Skeletal stability of maxillary advancement with and without a mandibular reduction in the cleft lip and palate patient

The stability of surgical maxillary advancement in a consecutive series of patients with cleft lip and palate who underwent Le Fort I osteotomy with and without simultaneous mandibular setback surgery was evaluated. Preoperative, postoperative, and follow-up lateral cephalograms of 21 patients were assessed to compare differences in surgical movement and postoperative relapse between two groups: those who underwent maxillary surgery alone and those who underwent bimaxillary surgery. Differences in the number of patients who experienced relapse of <2mm, 2–4mm, and >4mm between the groups were also compared.

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Recommendation for Axillary Lymph Node Dissection in Women with Early Breast Cancer and Sentinel Node Metastasis: A Systematic Review and Meta-analysis of Randomized Controlled Trials Using the GRADE System.

Recommendation for Axillary Lymph Node Dissection in Women with Early Breast Cancer and Sentinel Node Metastasis: A Systematic Review and Meta-analysis of Randomized Controlled Trials Using the GRADE System.

Int J Surg. 2016 Aug 22;

Authors: Huang TW, Kuo KN, Chen KH, Chen C, Hou WH, Lee WH, Chao TY, Tsai JT, Su CM, Huang MT, Tam KW

Abstract
BACKGROUND: In 2014, the American Society of Clinical Oncology published an updated clinical practice guideline on axillary lymph node dissection (ALND) for early-stage breast cancer patients. However, these recommendations have been challenged because they were based on data from only one randomized controlled trial (RCT). We evaluated the rationale of these recommendations by systematically reviewing RCTs using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system.
METHODS: We searched articles in the PubMed, EMBASE, CINAHL, Scopus, and Cochrane databases. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The secondary endpoints were recurrence rate and surgical complications of axillary dissection. The quality of evidence was assessed using the GRADE profiler.
RESULTS: Five eligible studies were retrieved and analyzed. We divided sentinel lymph node (SLN) metastasis into two categories: SLN micrometastasis and SLN macrometastasis. In patients with 1 or 2 SLN micrometastasis, no significant difference was observed in OS, DFS, or recurrence rate between the ALND and non-ALND groups. For patients with 1 or 2 SLN marcometastasis, only one trial with a moderate risk of bias was included, and non-ALND was the preferred management overall. However, ALND might be appropriate for patients who placed a greater emphasis on longer-term survival at any cost.
CONCLUSION: We recommend non-ALND management for early breast cancer patients with 1 or 2 SLN micrometastasis or macrometastasis on the basis of a systematic review of the current evidence conducted using the GRADE system. However, the optimal practice of evidence-based medicine should incorporate patient preferences, particularly when evidence is limited.

PMID: 27562691 [PubMed - as supplied by publisher]

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Recommendation for Axillary Lymph Node Dissection in Women with Early Breast Cancer and Sentinel Node Metastasis: A Systematic Review and Meta-analysis of Randomized Controlled Trials Using the GRADE System.

Recommendation for Axillary Lymph Node Dissection in Women with Early Breast Cancer and Sentinel Node Metastasis: A Systematic Review and Meta-analysis of Randomized Controlled Trials Using the GRADE System.

Int J Surg. 2016 Aug 22;

Authors: Huang TW, Kuo KN, Chen KH, Chen C, Hou WH, Lee WH, Chao TY, Tsai JT, Su CM, Huang MT, Tam KW

Abstract
BACKGROUND: In 2014, the American Society of Clinical Oncology published an updated clinical practice guideline on axillary lymph node dissection (ALND) for early-stage breast cancer patients. However, these recommendations have been challenged because they were based on data from only one randomized controlled trial (RCT). We evaluated the rationale of these recommendations by systematically reviewing RCTs using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system.
METHODS: We searched articles in the PubMed, EMBASE, CINAHL, Scopus, and Cochrane databases. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The secondary endpoints were recurrence rate and surgical complications of axillary dissection. The quality of evidence was assessed using the GRADE profiler.
RESULTS: Five eligible studies were retrieved and analyzed. We divided sentinel lymph node (SLN) metastasis into two categories: SLN micrometastasis and SLN macrometastasis. In patients with 1 or 2 SLN micrometastasis, no significant difference was observed in OS, DFS, or recurrence rate between the ALND and non-ALND groups. For patients with 1 or 2 SLN marcometastasis, only one trial with a moderate risk of bias was included, and non-ALND was the preferred management overall. However, ALND might be appropriate for patients who placed a greater emphasis on longer-term survival at any cost.
CONCLUSION: We recommend non-ALND management for early breast cancer patients with 1 or 2 SLN micrometastasis or macrometastasis on the basis of a systematic review of the current evidence conducted using the GRADE system. However, the optimal practice of evidence-based medicine should incorporate patient preferences, particularly when evidence is limited.

PMID: 27562691 [PubMed - as supplied by publisher]

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macrophage; +41 new citations

41 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

macrophage

These pubmed results were generated on 2016/08/27

PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Anaesthesics and analgesics; neurocognitive effects, organ protection and cancer reoccurrence an update.

Anaesthesics and analgesics; neurocognitive effects, organ protection and cancer reoccurrence an update.

Int J Surg. 2016 Aug 22;

Authors: Sellbrant I, Brattwall M, Jildenstål P, Warren-Stomberg M, Forsberg S, Jakobsson JG

Abstract
Available general and local anaesthetics, third generation inhaled anaesthetics, propofol and amide class local anaesthetics are effective and reassuringly safe. They are all associated to low incidence of toxicology and or adverse-effects. There is however a debate whether anaesthetic drug and technique could exhibit effects beyond the primary effects; fully reversible depression of the central nervous system, dose dependent anaesthesia. Anaesthetics may be involved in the progression of neurocognitive side effects seen especially in the elderly after major surgery, so called Postoperative Cognitive Dysfunction. On the other hand anaesthetics may exhibit organ protective potential, reducing ischemia reperfusion injury and improving survival after cardiac surgery. Anaesthetics and anaesthetic technique may also have effects of cancer reoccurrence and risk for metastasis. The present paper provides an update around the evidence base around anaesthesia potential contributing effect on the occurrence of postoperative cognitive adverse-effects, organ protective properties and influence on cancer re-occurrence/metastasis.

PMID: 27562690 [PubMed - as supplied by publisher]

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The future of surgical training in the context of the 'Shape of Training' Review: Consensus recommendations by the Association of Surgeons in Training.

The future of surgical training in the context of the 'Shape of Training' Review: Consensus recommendations by the Association of Surgeons in Training.

Int J Surg. 2016 Aug 22;

Authors: Harries RL, Williams AP, Ferguson HJ, Mohan HM, Beamish AJ, Gokani VJ, Council of the Association of Surgeons in Training

Abstract
ASiT has long maintained that in order to provide the best quality care to patients in the UK and Republic of Ireland, it is critical that surgeons are trained to the highest standards. In addition, it is imperative that surgery remains an attractive career choice, with opportunities for career progression and job satisfaction to attract and retain the best candidates. In 2013, the Shape of Training review report set out recommendations for the structure and delivery of postgraduate training in light of an ever increasingly poly-morbid and ageing population. This consensus statement outlines ASIT's position regarding recommendations for improving surgical training and aims to help guide discussions with regard to future proposed changes to surgical training.

PMID: 27562689 [PubMed - as supplied by publisher]

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Anaesthesics and analgesics; neurocognitive effects, organ protection and cancer reoccurrence an update.

Anaesthesics and analgesics; neurocognitive effects, organ protection and cancer reoccurrence an update.

Int J Surg. 2016 Aug 22;

Authors: Sellbrant I, Brattwall M, Jildenstål P, Warren-Stomberg M, Forsberg S, Jakobsson JG

Abstract
Available general and local anaesthetics, third generation inhaled anaesthetics, propofol and amide class local anaesthetics are effective and reassuringly safe. They are all associated to low incidence of toxicology and or adverse-effects. There is however a debate whether anaesthetic drug and technique could exhibit effects beyond the primary effects; fully reversible depression of the central nervous system, dose dependent anaesthesia. Anaesthetics may be involved in the progression of neurocognitive side effects seen especially in the elderly after major surgery, so called Postoperative Cognitive Dysfunction. On the other hand anaesthetics may exhibit organ protective potential, reducing ischemia reperfusion injury and improving survival after cardiac surgery. Anaesthetics and anaesthetic technique may also have effects of cancer reoccurrence and risk for metastasis. The present paper provides an update around the evidence base around anaesthesia potential contributing effect on the occurrence of postoperative cognitive adverse-effects, organ protective properties and influence on cancer re-occurrence/metastasis.

PMID: 27562690 [PubMed - as supplied by publisher]

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