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Improving outcomes of surgery in advanced infiltrative thymic tumours: the benefits of multidisciplinary approach.

Tumori 2021 Jun 22:3008916211023154. Epub 2021 Jun 22.

Department of Cardiac Surgery, Guy's Hospital London, London, UK.

Background: For stage III or IVa thymic tumours, a multimodality approach is recommended. The role of surgery is to achieve complete resection.

Aim: To present the outcomes of patients undergoing surgery for stage III or IVa thymoma. Read More

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Resident Involvement in Posterior Lumbar Interbody Fusion is Associated With Increased Readmissions and Operative Time, But No Increased Short-term Risks.

Clin Spine Surg 2021 Jul;34(6):E364-E369

Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH.

Study Design: A retrospective cohort study.

Objective: The aim was to compare rates of adverse events and additional posterior lumbar interbody fusion (PLIF) cases assisted by residents versus cases performed solely by an orthopedic attending.

Summary Of Background Data: PLIF is a widely accepted surgical technique for the management of a variety of spinal conditions requiring spinal stabilization and fusion. Read More

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Construction and Validation of a Nomogram for the Preoperative Prediction of Lymph Node Metastasis in Gastric Cancer.

Cancer Control 2021 Jan-Dec;28:10732748211027160

Department of General Surgery, 117865Tianjin Medical University General Hospital, Tianjin, China.

Background: Increasing evidence indicated that the tumor microenvironment (TME) plays a critical role in tumor progression. This study aimed to identify and evaluate mRNA signature involved in lymph node metastasis (LNM) in TME for gastric cancer (GC).

Methods: Gene expression and clinical data were downloaded from The Cancer Genome Atlas (TCGA). Read More

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Association between cerebral perfusion and paediatric postoperative cerebellar mutism syndrome after posterior fossa surgery-a systematic review.

Childs Nerv Syst 2021 Jun 21. Epub 2021 Jun 21.

Department of Pediatric Neurosurgery, Princess Maxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.

Background: Paediatric postoperative cerebellar mutism syndrome (ppCMS) is a common complication following the resection of a cerebellar tumour in children. It is hypothesized that loss of integrity of the cerebellar output tracts results in a cerebello-cerebral "diaschisis" and reduced function of supratentorial areas of the brain.

Methods: We performed a systematic review of the literature according to the PRISMA guidelines, in order to evaluate the evidence for hypoperfusion or hypofunction in the cerebral hemispheres in patients with ppCMS. Read More

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Diagnosis of postoperative recurrence of Crohn disease with MR-enterography: Value of diffusion-weighted imaging.

Diagn Interv Imaging 2021 Jun 18. Epub 2021 Jun 18.

Department of Radiology, Reims University Hospital and CRESTIC, URCA, 51092 Reims, France. Electronic address:

Purpose: To compare the diagnostic capabilities of MR enterography (MRE) using contrast-enhanced (CE) sequences with those of MRE using diffusion-weighted (DW) imaging for the diagnosis of postoperative recurrence at the neo-terminal ileum and/or anastomosis after ileocolonic resection in patients with Crohn disease (CD), and to clarify the role of additional DW imaging to CE-MRE in this context.

Material And Methods: Forty patients who underwent ileal resection for CD, and both endoscopy and MRE within the first year after surgery were included. There were 21 men and 19 women, with a mean age of 38 years±12 (SD) years (range: 18-67 years). Read More

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Acute complex instability of the elbow treated with internal joint stabilizer IJS-E System.

Rev Esp Cir Ortop Traumatol 2021 Jun 18. Epub 2021 Jun 18.

Unidad de Mano y Codo, Servicio Cirugía Ortopédica y Traumatología Hospital Universitario Doce de Octubre, Madrid, España; Universidad Complutense de Madrid (UCM), Madrid, España; Hospital La Milagrosa (Grupo Vithas), Madrid, España.

Introduction: Treatment of acute complex fracture-dislocation of the elbow has been associated with a high rate of complications. Internal Joint Stabilizer of the Elbow (IJSE) device appears as a valid option to optimize and improve our results.

Material And Methods: We present a retrospective case series of five patients treated at our institution with IJS-E System (Skeletal DynamicsR) from February 2019 to 2020. Read More

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The postoperative chest in lung cancer.

Clin Radiol 2021 Jun 18. Epub 2021 Jun 18.

Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Most of the complications following lung cancer surgery occur in the early postoperative period and can result in significant morbidity and mortality. Delayed complications can also occur. Diagnosing these complications can be challenging because clinical manifestations are non-specific. Read More

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Intraoperative gram staining of bile for the prevention of infectious complications in pancreaticoduodenectomy.

Cir Esp 2021 Jun 18. Epub 2021 Jun 18.

Servicio de Cirugía General y Digestiva, Hospital Virgen de la Victoria, Málaga, España.

Introduction: Infectious complications play a prominent role in pancreaticoduodenectomy. Their incidence increases in cases with preoperative biliary drainage (PBD), due to the higher risk of bacterobilia. The aim of this study is to evaluate an antibiotherapy protocol based on intraoperative gram staining of bile and its impact on postoperative infectious complications. Read More

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Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre, open-label, randomised, phase 3 trial.

Authors:

Lancet Respir Med 2021 Jun 18. Epub 2021 Jun 18.

Background: Respiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.

Methods: PRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Read More

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The role of Hashimoto thyroiditis in predicting radioiodine ablation efficacy and prognosis of low to intermediate risk differentiated thyroid cancer.

Ann Nucl Med 2021 Jun 21. Epub 2021 Jun 21.

Department of Molecular and Translation Medicine, Surgical Clinic, University of Brescia, Brescia, Italy.

Objective: The baseline treatment of differentiated thyroid cancer (DTC) consists of thyroidectomy followed by postoperative risk-adapted radioiodine therapy (RAIT) when indicated. The choice of most appropriate RAI activities to administer with the aim to reach an efficient remnant ablation and reduce the risk of recurrence is yet an open issue and the detection of basal factors that may predict treatment response seems fundamental. The aim of this study was to investigate the potential role of Hashimoto thyroiditis (HT) in predicting 1-year and 5-year treatment response after RAIT and prognosis. Read More

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Lymph node dissection in thymic carcinomas and neuroendocrine carcinomas.

Interact Cardiovasc Thorac Surg 2021 Jun 21. Epub 2021 Jun 21.

Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan.

Objectives: Although lymph node (LN) metastases are not uncommon in thymic carcinomas, preoperative LN evaluation, intraoperative lymph node dissection (LND) and postoperative outcomes remain unknown. The aim of this study was to elucidate the characteristics of and outcomes in patients with thymic carcinomas and thymic neuroendocrine carcinomas undergoing LND.

Methods: A retrospective chart review was performed using our multi-institutional database to identify patients who underwent resection and LND for thymic carcinoma or thymic neuroendocrine carcinoma between 1991 and 2018. Read More

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Progression-Free Survival, Prognostic Factors, and Surgical Outcome of Spheno-Orbital Meningiomas.

Front Oncol 2021 4;11:672228. Epub 2021 Jun 4.

Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.

Objective: Spheno-orbital meningiomas (SOM) are rare intracranial tumors that arise at the sphenoid wing. These tumors can invade important neurovascular structures making radical resection difficult, while residual tumors often lead to recurrence. The purpose of this study was to evaluate prognostic factors influencing the recurrence and progression-free survival (PFS) rates of spheno-orbital meningiomas, with a particular focus on the role of surgery and postoperative radiotherapy. Read More

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Postoperative Pain Management: Role of Dexmedetomidine as an Adjuvant.

Anesth Pain Med 2020 Dec 2;10(6):e112176. Epub 2021 Jan 2.

Pain Medicine HUB, Department of Anesthesiology and Intensive Care, "San Giuliano" Hospital, ASL Napoli2 Nord, Giugliano, Italy.

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December 2020

The effect of continuing care on postoperative life quality and long-term functional recovery in elderly patients with hip fracture.

Am J Transl Res 2021 15;13(5):5512-5518. Epub 2021 May 15.

The First Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an, Shaanxi Province, China.

Objective: To apply continuing care to elderly patients with hip fracture undergoing surgery, and to explore its impact on life quality and long-term functional recovery.

Methods: This prospective study was performed in 136 elderly hip fracture patients, who were admitted to the department of orthopedics of our hospital for surgical treatment. According to the random number table, these patients were assigned to the control group and the experimental group (68 patients in each group). Read More

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Role of network cloud platform-based and progressive health education in postoperative rehabilitation of patients with tibial fracture.

Am J Transl Res 2021 15;13(5):4819-4824. Epub 2021 May 15.

Department of Enrollment and Internship Employment, Shijiazhuang Medical College Shijiazhuang 050500, China.

Objective: To explore the short-term and long-term effect of rehabilitation in patients with tibial fracture based on network cloud platform and progressive health education.

Methods: A total of 100 patients with tibial fracture treated in our hospital from December 2018 to February 2020 were selected as the research subjects. According to their admission order, they were divided into a control group (n=50) and experimental group (n=50). Read More

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The Role of Regional Anesthesia During the SARS-CoV2 Pandemic: Appraisal of Clinical, Pharmacological and Organizational Aspects.

Front Pharmacol 2021 4;12:574091. Epub 2021 Jun 4.

Department of Anesthesia, Critical Care and Pain Medicine, Niguarda Ca' Granda Hospital, Milan, Italy.

The severe acute respiratory syndrome coronavirus SARS-CoV2 is spreading over millions of people worldwide, leading to thousands of deaths, even among the healthcare providers. Italy has registered the deaths of 337 physicians and more than 200 nurses as of March 14, 2021. Anesthesiologists are at higher risk as they are the care providers in both ICU and operating rooms. Read More

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Cervical laminoplasty with unilateral C4-5 foraminotomy: Technical note and case series.

Neurocirugia (Astur : Engl Ed) 2021 Jun 17. Epub 2021 Jun 17.

Departamento de Neurocirugía, FLENI, Buenos Aires, Argentina.

Objective: The open-door laminoplasty technique is widely used in the treatment of multilevel cervical myelopathy. Despite the satisfactory functional and radiological results of this technique, postoperative C5 palsy is still a severe and disabling complication with a variable incidence in the literature. The objective of this article is to describe and demonstrate the surgical technique step by step with the addition of unilateral C4-5 foraminotomy and to evaluate the results obtained to date, with special emphasis on C5 palsy. Read More

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Potential optimization of focused ultrasound capsulotomy for obsessive compulsive disorder.

Brain 2021 Jun 18. Epub 2021 Jun 18.

Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada.

Obsessive-compulsive disorder is a debilitating and often refractory psychiatric disorder. Magnetic resonance-guided focused ultrasound is a novel, minimally invasive neuromodulatory technique that has shown promise in treating this condition. We investigated the relationship between lesion location and long-term outcome in obsessive-compulsive disorder patients treated with focused ultrasound to discern the optimal lesion location and elucidate the efficacious network underlying symptom alleviation. Read More

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Open Treatment of Osteochondral Lesions of the Talus With Bone Grafting and Particulated Juvenile Cartilage Allografting.

Foot Ankle Spec 2021 Jun 18:19386400211009732. Epub 2021 Jun 18.

Department of Orthopaedic Surgery, Medical College of Wisconsin, Wauwatosa, Wisconsin.

Background: Large cystic osteochondral lesions of the talus (OLT) are challenging pathological conditions to treat, but particulated juvenile cartilage allografts (PJCAs) supplemented with bone grafts are a promising therapeutic option. The purpose of this project was to further elucidate the role of PJCA with concomitant bone autografts for treating large cystic OLTs with extensive subchondral bone involvement (greater than 150 mm in area and/or deeper than 5 mm).

Methods: We identified 6 patients with a mean OLT area of 307. Read More

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New Insights Into the Role of Autophagy in Liver Surgery in the Setting of Metabolic Syndrome and Related Diseases.

Front Cell Dev Biol 2021 1;9:670273. Epub 2021 Jun 1.

Hospital Regional de Alta Especialidad de Ciudad Victoria "Bicentenario 2010", Ciudad Victoria, Mexico.

Visceral obesity is an important component of metabolic syndrome, a cluster of diseases that also includes diabetes and insulin resistance. A combination of these metabolic disorders damages liver function, which manifests as non-alcoholic fatty liver disease (NAFLD). NAFLD is a common cause of abnormal liver function, and numerous studies have established the enormously deleterious role of hepatic steatosis in ischemia-reperfusion (I/R) injury that inevitably occurs in both liver resection and transplantation. Read More

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The role of ultrasound guided serratus plane block on chronic neuropathic pain after breast surgery in cancer patient.

Rev Esp Anestesiol Reanim (Engl Ed) 2021 Jun 14. Epub 2021 Jun 14.

Departamento de Anestesiología y Cuidados Intensivos, Instituto Portugués de Oncología de Porto, Porto, Portugal.

Background: Breast cancer is the most commonly occurring cancer among women. Among its treatment sequelae is chronic neuropathic pain after breast surgery (CNPBS). Pain management is difficult and classicaly consists in a pharmacological approach, however recent studies have advocated the use of locoregional techniques as adjuvants. Read More

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Role of soluble receptor for advanced glycation end products in postoperative fibrotic lung injury.

Ann Thorac Surg 2021 Jun 14. Epub 2021 Jun 14.

Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Background: In lung cancer patients with interstitial lung disease, postoperative acute exacerbation can be fatal. However, the predictive biomarkers for postoperative exacerbation of interstitial lung disease have not been fully elucidated. The soluble receptor for advanced glycation end products is a lung-derived anti-inflammatory protein, which can prevent acute lung injury. Read More

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Paracetamol, NSAIDs, and glucocorticoids for postoperative pain: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis.

Acta Anaesthesiol Scand 2021 Jun 17. Epub 2021 Jun 17.

Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Zealand Region of Denmark, Køge, Denmark.

Background: Multimodal analgesia is the leading principle for managing postoperative pain. Recent guidelines recommend combinations of paracetamol and an NSAID for most surgeries. Glucocorticoids have been used for decades due to their potent anti-inflammatory and antipyretic properties. Read More

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Case Report: Optimizing Pre- and Intraoperative Planning With Hyperaccuracy Three-Dimensional Virtual Models for a Challenging Case of Robotic Partial Nephrectomy for Two Complex Renal Masses in a Horseshoe Kidney.

Front Surg 2021 31;8:665328. Epub 2021 May 31.

Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.

To report a case of robot-assisted partial nephrectomy (RAPN) for two highly complex renal tumors in a patient with a Horseshoe kidney (HSK), focusing on the utility of hyperaccuracy three-dimensional (HA3D) virtual models for accurate preoperative and intraoperative planning of the procedure. A 74-year-old Caucasian male patient was referred to our Unit for incidental detection of two complex renal masses in the left portion of a HSK. The 50 × 55 mm, larger, predominantly exophytic renal mass was located at the middle-lower pole of the left-sided kidney (PADUA score 9). Read More

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Imaging after laparoscopic sleeve gastrectomy - literature review with practical recommendations.

Pol J Radiol 2021 31;86:e325-e334. Epub 2021 May 31.

1st Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.

In the XXI century obesity has become one of the most demanding epidemiological threats worldwide. At the same time, bariatric surgery has established itself as an effective treatment for morbidly obese patients, with laparoscopic sleeve gastrectomy (LSG) emerging as the most popular bariatric procedure. This paper reviews the role of imaging studies of patients after LSG. Read More

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The association between preoperative modified frailty index and postoperative complications in Chinese elderly patients with hip fractures.

BMC Geriatr 2021 Jun 16;21(1):370. Epub 2021 Jun 16.

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.

Objectives: To investigate the role of a preoperative modified frailty index (mFI) based on data from medical records in predicting postoperative complications among older Chinese patients with hip fractures.

Methods: This retrospective cohort study included consecutive older patients with hip fracture admitted to the Department of Orthopaedics, West China Hospital, Sichuan University, from December 2010 to June 2017 who underwent surgical repair. We selected 33 variables, including characteristics of hip fracture, to construct a mFI. Read More

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Neurofilament light: a narrative review on biomarker utility.

Fac Rev 2021 7;10:46. Epub 2021 May 7.

Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.

Neurofilament light (NfL) is a scaffolding protein that is located primarily within myelinated axons and that provides increased conduction speed and structural support. In recent years, NfL has been used as a disease biomarker on the basis of the observation that axonal injury results in elevated levels of NfL in cerebrospinal fluid or blood. This review focuses on how cerebrospinal fluid and plasma NfL have been studied in various disorders such as Alzheimer's disease (AD) and multiple sclerosis (MS) in relation to neuroinflammation and cognitive dysfunction. Read More

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The Current Role of Platelet Function Testing in Clinical Practice.

Semin Thromb Hemost 2021 Jun 15. Epub 2021 Jun 15.

Lismore Cancer and Haematology Unit, Lismore Base Hospital, Lismore, New South Wales, Australia.

Platelet dysfunction, whether hereditary or acquired, may increase an individual's risk of spontaneous, posttraumatic, or postoperative bleeding. Conversely, increased platelet reactivity on antiplatelet agents following vascular (in particular, coronary vascular) intervention may increase the risk of thrombosis and adverse vascular events. The aim of platelet function testing is to identify and characterize platelet dysfunction in these settings to inform bleeding/ thrombosis risk and guide perioperative prophylactic management strategies. Read More

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Proximal femoral derotation osteotomy in children with CP : long term outcome and the role of age at time of surgery.

Acta Orthop Belg 2021 Mar;87(1):167-173

The femoral derotation osteotomy (FDO) is seen as the golden standard treatment in children with cerebral palsy and internal rotated gait. This study provides quantitative evidence in support of the beneficial effect of FDO after long term follow up. Retrospective clinical and kinematic evaluation of 31 CP patients (55 operated limbs) pre-, 1 and 3 years postoperatively after proximal FDO was conducted for a minimal follow-up of 3 years. Read More

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Should be a locally advanced colon cancer still considered a contraindication to laparoscopic resection?

Surg Endosc 2021 Jun 15. Epub 2021 Jun 15.

Department of Surgical Sciences, University of Torino, Corso A. M. Dogliotti, 14, 10126, Turin, Italy.

Background: The role of elective laparoscopic resection (LR) for the treatment of locally advanced colon cancer (LACC) is unclear. Most studies have retrospectively investigated the outcomes of LR for pT4 cancers, while clinical T4 (cT4) cancers are excluded in the large randomized controlled trials comparing LR and open resection (OR). The aim of this study was to investigate the outcomes in patients undergoing elective LR for LACC. Read More

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