium mesh exposure and large skull defects with soft tissue infection after cranioplasty: Report of 19 cases.

Microsurgery 2021 Sep 2. Epub 2021 Sep 2.

Department of Plastic and Reconstructive Surgery, First Medical Center of PLA General Hospital, Beijing, China.

Background: Management of cranial defects following failed cranioplasty due to titanium mesh exposure and infection is challenging. The purpose of this report is to describe a modified technique using a free myocutaneous flap transfer for primary soft tissue reconstruction, and titanium mesh reinsertion for cranioplasty revision.

Methods: Nineteen patients with titanium mesh exposure and infection following cranioplasty were treated from January 2012 to January 2019. Read More

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September 2021

A Biologic Surgical Implant in Complex Abdominal Wall Repair: 3-Year Follow-Up Results of a Multicentric Prospective Study.

Med Devices (Auckl) 2021 25;14:257-264. Epub 2021 Aug 25.

Department of Abdominal Wall Surgery, University Hospital (C/O Instituto Clinica Chirugica II), Rome, Italy.

Purpose: Despite the advancements in the reinforcement and closure techniques available, complex abdominal wall reconstruction (CAWR) remains a challenging surgical undertaking with considerable risk of postoperative complications. Biological meshes were developed that may help to complement standard closure techniques and offer an alternative to synthetic meshes, which carry significant risks with their use in complex cases.

Patients And Methods: A total of 114 patients underwent surgical treatment for CAWR with a Permacol™ (a biologic surgical implant). Read More

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Prognostic significance of viable tumor size measurement in hepatocellular carcinomas after preoperative locoregional treatment.

J Pathol Transl Med 2021 Sep 2. Epub 2021 Sep 2.

Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Background: Preoperative locoregional treatment (LRT) for hepatocellular carcinoma (HCC) often induces intratumoral necrosis without affecting the overall tumor size, and residual viable tumor size (VTS) on imaging is an important clinical parameter for assessing post-treatment response. However, for surgical specimens, it is unclear whether the VTS would be more relevant to prognosis compared to total tumor size (TTS).

Materials And Methods: A total of 142 surgically resected solitary HCC cases were retrospectively reviewed. Read More

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September 2021

Efficacy of Two-Stage Surgery for Spinal Cord Ependymomas.

Asian Spine J 2021 Sep 1. Epub 2021 Sep 1.

Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan.

Study Design: Retrospective cohort study.

Purpose: This study aimed to elucidate cases for which staged surgeries are effective by a retrospective review of previous operative cases of spinal ependymomas.

Overview Of Literature: Patients with spinal ependymomas are expected to have a good prognosis following total resection. Read More

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September 2021

Internal Staging Discordance in National Cancer Databases for Non-Small-Cell Lung Cancer.

Ann Thorac Surg 2021 Aug 27. Epub 2021 Aug 27.

Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Background: The Surveillance, Epidemiology and End Results (SEER) and the National Cancer Database (NCDB) are databases for cancer analysis which may be subject to error in data reporting. We examined rates and impact of discordant data for non-small cell lung cancer.

Methods: NCDB and SEER were queried for non-small cell lung cancer pathologic Tumor, Node, Metastasis data (NCDB) or "derived" data (SEER). Read More

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A Multimodal Interdisciplinary QI Intervention Is Associated with Reduction in After Hours Inpatient Endoscopy Cases.

Tech Innov Gastrointest Endosc 2021 14;23(3):226-233. Epub 2021 May 14.

Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA.

Background And Aims: Increasing demand for inpatient endoscopic services results in performing more non-emergent endoscopic cases after-hours, which poses risks to patient safety and negatively impacts patient and provider satisfaction. This study sought to quantify the existing state using quality improvement (QI) methodology, design targeted interventions, and determine their effectiveness.

Methods: We conducted an existing state evaluation through a process map, time-series study, and caseload analysis from 7/2017-12/2018. Read More

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Management of intravascular thrombus in cases of bilateral Wilms tumor or horseshoe kidney.

J Pediatr Surg 2021 Aug 5. Epub 2021 Aug 5.

Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 133, Memphis, TN 38105, United States; Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN 38105, United States. Electronic address:

Purpose: To describe the oncologic and surgical management of bilateral Wilms tumor or Wilms tumor arising in a horseshoe kidney with intravenous tumor thrombus to help pediatric surgeons negotiate this rare and difficult anatomic circumstance.

Methods: A single-institution, retrospective medical record review identified 4 cases of bilateral WT and one case of WT arising in a horseshoe kidney with intravenous tumor thrombus between 2009 and 2021. The presentation, imaging, chemotherapy regimen, intraoperative approach, and surgical and oncologic outcomes were reviewed for each of these patients. Read More

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Staged reflexive artificial intelligence driven testing algorithms for early diagnosis of pituitary disorders.

Clin Biochem 2021 Aug 23. Epub 2021 Aug 23.

Division of Endocrinology, Dalhousie University, Halifax, NS Canada. Electronic address:

Background: Sellar masses (SM) frequently present with insidious hormonal dysfunction. We previously showed that, by utilizing a combined reflex/reflecting approach involving a laboratory clinician (LC) on common endocrine test results requested by non-specialists, and subsequently adding further warranted tests, previously undiagnosed pituitary disorders can be identified. However, manually employing these strategies by an LC is not feasible for wider screening of pituitary disorders. Read More

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HER-2 positivity is a high risk of recurrence of stage I gastric cancer.

Korean J Intern Med 2021 Aug 26. Epub 2021 Aug 26.

Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.

Background/aims: The treatment of gastric cancer remains unsatisfactory. We aimed to investigate the prognostic value of immunohistochemical staining in gastric cancer.

Methods: We analyzed 505 (279 early staged, 226 advanced-staged) gastric cancer tissues from patients who underwent radical gastric resection between January 2014 and December 2016. Read More

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