Database : MEDLINE
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[PMID]: 29524712
[Au] Autor:Miao X; He D; Wu T; Cheng X
[Ad] Address:Department of Orthopaedic Surgery, The Affiliated Second Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China.
[Ti] Title:Percutaneous endoscopic spine minimal invasive technique for the decompression therapy of thoracic myelopathy caused by ossification of the ligamentum flavum.
[So] Source:World Neurosurg;, 2018 Mar 07.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Percutaneous endoscopic technique via interlaminar approach is one of the prevalent minimal invasive procedures in the treatment of lumbar disc herniation even lumbar spinal stenosis. The aim of this report is to perform complete decompressions for the cases with thoracic ossification of the ligamentum flavum using percutaneous endoscopic technique. CASE DESCRIPTION: We experienced surgical decompressions of two patients with thoracic myelopathy caused by OLF using percutaneous endoscopic surgery via interlaminar approach. After surgery, the patients complained the preoperative neurological symptoms were improved significantly. Postoperative thoracic computed tomography showed the ossification of ligaments was removed completely. CONCLUSION: We have applied the percutaneous endoscopic technique for the treatment of thoracic OLF. It performed direct decompression of the ossified ligaments with minimizing trauma and instability which could be used as a alternative choice. However, the fused types would be performed prudently due to the operational difficulties.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 160390 MEDLINE  
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[PMID]: 29524617
[Au] Autor:McCambridge AJ; Napolitano A; Mansfield AS; Fennell DA; Sekido Y; Nowak AK; Reungwetwattana T; Mao W; Pass HI; Carbone M; Yang H; Peikert T
[Ad] Address:Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
[Ti] Title:State of the Art: Advances in Malignant Pleural Mesothelioma in 2017.
[So] Source:J Thorac Oncol;, 2018 Mar 07.
[Is] ISSN:1556-1380
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Malignant pleural mesothelioma (MPM) is an uncommon, almost universally fatal, asbestos-induced malignancy. New and effective strategies for diagnosis, prognostication and treatment are urgently needed. Herein we review the advances in MPM achieved in 2017. While recent epidemiological data demonstrated that the incidence of MPM-related death continued to increase in United States between 2009 and 2015, new insight into the molecular pathogenesis and the immunological tumor microenvironment of MPM, for example, regarding the role of BRCA1 associated protein 1 (BAP1) and the expression programmed death receptor ligand 1 (PD-L1), are highlighting new potential therapeutic strategies. Furthermore, there continues to be an ever-expanding number of clinical studies investigating systemic therapies for MPM. These trials are primarily focused on immunotherapy using immune checkpoint inhibitors alone or in combination with other immuno- andnon-immuno therapies. In addition, other promising targeted therapies including ADI-PEG20 focusing on argininosuccinate synthase 1 deficient tumors and Tazemetostat, an EZH2 inhibitor of BAP1 deficient tumors are currently being explored.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  3 / 160390 MEDLINE  
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[PMID]: 29524603
[Au] Autor:Shieh HF; Smithers CJ; Hamilton TE; Zurakowski D; Visner GA; Manfredi MA; Jennings RW; Baird CW
[Ad] Address:Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115.
[Ti] Title:Descending Aortopexy and Posterior Tracheopexy for Severe Tracheomalacia and Left Mainstem Bronchomalacia.
[So] Source:Semin Thorac Cardiovasc Surg;, 2018 Mar 07.
[Is] ISSN:1532-9488
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Posterior descending aortopexy can relieve posterior intrusion of the left mainstem bronchus that may limit the effectiveness of posterior tracheobronchopexy. We review outcomes of patients undergoing both descending aortopexy and posterior tracheopexy for severe tracheobronchomalacia with posterior intrusion and left mainstem compression to determine if there were resolution of clinical symptoms and bronchoscopic evidence of improvement in airway collapse. METHODS: All patients who underwent both descending aortopexy and posterior tracheopexy from October 2012 to October 2016 were retrospectively reviewed. Clinical symptoms, tracheomalacia scores based on standardized dynamic airway evaluation by anatomical region, and persistent airway intrusion requiring reoperation were collected. Data were analyzed by Wald and Wilcoxon signed-ranks tests. RESULTS: 32 patients underwent descending aortopexy and posterior tracheopexy at median age 18 months (IQR 6-40 months). Median follow up was 3 months (IQR 1-7 months). There were statistically significant improvements in clinical symptoms postoperatively, including cough, noisy breathing, prolonged and recurrent respiratory infections, ventilator dependence, blue spells, and brief resolved unexplained events (BRUEs) (all P<.001), as well as exercise intolerance (P=.033), transient respiratory distress requiring positive pressure (P=.003), and oxygen dependence (P=.007). Total tracheomalacia scores improved significantly (P<.001), with significant segmental improvements in the middle (P=.003) and lower (P<.001) trachea, and right (P=.011) and left (P<.001) mainstem bronchi. 2 patients (6%) had persistent airway intrusion requiring reoperation with anterior aortopexy and/or tracheopexy. CONCLUSIONS: Descending aortopexy and posterior tracheopexy are effective in treating severe tracheobronchomalacia and left mainstem intrusion with significant improvements in clinical symptoms and degree of airway collapse on bronchoscopy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  4 / 160390 MEDLINE  
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[PMID]: 29524602
[Au] Autor:Solomon Z; Breton C; Rowin EJ; Maron BJ; Maron MS; Chen FY; Rastegar H
[Ad] Address:Hypertrophic Cardiomyopathy Institute, Division of Cardiac Surgery.
[Ti] Title:Surgical Approaches to Hypertrophic Obstructive Cardiomyopathy.
[So] Source:Semin Thorac Cardiovasc Surg;, 2018 Mar 07.
[Is] ISSN:1532-9488
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Left ventricular outflow tract obstruction secondary to hypertrophic obstructive cardiomyopathy remains a challenging entity facing clinicians. Despite the success of invasive therapies, some clinicians remain hesitant due to early results with unacceptable morbidity and mortality rates. However, current literature strongly suggests improved short and long-term outcomes with extended septal myectomy and alcohol septal ablation compared to patients not undergoing such interventions. This review evaluates hypertrophic obstructive cardiomyopathy treatment with a focus on short and long-term outcomes, perioperative complications, and major tenets of surgical intervention. The data reveals mortality rates approaching zero, and peri-operative complications occur infrequently. Alcohol septal ablation and extended septal myectomy both consistently decrease left ventricular outlet tract pressure gradients and result in improved functional capacity with lower NYHA class, and should be recommended as treatment for patients with symptoms refractory to standard medical treatment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  5 / 160390 MEDLINE  
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[PMID]: 29524601
[Au] Autor:Steliga MA
[Ad] Address:Associate Professor of Surgery, Thoracic Surgery, Winthrop P. Rockefeller Cancer Institute, University of Arkansas.
[Ti] Title:Smoking Cessation in Clinical Practice: How to Get Patients to Stop.
[So] Source:Semin Thorac Cardiovasc Surg;, 2018 Mar 07.
[Is] ISSN:1532-9488
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  6 / 160390 MEDLINE  
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[PMID]: 29524462
[Au] Autor:Tigkiropoulos K; Sigala F; Tsilimigras DI; Moris D; Filis K; Melas N; Karamanos D; Kontogiannis C; Lazaridis I; Saratzis N
[Ad] Address:1(st) Department of Surgery, Aristotle University Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
[Ti] Title:Endovascular Repair of Blunt Thoracic Aortic Trauma: Is Post-Implant Hypertension an Incidental Finding?
[So] Source:Ann Vasc Surg;, 2018 Mar 07.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Blunt thoracic aortic injury (BTAI) is the second most common cause of death in trauma patients. Nowadays, thoracic endovascular aortic repair (TEVAR) has become the treatment of choice due to lower rates of mortality, paraplegia and stroke. However, concerns have been raised whether graft implantation is related to the development of hypertension in the postoperative period. OBJECTIVES: To report short- and long-term outcomes of patients undergoing TEVAR for BTAIs at a tertiary hospital as well as investigate post-implant hypertension. MATERIALS & METHODS: Between January 2005 and January 2016, 23 patients with blunt thoracic aortic trauma underwent TEVAR. Median age was 44 years (range 18-73). Among them, 14 (60.9%) patients were diagnosed with aortic rupture, while 9 (39.1%) with pseudoaneurysm. Α single thoracic stent graft was deployed in 21 patients and the rest 2 patients received two stent grafts. RESULTS: Complete exclusion of the injury was feasible in all subjects (100% primary success). The left subclavian artery (SCA) was intentionally covered in 6 patients (26%). Intraoperative complications included one nonfatal stroke managed conservatively and one external iliac artery rupture, treated with iliofemoral bypass. One patient (4.3%) died on the first postoperative day in the intensive care unit (ICU) due to hemorrhagic shock. The overall 30-day mortality and morbidity were 4.3% and 8.7%, respectively. New-onset post-implantation arterial hypertension was observed in 8 (34.8%) previously non-hypertensive patients. Younger age (p=0.027) and SCA coverage (p=0.01) were identified as potential risk factors for the development of post-implant hypertension, whereas the presence of concomitant injuries (p=0.3) and intraoperative complications (p=0.1) were not. Following a median follow-up of 100 months (range, 18-120), six of them still remain on antihypertensive therapy, whereas the other 2 did not require permanent treatment. CONCLUSIONS: TEVAR is a safe approach in the treatment of BTAI associated with low short- and long-term morbidity and mortality rates. Lower age and SCA coverage may contribute to the development of post-implant hypertension. Further larger cohort studies are warranted in order to elucidate the underlying mechanisms of post-implant hypertension.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  7 / 160390 MEDLINE  
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[PMID]: 29524461
[Au] Autor:Srinivasa RN; Chick JFB; Gemmete JJ; Hage AN; Srinivasa RN
[Ad] Address:Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health Systems, 1500 East Medical Center Drivem Ann Arbor, MI 48109.
[Ti] Title:Endolymphatic Interventions for the Treatment of Chylothorax and Chylous Ascites in Neonates: Technical and Clinical Success and Complications.
[So] Source:Ann Vasc Surg;, 2018 Mar 07.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: To report the technical and clinical success of performing minimally invasive endolymphatic embolization in neonates presenting with a chylothorax or chylous ascites. MATERIALS AND METHODS: 3 neonates, 2 males and 1 female, with a mean age of 28 days (range: 19-39 days) presented with a chylothorax (2) or chylous ascites (1) which was refractory to conservative management. All 3 patients (1 previously reported) underwent intranodal lymphangiography followed by thoracic duct embolization with 1 patient undergoing additional sclerosis of the retroperitoneal abdominal lymphatics. RESULTS: Lymphangiography, thoracic duct embolization, and sclerosis of the retroperitoneal abdominal lymphatics was technically successful. The chylothorax resolved in both patients. Persistent chylous ascites was noted after treatment that resolved after surgical placement of a vicryl mesh and fibrin sealant. 1 major complication occurred with non-target embolization of glue into the lungs requiring embolectomy. CONCLUSION: Thoracic duct and retroperitoneal abdominal lymphatic embolization can be performed in neonates. Resolution of chylothorax was seen in two patients (one previously reported) following embolization, while 1 patient with chylous ascites required surgical management after endolymphatic intervention.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  8 / 160390 MEDLINE  
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[PMID]: 29462739
[Au] Autor:Wang Y; Liu Z; Chen S; Ye X; Xie W; Hu C; Iezzi T; Jackson T
[Ad] Address:Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China.
[Ti] Title:Pre-surgery beliefs about pain and surgery as predictors of acute and chronic post-surgical pain: A prospective cohort study.
[So] Source:Int J Surg;52:50-55, 2018 Feb 17.
[Is] ISSN:1743-9159
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Chronic pain post-surgical pain (CPSP) is common and has far-reaching negative consequences for patients, yet relatively few studies have evaluated the impact of both deficit- and resource-based beliefs about pain and surgery on subjective intensities of acute and chronic post-surgical pain. To address this issue a prospective cohort study was performed. METHOD: 259 consecutive surgery patients from general surgery, gynecology, and thoracic departments completed a self-report battery of demographics, pain experiences, and psychological factors 24 h before surgery (T1) and provided follow-up pain intensity ratings 48 h-72 h after surgery (T2), and at a 4-month follow-up (T3). RESULTS: In the hierarchical regression model for acute post-operative pain intensity, pre-surgery pain self-efficacy beliefs made a significant unique contribution independent of all other pre-surgery and surgery-related factors (i.e., age, presence of pre-surgical pain, type of anesthesia, surgery duration). In the prediction model for intensity of chronic post-surgical pain, beliefs about long-term effects of surgery had a unique impact after controlling other significant pre-surgery and surgery influences (gender, education, surgery time). CONCLUSION: Results underscored the potential utility of considering specific pre-surgery pain- and surgery-related beliefs as factors that predict patient experiences of acute and chronic post-operative pain.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  9 / 160390 MEDLINE  
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[PMID]: 29428700
[Au] Autor:Semenkovich TR; Panni RZ; Hudson JL; Thomas T; Elmore LC; Chang SH; Meyers BF; Kozower BD; Puri V
[Ad] Address:Divisions of Cardiothoracic Surgery, Washington University, St Louis, Mo.
[Ti] Title:Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: A decision analysis.
[So] Source:J Thorac Cardiovasc Surg;, 2018 Jan 12.
[Is] ISSN:1097-685X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: We compared the effectiveness of upfront esophagectomy versus induction chemoradiation followed by esophagectomy for overall survival in patients with clinical T2N0 (cT2N0) esophageal cancer. We also assessed the influence of the diagnostic uncertainty of endoscopic ultrasound on the expected benefit of chemoradiation. METHODS: We created a decision analysis model representing 2 treatment strategies for cT2N0 esophageal cancer: upfront esophagectomy that may be followed by adjuvant therapy for upstaged patients and induction chemoradiation for all patients with cT2N0 esophageal cancer followed by esophagectomy. Parameter values within the model were obtained from published data, and median survival for pathologic subgroups was derived from the National Cancer Database. In sensitivity analyses, staging uncertainty of endoscopic ultrasound was introduced by varying the probability of pathologic upstaging. RESULTS: The baseline model showed comparable median survival for both strategies: 48.3months for upfront esophagectomy versus 45.9months for induction chemoradiation and surgery. The sensitivity analysis demonstrated induction chemoradiation was beneficial, with probability of upstaging > 48.1%, which is within the published range of 32% to 65% probability of pathologic upstaging after cT2N0 diagnosis. The presence of any of 3 key variables (size larger than3cm, high grade, or lymphovascular invasion) was associated with >48.1% risk of upstaging, thus conferring a survival advantage to induction chemoradiation. CONCLUSIONS: The optimal treatment strategy for cT2N0 esophageal cancer depends on the accuracy of endoscopic ultrasound staging. High-risk features that confer increased probability of upstaging can inform clinical decision making to recommend induction chemoradiation for select cT2N0 patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:Publisher

  10 / 160390 MEDLINE  
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[PMID]: 29362794
[Au] Autor:Friedman DJ; Piccini JP; Wang T; Zheng J; Malaisrie SC; Holmes DR; Suri RM; Mack MJ; Badhwar V; Jacobs JP; Gaca JG; Chow SC; Peterson ED; Brennan JM
[Ad] Address:Duke Clinical Research Institute, Durham, North Carolina.
[Ti] Title:Association Between Left Atrial Appendage Occlusion and Readmission for Thromboembolism Among Patients With Atrial Fibrillation Undergoing Concomitant Cardiac Surgery.
[So] Source:JAMA;319(4):365-374, 2018 01 23.
[Is] ISSN:1538-3598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: The left atrial appendage is a key site of thrombus formation in atrial fibrillation (AF) and can be occluded or removed at the time of cardiac surgery. There is limited evidence regarding the effectiveness of surgical left atrial appendage occlusion (S-LAAO) for reducing the risk of thromboembolism. Objective: To evaluate the association of S-LAAO vs no receipt of S-LAAO with the risk of thromboembolism among older patients undergoing cardiac surgery. Design, Setting, and Participants: Retrospective cohort study of a nationally representative Medicare-linked cohort from the Society of Thoracic Surgeons Adult Cardiac Surgery Database (2011-2012). Patients aged 65 years and older with AF undergoing cardiac surgery (coronary artery bypass grafting [CABG], mitral valve surgery with or without CABG, or aortic valve surgery with or without CABG) with and without concomitant S-LAAO were followed up until December 31, 2014. Exposures: S-LAAO vs no S-LAAO. Main Outcomes and Measures: The primary outcome was readmission for thromboembolism (stroke, transient ischemic attack, or systemic embolism) at up to 3 years of follow-up, as defined by Medicare claims data. Secondary end points included hemorrhagic stroke, all-cause mortality, and a composite end point (thromboembolism, hemorrhagic stroke, or all-cause mortality). Results: Among 10 524 patients undergoing surgery (median age, 76 years; 39% female; median CHA2DS2-VASc score, 4), 3892 (37%) underwent S-LAAO. Overall, at a mean follow-up of 2.6 years, thromboembolism occurred in 5.4%, hemorrhagic stroke in 0.9%, all-cause mortality in 21.5%, and the composite end point in 25.7%. S-LAAO, compared with no S-LAAO, was associated with lower unadjusted rates of thromboembolism (4.2% vs 6.2%), all-cause mortality (17.3% vs 23.9%), and the composite end point (20.5% vs 28.7%) but no significant difference in rates of hemorrhagic stroke (0.9% vs 0.9%). After inverse probability-weighted adjustment, S-LAAO was associated with a significantly lower rate of thromboembolism (subdistribution hazard ratio [HR], 0.67; 95% CI, 0.56-0.81; P < .001), all-cause mortality (HR, 0.88; 95% CI, 0.79-0.97; P = .001), and the composite end point (HR, 0.83; 95% CI, 0.76-0.91; P < .001) but not hemorrhagic stroke (subdistribution HR, 0.84; 95% CI, 0.53-1.32; P = .44). S-LAAO, compared with no S-LAAO, was associated with a lower risk of thromboembolism among patients discharged without anticoagulation (unadjusted rate, 4.2% vs 6.0%; adjusted subdistribution HR, 0.26; 95% CI, 0.17-0.40; P < .001), but not among patients discharged with anticoagulation (unadjusted rate, 4.1% vs 6.3%; adjusted subdistribution HR, 0.88; 95% CI, 0.56-1.39; P = .59). Conclusions and Relevance: Among older patients with AF undergoing concomitant cardiac surgery, S-LAAO, compared with no S-LAAO, was associated with a lower risk of readmission for thromboembolism over 3 years. These findings support the use of S-LAAO, but randomized trials are necessary to provide definitive evidence.
[Mh] MeSH terms primary: Atrial Appendage/surgery
Atrial Fibrillation
Cardiac Surgical Procedures/adverse effects
Patient Readmission/statistics & numerical data
Thromboembolism/prevention & control
[Mh] MeSH terms secundary: Aged
Aortic Valve/surgery
Coronary Artery Bypass/adverse effects
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Mitral Valve/surgery
Proportional Hazards Models
Retrospective Studies
Septal Occluder Device
Thromboembolism/epidemiology
Thromboembolism/etiology
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Entry month:1801
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180125
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20125


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