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Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

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https://www.readbyqxmd.com/read/28284517/antibiotics-first-strategy-for-uncomplicated-acute-appendicitis-in-adults-is-associated-with-increased-rates-of-peritonitis-at-surgery-a-systematic-review-with-meta-analysis-of-randomized-controlled-trials-comparing-appendectomy-and-non-operative-management
#1
REVIEW
Mauro Podda, Nicola Cillara, Salomone Di Saverio, Antonio Lai, Francesco Feroci, Gianluigi Luridiana, Ferdinando Agresta, Nereo Vettoretto
BACKGROUND: Acute appendicitis is the most common surgical diagnosis in young patients, with lifetime prevalence of about 7%. Debate remains on whether uncomplicated AA should be operated or not. Aim of this meta-analysis of randomized controlled trials was to assess current evidence on antibiotic treatment for uncomplicated AA compared to standard surgical treatment. METHODS: Systematic literature search was performed using PubMed, EMBASE, Medline, Google Scholar and Cochrane Central Register of Controlled Trials databases for randomized controlled trials comparing antibiotic therapy (AT) and surgical therapy-appendectomy (ST) for uncomplicated AA...
March 8, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28162908/does-bacterial-translocation-influence-the-postoperative-infections-in-splenectomized-patients-after-abdominal-trauma
#2
Mario Schietroma, Beatrice Pessia, Sara Colozzi, Francesco Carlei, Gianfranco Amicucci
BACKGROUND: Some studies suggested that after abdominal trauma, postoperative infections are associated with bacterial translocation, whereas others have not replicated these findings. We have assessed the bacterial translocation and postoperative infections in patients undergoing splenectomy after abdominal trauma, using a very homogeneous study population. METHODS: We consecutively studied, in a prospective observational clinical study, 125 patients who required urgent surgical treatment (splenectomy) following blunt abdominal trauma...
February 2, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28139371/a-comparison-of-outcomes-in-morbidly-obese-obese-and-non-obese-patients-undergoing-primary-total-knee-and-total-hip-arthroplasty
#3
Angela H Deakin, Aghimien Iyayi-Igbinovia, Gavin J Love
BACKGROUND: Obesity is a growing public health issue with the prevalence of morbid obesity, (Body Mass Index (BMI) ≥ 40 kg/m(2)) increasing. There is some evidence these patients have more peri- and post-operative complications and poorer outcomes when undergoing arthroplasty procedures. This audit aimed to determine and compare the outcomes of non-obese, obese and morbidly obese patients undergoing arthroplasty at our institution. METHOD: This was a retrospective audit of patients from our institution who had undergone total knee (TKA) or total hip arthroplasty (THA) in 2009...
January 27, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28108269/are-hemoglobin-levels-really-lower-in-faecal-immunochemical-test-positive-patients-with-colorectal-cancer
#4
Jing Yu Ng, Ian Jse-Wei Tan, Ker-Kan Tan
INTRODUCTION: Faecal immunochemical test (FIT) is advocated in many colorectal cancer-screening programs. A positive FIT translates to the need for a colonoscopy. However, waiting times for diagnostic colonoscopy is long. The aim of our study is to determine the correlation of hemoglobin levels in patients with a positive FIT who were subsequently diagnosed with colorectal cancer, and to compare them with patients with only colonic adenomas and those with normal colonoscopy with the intention of determining if hemoglobin levels could be used to stratify the urgency of colonoscopy...
January 17, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28034631/emergency-endovascular-management-of-acute-thoracic-aortic-pathology-a-safe-and-feasible-option
#5
Z Ahmed, S M McHugh, A Elmallah, M P Colgan, A O'Callaghan, S M O'Neill, P Madhavan, Z Martin
Endovascular repair has revolutionised the emergency treatment of thoracic aortic disease. We report our 10 year experience using this treatment in emergency cases. A prospectively maintained vascular database was analysed. Patients' medical records and CT images stored on the hospital PACS system were also reviewed. Statistical analysis was done using IBM SPSS V21. There were a total of 59 thoracic aortic stenting procedures of which 33 (60% males with a mean age of 58 yrs) were performed for emergency thoracic pathologies: traumatic transection (n = 10), ruptured aneurysm (n = 6), non-traumatic dissection (n = 8) and penetrating aortic ulcer (n = 9)...
December 27, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27729210/reply-trauma-networks-and-rural-trauma
#6
LETTER
Jan O Jansen, Jonathan J Morrison
No abstract text is available yet for this article.
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27612947/the-evolving-management-of-the-appendix-mass-in-the-era-of-laparoscopy-and-interventional-radiology
#7
REVIEW
James Forsyth, Konstantinos Lasithiotakis, Mark Peter
AIM: An appendix mass is the result of a walled-off perforation of the appendix which localises, resulting in a mass and it is encountered in up to 7% of patients presenting with acute appendicitis. However, its management is controversial due to the lack of high level evidence. This review article sets out a rationale diagnostic and therapeutic strategy for the appendix mass based upon up-to-date available evidence. METHODS: A literature review of the investigation and management of appendix mass/complicated appendicitis was undertaken using PubMed, EMBASE and Google Scholar...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27520332/retrievable-ivc-filters-friend-or-foe
#8
REVIEW
E Ryan, H K Kok, M J Lee
Venous thromboembolism is a common condition with widely varied outcomes. Pulmonary embolism is associated with a case-fatality rate of up to 8%, increasing up to 18-fold in massive PE. Pharmacological treatment of VTE with anticoagulant medication (AC) is the first line therapy of choice. Retrievable inferior vena cava filters (IVCF) are indicated as a short-term replacement for AC in certain circumstances. Most of the evidence concerning IVCF pertains to permanent filters and older filter models. Limited evidence for retrievable IVCF results in poor consensus regarding indications, follow-up and retrieval...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27396932/predictive-models-in-cancer-management-a-guide-for-clinicians
#9
REVIEW
Mohammed Ali Kazem
BACKGROUND: Predictive tools in cancer management are used to predict different outcomes including survival probability or risk of recurrence. The uptake of these tools by clinicians involved in cancer management has not been as common as other clinical tools, which may be due to the complexity of some of these tools or a lack of understanding of how they can aid decision-making in particular clinical situations. AIMS: The aim of this article is to improve clinicians' knowledge and understanding of predictive tools used in cancer management, including how they are built, how they can be applied to medical practice, and what their limitations may be...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27346244/management-of-acute-periprosthetic-joint-infection-of-the-knee-algorithms-for-the-on-call-surgeon
#10
REVIEW
Robert Petretta, Jonathan Phillips, Andrew Toms
Periprosthetic joint infection (PJI) remains a serious complication following a total knee replacement. Infections rates following arthroplasty range from 0.5% to 3%. The acutely infected knee replacement often presents to the on call Orthopaedic Surgeon who can often lack the expertise or resources for the definitive management. However, obtaining an early and accurate diagnosis and potentially performing an early treatment such as irrigation and debridement may be required by the on call surgeon. Management of these patients should include a team of specialists including Medical or Intensive Care, and Infectious Disease...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27167904/the-effect-of-deprivation-on-the-incidence-of-mandibular-fractures-in-a-british-city
#11
M H Wilson, J P Robinson, R T Sisson, P J Revington, S J Thomas
AIM: To examine the relationship between social and material deprivation and mandibular fractures. METHOD: Three hundred and forty three consecutive patients who underwent mandibular fracture fixation were selected for the study. After exclusions, 290 were divided into age groups and ranked according to their Index of Multiple Deprivation (IMD) score. Rankings were determined using postcodes, and divided into quintiles for statistical analysis. RESULTS: Ages ranged from 7 to 82 with 146 (50%) patients aged between 20 and 29...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26530998/vacuum-assisted-biopsy-is-a-viable-alternative-to-surgical-biopsy-in-the-investigation-of-breast-lesions-of-uncertain-malignant-potential
#12
Andrew Pieri, Diane Hemming, Jackie Westgarth, Linsley Lunt
AIMS: In patients presenting with a breast lesion, when initial core biopsy histology falls into the category of "uncertain malignant potential" (i.e. a B3 lesion), the next line of investigation has traditionally been a surgical biopsy (SBx). Vacuum-assisted biopsy (VAB) may be a viable minimally invasive alternative to SBx for B3 lesions. The primary aims of this study were to establish whether VAB reduces the need for surgical biopsy and determine VAB sensitivity for carcinoma following initial B3 histology...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26164740/a-comparison-of-tibial-and-peroneal-venous-and-heptfe-bypasses-in-diabetics-with-critical-limb-ischemia
#13
C Hock, T Betz, I Töpel, S Bröckner, M Steinbauer, C Uhl
OBJECTIVE: In this study we analyzed the outcome of tibial and peroneal venous and heparin-bonded expanded polytetrafluoroethylene (HePTFE) bypasses in diabetics with critical limb ischemia (CLI). We aimed to verify our hypothesis that HePTFE grafts will achieve acceptable 1-year patency and limb salvage results in patients who lack an adequate vein. METHODS: We conducted a retrospective analysis for all diabetics who underwent tibial bypass surgery in our department between October 2007 and October 2012...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27374183/pancreatic-cancer-actionable-genes-in-precision-medicine-and-personalized-surgery
#14
REVIEW
Juehua Yu, Shi-He Liu, Robbi Sanchez, John Nemunaitis, Enrique Rozengurt, F Charles Brunicardi
Pancreatic ductal adenocarcinoma (PDAC) is a deadly cancer with an overall 5-year survival rate less than 5% due to the poor early diagnosis and lack of effective therapeutic options. The most effective therapy remains surgery, however post-operative survival could be enhanced with effective adjuvant therapy. The massive information gained from Omics techniques on PDAC at the beginning of the 21st century is a remarkable accomplishment. However, the information gained from the omics data, including next generation sequencing data, has yet to successfully affect care of patients suffering with PDAC...
February 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26993759/a-systematic-review-of-new-treatments-for-cryptoglandular-fistula-in-ano
#15
REVIEW
Sunil K Narang, Kenneth Keogh, Nasra N Alam, Samir Pathak, Ian R Daniels, Neil J Smart
AIM: In 2007 the ACPGBI published a position statement on the management of cryptoglandular fistula in ano. Over the last seven years a number of new treatments have been developed and the aim of this systematic review was to assess their effectiveness. METHOD: A systematic review of all English language literature relevant to novel treatment strategies for cryptoglandular fistula in ano, published between 1 January 2007 and 31 Dec 2014 was carried out using MEDLINE (PubMed and Ovid), EMBASE (Ovid) and the Cochrane Library of Systematic Reviews/Controlled Trials for relevant literature...
February 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26895656/local-anaesthesia-versus-spinal-anaesthesia-in-inguinal-hernia-repair-a-systematic-review-and-meta-analysis
#16
REVIEW
Deepali Prakash, Leonie Heskin, Sally Doherty, Rose Galvin
BACKGROUND: Inguinal hernias are a significant cause of morbidity. The purpose of this systematic review and meta-analysis is to determine the totality of evidence regarding the effectiveness of local anaesthesia when compared to spinal anaesthesia in individuals undergoing open inguinal hernia repair. METHODS: A systematic literature search was conducted. Inclusion criteria were randomised controlled trials (RCTs) comparing spinal and local anaesthesia on clinical and self-reported outcomes, in patients undergoing open inguinal hernia repairs...
February 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26464072/using-a-multimedia-presentation-to-improve-patient-understanding-and-satisfaction-with-informed-consent-for-minimally-invasive-vascular-procedures
#17
N Bowers, E Eisenberg, J Montbriand, J Jaskolka, G Roche-Nagle
OBJECTIVE: As vascular procedures become more complex, patient understanding of their treatment(s) can become more difficult. We wished to evaluate the utility of multimedia presentations (MPs) to improve patient understanding of their vascular interventions. METHODS: Patients undergoing endovascular aneurysm repair (EVAR), peripheral angioplasty, Hickman catheter and peripherally inserted central catheter (PICC) insertion were randomized into a control group receiving traditional verbal consent, and a MP group that were shown a two minute simplified video of their procedure on an iPad™ computer in addition to the traditional verbal consent...
February 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26409623/refinement-of-myotome-values-in-the-upper-limb-evidence-from-brachial-plexus-injuries
#18
S W Bell, M J C Brown, T J Hems
PURPOSE: We reviewed patients with partial supraclavicular brachial plexus injuries in order to refine the myotome values of the upper limb. METHODS: Forty-two patients with defined partial injuries to the supraclavicular brachial plexus were reviewed from a prospective database. The injuries patterns covered C5, C5-6, C5-7, C5-8, C7-T1 and C8-T1 roots. Upper plexus injuries were classified on the basis of surgical exploration and intraoperative stimulation and lower plexus injuries from MRI...
February 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26279202/patient-awareness-and-sun-protection-behaviour-following-excision-of-basal-cell-carcinoma
#19
Catherine de Blacam, Clodagh Mc Dermott, Conor Sugrue, Darren Kilmartin, Jack Kelly
BACKGROUND: Limited information is available regarding disease awareness and sun protection behaviour in patients previously treated for non-melanoma skin cancer. METHODS: Using a telephone-administered questionnaire, we investigated these characteristics in 250 patients in the west of Ireland who had undergone excision of basal cell carcinomas between January 2011 and December 2012. RESULTS: Only 28.8% of respondents knew that the lesion they had excised was a BCC and understood that there was a significant chance of developing another similar lesion in the next 3 years...
February 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26279201/isolated-roux-en-y-reconstruction-versus-conventional-reconstruction-after-pancreaticoduodenectomy
#20
De-Bang Li, Chen Chai, Long Cao, Yan-Ming Zhou
BACKGROUND: Pancreatic fistula (PF) is the major cause for morbidity and mortality following pancreaticoduodenectomy. The primary aim of this study was to compare the occurrence rate of postoperative PF between isolated Roux-en-Y reconstruction (RYR) and conventional reconstruction (CR) after pancreaticoduodenectomy. METHODS: Data of 43 patients who underwent RYC were compared with those of a pair-matched equal number of patients undergoing CR. We also performed a meta-analysis of comparative studies of the two procedures...
February 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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