570,855 results match your criteria surgical management

ROTEM Testing for Direct Oral Anticoagulants.

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

Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.

Direct oral anticoagulants (DOACs) are increasingly used worldwide for the prevention of stroke in patients with atrial fibrillation and to prevent or treat venous thromboembolism. In situations such as serious bleeding, the need for urgent surgery/intervention or the management of a thromboembolic event, the laboratory measurement of DOACs levels or anticoagulant activity may be required. Rotational thromboelastometry (ROTEM) is a viscoelastic hemostatic assay (VHA) which has been used in emergencies (trauma and obstetrics), and surgical procedures (cardiac surgery and liver transplants), but experience with this assay in DOACs-treated patients is still limited. Read More

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Abdominal Wall Thickness Predicts Surgical Site Infection in Emergency Colon Operations.

J Surg Res 2021 Jun 12;267:37-47. Epub 2021 Jun 12.

Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address:

Background: Body mass index (BMI) does not reliably predict Surgical site infections (SSI). We hypothesize that abdominal wall thickness (AWT) would serve as a better predictor of SSI for patients undergoing emergency colon operations.

Methods: We retrospectively evaluated our Emergency Surgery Database (2007-2018). Read More

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The usefulness of ultrasound before induction of labor.

Am J Obstet Gynecol MFM 2021 Jun 12:100423. Epub 2021 Jun 12.

Obstetric Unit, Department of Medical and Surgical Sciences, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy.

The indications for induction of labor have been consistently on the rise. These indications are mainly medical (maternal or fetal), social or indications that are related to convenience or maternal preferences. With the increase in prevalence of these indications, the incidence rates of induction of labor are expected to continue to rise. Read More

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Coronavirus Disease-2019 (COVID-19) and Pituitary Apoplexy: A Single-Center Case Series and Review of the Literature.

World Neurosurg 2021 Jun 12. Epub 2021 Jun 12.

Departments of Neurosurgery(,) University of Mississippi Medical Center, Jackson, MS, United States.

Background: Pituitary apoplexy (PA) is a rare but life-threatening condition characterized by pituitary infarction and hemorrhage, most often in the setting of a preexisting adenoma. The risk factors and mechanisms associated with PA are poorly understood. Although neurovascular manifestations of coronavirus disease-19 (COVID-19) infection have been documented, its association with PA is to be determined. Read More

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Healthcare professional's choice for surgical management of stress urinary incontinence in a U.K. tertiary hospital.

Eur J Obstet Gynecol Reprod Biol 2021 May 24;263:7-14. Epub 2021 May 24.

Department of Urogynaecology, King's College Hospital, London, UK.

Objective: In July 2018, NHS England, introduced a pause on vaginal mesh, including the mid-urethral sling (MUS) for treatment of stress urinary incontinence (SUI). NICE guidelines recommend MUS as one of the surgical options for SUI. The aim of our study was to investigate healthcare professionals choices for surgical treatment of SUI, if conservative measures failed. Read More

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Treatment of open tibia fractures in Sub-Saharan African countries : a systematic review.

Acta Orthop Belg 2021 Mar;87(1):85-92

Open tibia fracture (OTF) treatment is well documented in developed countries. Yet, this fracture pattern remains challenging because it is associated with an increased risk of infection and delayed union, particularly in case of Gustilo III B and C open fractures. Since access to healthcare is limited in Sub- Saharan African countries, this paper explores the results of OTF management in this setting. Read More

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Differential diagnosis of acute traumatic hip pain in the elderly.

Acta Orthop Belg 2021 Mar;87(1):1-7

Elderly patients who present with an inability to weight bear following a fall, with normal radiographs, should be appropriately investigated to rule out an occult hip fracture (OHF). We aim to identify both the range and incidence of the differential diagnosis of acute traumatic hip pain in a large series of patients investigated for OHF. A retrospective analysis of consecutive patients investigated for an OHF with magnetic resonance imaging (MRI) was performed. Read More

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Critical care and ventilatory management of deceased organ donors impacts lung use and recipient graft survival.

Am J Transplant 2021 Jun 15. Epub 2021 Jun 15.

Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, Portland, OR, USA.

Current risk-adjusted models for donor lung use and lung graft survival do not include donor critical care data. We sought to identify modifiable donor physiologic and mechanical ventilation parameters that predict donor lung use and lung graft survival. This is a prospective observational study of donors after brain death (DBDs) managed by 19 organ procurement organizations from 2016 to 2019. Read More

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Transoral Gunshot Injury Resulting in Mechanical Block to Cervical Rotation: A Case Report.

JBJS Case Connect 2021 Jun 15;11(2). Epub 2021 Jun 15.

Cardiff and Vale Orthopaedic Center, University Hospital Llandough, Penarth, United Kingdom.

Case: We report a case of self-inflicted transoral gunshot injury in a 24-year-old man resulting in mechanical block to cervical rotation. Anterior surgical removal of the pellet was successful with the patient experiencing no early or long-term functional deficits.

Conclusion: Given the rarity of a cervical spine injury from gunshot wound without long-term complications, this unique case supports the role of early operative management in such injuries. Read More

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Morbidity and Mortality Trends of Pancreatitis: An Observational Study.

Surg Infect (Larchmt) 2021 Jun 15. Epub 2021 Jun 15.

Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota, USA.

Pancreatitis accounts for more than $2.5 billion of healthcare costs and remains the most common gastrointestinal (GI) admission. Few contemporary studies have assessed temporal trends of incidence, complications, management, and outcomes for acute pancreatitis in hospitalized patients at the national level. Read More

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The Use of Aerosolized Medications in Adult Intensive Care Unit Patients: A Prospective, Multicenter, Observational, Cohort Study.

J Aerosol Med Pulm Drug Deliv 2021 Jun 14. Epub 2021 Jun 14.

Department of Respiratory and Critical Care Medicine, West China Medical Center, Sichuan University, Chengdu, China.

Only limited data are available on the real-life clinical utilization of aerosolized medications in intensive care unit (ICU) patients. Exploring the utilization of aerosolized medications in the ICU may contribute to develop appropriate education and improve the quality of aerosol therapy. A 2-week, prospective, multicenter, observational, cohort study was conducted to record how the aerosolized medications were utilized in the Chinese ICUs, including indications, medications used in solo or combination, dosage, and side-effects in adult patients. Read More

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Nickel Hypersensitivity to Atrial Septal Occluders: Smoke Without Fire?

Clin Rev Allergy Immunol 2021 Jun 15. Epub 2021 Jun 15.

First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece.

Nickel is one of the most common contact allergens worldwide; it is used as the main component of the devices used for atrial septal defects (ASDs) and patent foramen ovale (PFO) closure. Developing nickel hypersensitivity after PFO/ASD occlusion is significantly rarer described in medical literature than typical nickel contact sensitization. The exact pathophysiological mechanism of this "device syndrome" remains unknown, and many question the real incidence or even the existence of this clinical entity. Read More

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Diaphragmatic herniation after esophagogastric surgery: systematic review and meta-analysis.

Langenbecks Arch Surg 2021 Jun 15. Epub 2021 Jun 15.

Division of General Surgery, Department of Biomedical Science for Health, Istituto Clinico Sant'Ambrogio, University of Milan, Via Luigi Giuseppe Faravelli, 16, 20149, Milan, Italy.

Introduction: The anatomy of the esophageal hiatus is altered during esophagogastric surgery with an increased risk of postoperative hiatus hernia (HH). The purpose of this article was to examine the current evidence on the surgical management and outcomes associated with HH after esophagogastric surgery for cancer.

Materials And Methods: Systematic review and meta-analysis. Read More

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Combined surgical and endovascular treatment for spinal arteriovenous fistula associated with Parkes Weber syndrome.

Childs Nerv Syst 2021 Jun 15. Epub 2021 Jun 15.

Department of Neurosurgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, NO.639 Shanghai Zhizaoju Road, Huangpu District, Shanghai, China.

Background: Parkes Weber syndrome (PWS) is a rare and congenital vascular malformation manifesting as hemihypertrophy of the extremities, cutaneous hemangiomas, varicose veins, and arteriovenous fistula of the affected limbs. The incidence rate of spinal arteriovenous fistula (AVF) associated with PWS is extremely rare.

Case Presentation: We reported a case of an adolescent girl with PWS who presented with a rupture spinal perimedullary AVF at the level of T12-L1. Read More

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Management of traumatic posterior fossa epidural hematomas in pediatrics: our experience and review of the literature.

Childs Nerv Syst 2021 Jun 15. Epub 2021 Jun 15.

Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.

Background And Aims: Conservative management of posterior fossa epidural hematoma in the pediatric age group has been increasingly considered in the last decade with good clinical outcomes and comparable results to surgical intervention in carefully selected patients. The purpose of this study is to evaluate the outcome of observation in the management of pediatric patients with posterior fossa epidural hematoma (PFEDH) in our tertiary hospital and present a literature review on PFEDH pediatric patients.

Methods: We conducted a retrospective observational study at King Abdullah University Hospital (KAUH), a tertiary hospital in North Jordan. Read More

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[Imaging in breast cancer follow-up: preliminary investigation on clinical practice adherence to the guidelines.]

Recenti Prog Med 2021 Jun;112(6):465-469

UO Medicina Nucleare, Dipartimento Interdisciplinare di Medicina, Università di Bari "Aldo Moro", Bari.

Purpose: The aim of this study was to assess compliance with guidelines recommendations in the follow-up of patients with breast cancer. In this setting of patients we analyzed the appropriateness of the imaging exams recommended by different specialists in the management of follow-up.

Materials And Methods: From January 2019 to December 2019 we analyzed the clinical data and the results of the imaging exams of 146 asymptomatic patients followed for follow-up in different regional radiotherapy centers. Read More

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The process of EUSOMA certification improves the quality of breast cancer care: the experience of an Italian EUSOMA certificated Breast Unit (BU) according to the results of a cross-sectional study.

Recenti Prog Med 2021 Jun;112(6):458-464

Unit of Medical Oncology, Brest Unit located at the Mater Salutis Hospital in Legnago, Italy.

Introduction: The adherence to recognized guidelines and the constant monitoring of performance throughout quality indicators (QIs) are strategic tools to improve the quality of care. The study is aimed to assess the effect of the EUSOMA (European Society of Breast Cancer Specialists) certification process on the quality of breast cancer care of an EUSOMA certified Breast Unit (BU) of Northern Italy.

Materials And Methods: Seventeen mandatory and recommended EUSOMA QIs, based on 594, were analysed for the years 2015-2018. Read More

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Survey of provider perceptions of enhanced recovery after surgery and perioperative surgical home protocols at a tertiary care hospital.

Medicine (Baltimore) 2021 Jun;100(24):e26079

Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Abstract: Enhanced recovery after surgery (ERAS) and perioperative surgical home (PSH) initiatives are widely utilized to improve quality of patient care. Despite their established benefits, implementation still has significant barriers. We developed a survey for perioperative clinicians to gather information on perception and knowledge of ERAS/PSH programs to guide future expansion of these programs at our institution. Read More

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The Genitourinary Pathology Society Update on Classification of Variant Histologies, T1 Substaging, Molecular Taxonomy, and Immunotherapy and PD-L1 Testing Implications of Urothelial Cancers.

Adv Anat Pathol 2021 Jul;28(4):196-208

Department of Pathology, West German Cancer Center/University Hospital Essen, University of Duisburg-Essen, Duisburg.

The Genitourinary Pathology Society (GUPS) undertook a critical review of the recent advances in bladder cancer focusing on important topics of high interest for the practicing surgical pathologist and urologist. This review represents the second of 2 manuscripts ensuing from this effort. Herein, we address the effective reporting of bladder cancer, focusing particularly on newly published data since the last 2016 World Health Organization (WHO) classification. Read More

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The Impact of Surgical Posterior Nasal Nerve Cryoablation on Symptoms and Disease-Specific Quality of Life in Patients With Chronic Rhinitis.

Ear Nose Throat J 2021 Jun 15:1455613211018576. Epub 2021 Jun 15.

UC Davis Health, Department of Otolaryngology-Head and Neck Surgery, Sacramento, CA, USA.

Objective: Preliminary data have demonstrated long-term efficacy of posterior nasal nerve (PNN) cryoablation in reducing rhinitis symptoms for patients with allergic rhinitis (AR) and nonallergic rhinitis (NAR). We sought to evaluate the impact of procedural cryoablation of the PNN on quality of life (QOL) in patients with AR and NAR.

Methods: Adult patients undergoing PNN cryoablation for AR or NAR after appropriate medical therapy were included for analysis. Read More

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Updates on Excisional Procedures for Lymphedema.

Adv Wound Care (New Rochelle) 2021 Jun 15. Epub 2021 Jun 15.

University of Washington Department of Surgery, 312784, Division of Plastic Surgery, Seattle, Washington, United States;

Significance: Excisional procedures for lymphedema have been used for over a century, and many surgeons have abandoned the old techniques as improvements in non-surgical management and microsurgery have limited their clinical utility. Nonetheless, excisional procedures remain relevant as an important tool in the comprehensive surgical management of lymphedema. Recent Advances: Modifications to the Charles procedure and other direct excisional procedures have improved the complication profile and patient outcomes. Read More

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Report of two cases of endobronchial tumour mass resection in children.

Can J Anaesth 2021 Jun 14. Epub 2021 Jun 14.

Department of Pediatric Anesthesia, Montreal Children's Hospital, 1001 Blvd Decarie, Montreal, QC, H4A 3J1, Canada.

Purpose: Anesthesia for endotracheal tumour mass resection in pediatric patients is a rare, complex, and high-risk procedure. The purpose of this case report is to emphasize the importance of multidisciplinary team collaboration and close communication during the perioperative management of shared airway surgery.

Clinical Features: A six-year-old boy with no previous history of comorbidity and a 13-yr-old boy with a six-month history of upper respiratory tract infection, refractory asthma, chronic wheeze, and exercise-related dyspnea presented for acute endobronchial tumour mass resection. Read More

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A simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission.

NPJ Digit Med 2021 Jun 14;4(1):98. Epub 2021 Jun 14.

Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA.

The interest in applying machine learning in healthcare has grown rapidly in recent years. Most predictive algorithms requiring pathway implementations are evaluated using metrics focused on predictive performance, such as the c statistic. However, these metrics are of limited clinical value, for two reasons: (1) they do not account for the algorithm's role within a provider workflow; and (2) they do not quantify the algorithm's value in terms of patient outcomes and cost savings. Read More

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Expert Consensus Statement on the Perioperative Management of Adult Patients Undergoing Head and Neck Surgery and Free Tissue Reconstruction From the Society for Head and Neck Anesthesia.

Anesth Analg 2021 Jul;133(1):274-283

Departments of General Anesthesiology and Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.

The perioperative care of adult patients undergoing free tissue transfer during head and neck surgical (microvascular) reconstruction is inconsistent across practitioners and institutions. The executive board of the Society for Head and Neck Anesthesia (SHANA) nominated specialized anesthesiologists and head and neck surgeons to an expert group, to develop expert consensus statements. The group conducted an extensive review of the literature to identify evidence and gaps and to prioritize quality improvement opportunities. Read More

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Qualities of Effective Vital Anaesthesia Simulation Training Facilitators Delivering Simulation-Based Education in Resource-Limited Settings.

Anesth Analg 2021 Jul;133(1):215-225

Department of Anesthesia, Pain Management, and Perioperative Medicine.

Background: Lack of access to safe and affordable anesthesia and surgical care is a major contributor to avoidable death and disability across the globe. Effective education initiatives are a viable mechanism to address critical skill and process gaps in perioperative teams. Vital Anaesthesia Simulation Training (VAST) aims to overcome barriers limiting widespread application of simulation-based education (SBE) in resource-limited environments, providing immersive, low-cost, multidisciplinary SBE and simulation facilitator training. Read More

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Clinical practice guideline for transcatheter versus surgical valve replacement in patients with severe aortic stenosis in Latin America.

Heart 2021 Jun 14. Epub 2021 Jun 14.

Internal Medicine, Hospital Alemán, Buenos Aires, Argentina.

In elderly (75 years or older) patients living in Latin America with severe symptomatic aortic stenosis candidates for transfemoral approach, the panel suggests the use of transcatheter aortic valve implant (TAVI) over surgical aortic valve replacement (SAVR). This is a conditional recommendation, based on moderate certainty in the evidence (⨁⨁⨁Ο).This recommendation does not apply to patients in which there is a standard of care, like TAVI for patients at very high risk for cardiac surgery or inoperable patients, or SAVR for non-elderly patients (eg, under 65 years old) at low risk for cardiac surgery. Read More

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Radiation Therapy in Non-Small-Cell Lung Cancer.

Cold Spring Harb Perspect Med 2021 Jun 14. Epub 2021 Jun 14.

Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas, USA.

The management of non-small-cell lung cancer (NSCLC) varies according to stage. Surgical resection is reserved for operable patients with early-stage NSCLC, while high-dose target radiation-stereotactic body radiation therapy (SBRT)-is reserved for patients whose comorbidities prohibit them from a major surgical procedure. The treatment of locally advanced NSCLC (LA-NSCLC) is stratified according to resectability. Read More

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Accuracy of Frozen Section Analysis of Urethral and Ureteral Margins During Radical Cystectomy for Bladder Cancer: A Systematic Review and Diagnostic Meta-Analysis.

Eur Urol Focus 2021 Jun 11. Epub 2021 Jun 11.

Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Context: The question of the ability of frozen section analysis (FSA) to accurately detect malignant pathology intraoperatively has been discussed for many decades.

Objective: We aimed to conduct a systematic review and meta-analysis assessing the diagnostic estimates of FSA of the urethral and ureteral margins in patients treated with radical cystectomy (RC) for bladder cancer (BCa).

Evidence Acquisition: The MEDLINE and EMBASE databases were searched in February 2021 for studies analyzing the association between FSA and the final urethral and ureteral margin status in patients treated with RC for BCa. Read More

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Special Issue - "Frontiers of Simulation and Experimentation for Personalised Cardiovascular Management and Treatment".

Med Eng Phys 2021 Jun 6. Epub 2021 Jun 6.

Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College Sciences London, UK. Electronic address:

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CT as a first-line modality in elderly patients with stable blunt chest trauma.

Chin J Traumatol 2021 Apr 1. Epub 2021 Apr 1.

Department of Surgery A, Emek Medical Center, Afula, 18101, Israel; Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, 31096, Israel.

Purpose: Blunt thoracic injuries are common among elderly patients and may be a common cause of morbidity and death from blunt trauma injuries. We aimed to examine the impact of chest CT on the diagnosis and change of management plan in elderly patients with stable blunt chest trauma. We hypothesized that chest CT may play an important role in providing optimal management to this subgroup of trauma patients. Read More

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