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Annals of Medicine and Surgery

A Khudan, G Jugmohansingh, S Islam, S Medford, V Naraynsingh
OBJECTIVES: Conservative management for retropharyngeal abscesses <2 cm is now a first line option. It is unclear if conservative management can be used to manage larger abscesses without increased morbidity and mortality. STUDY DESIGN: A prospective case series was performed from 2012 to 2015 by the Otolaryngology department of the San Fernando General Hospital involving pediatric patients who presented with retropharyngeal abscesses. All patients were initially treated with antibiotics alone...
November 2016: Annals of Medicine and Surgery
Vittorio Bresadola, Riccardo Pravisani, Marina Pighin, Luca Seriau, Vittorio Cherchi, Sergio Giuseppe, Andrea Risaliti
BACKGROUND: Training programs for resident surgeons represent a challenge for the mentoring activity. The aim of the present study is to investigate the impact of our training program for laparoscopic cholecystectomy on patient's safety and on the modulation of the residents' exposure to clinical scenario with different grades of complexity. MATERIAL AND METHODS: This is a retrospective study based on a clinical series of laparoscopic cholecystectomy performed in a teaching hospital...
November 2016: Annals of Medicine and Surgery
Jacob Calvert, Qingqing Mao, Jana L Hoffman, Melissa Jay, Thomas Desautels, Hamid Mohamadlou, Uli Chettipally, Ritankar Das
BACKGROUND: Clinical decision support systems are used to help predict patient stability and mortality in the Intensive Care Unit (ICU). Accurate patient information can assist clinicians with patient management and in allocating finite resources. However, systems currently in common use have limited predictive value in the clinical setting. The increasing availability of Electronic Health Records (EHR) provides an opportunity to use medical information for more accurate patient stability and mortality prediction in the ICU...
November 2016: Annals of Medicine and Surgery
Adam Thomas Cristaudo, Ryo Mizumoto, Rasika Hendahewa
BACKGROUND: Giant cell arteritis (GCA) has the potential to cause irreversible blindness and stroke in affected patients [1-4]. Temporal artery biopsy (TAB) remains the gold standard test for GCA [6-8]. Recent literature suggests that TAB does not change management of patients with suspected GCA and that ultrasound scan (USS) may be sufficient enough alone to confirm the diagnosis [9-11,13]. The aim of this study is to therefore determine the impact of TAB on current surgical practice and emergency theatre services...
November 2016: Annals of Medicine and Surgery
Riyadh Mohamad Hasan
BACKGROUND: Perianal abscess which can lead to a devastating complications. The management of perianal abscess involves incision and drainage by different methods one of them is packing the cavity. AIM OF THE STUDY: The aim is using Corrugate Rubber drain as an alternative to other methods. PATIENTS AND METHODS: This study was an observational retrospective review of 137 'case series' of patients with perianal abscess over a fifteen-year period from January 2000 to December 2015...
November 2016: Annals of Medicine and Surgery
Akio Kanda, Kazuo Kaneko, Osamu Obayashi, Atsuhiko Mogami, Itaru Morohashi
Acetabular fracture is usually treated with osteosynthesis. However, in the case of an intra-articular fracture, osteosynthesis can result in arthropathy of the hip joint and poor long-term results, hence, total hip arthroplasty is required. However, in total hip arthroplasty for postoperative acetabular fracture, sciatic nerve palsy tends to develop more commonly than after primary total hip arthroplasty. This is a case report of a 57-year-old Japanese male who had internal skeletal fixation for a left acetabular fracture that had occurred 2 years earlier...
November 2016: Annals of Medicine and Surgery
Conrad Harrison, Cian Wade, Sinclair Gore
A best evidence topic was written according to the structured protocol. The three part question addressed was: [In patients undergoing closure of surgical wounds with sutures] does [keeping the wound dry for the first 48 h after closure] [reduce the incidence of surgical site infections (SSIs)]? 4 relevant papers were culled from the literature and appraised. The authors, date, country, population, study type, main outcomes, key results and study weaknesses were tabulated. Current NICE guidelines recommend cleaning surgical wounds with sterile saline only for the first 48 h following skin closure...
November 2016: Annals of Medicine and Surgery
Margaret M Monette, Rodney T Harney, Melanie S Morris, Daniel I Chu
INTRODUCTION: One of the most common late complications following stoma construction is prolapse. Although the majority of prolapse can be managed conservatively, surgical revision is required with incarceration/strangulation and in certain cases laparotomy and/or stoma reversal are not appropriate. This report will inform surgeons on safe and effective approaches to revising prolapsed stomas using local techniques. PRESENTATION OF CASE: A 58 year old female with an obstructing rectal cancer previously received a diverting transverse loop colostomy...
November 2016: Annals of Medicine and Surgery
Cesar Antonio Martínez Ortiz, Maricela Jiménez-López, Salvador Serrano Franco
BACKGROUND: Biliary cysts are duct dilatation that can occur on all biliary ducts, 20-25% is diagnosed in adults. The classic triad for the clinical presentation consists on abdominal pain, jaundice and abdominal mass. The standard treatment is surgical resection and bilioenteric anastomosis. The objective of this study is to analyze the prevalence and characteristics of biliary cysts in our center. METHODS: This is an observational retrospective study, we included patients older than 16 years old with biliary cyst from march 1989 to February 2015...
November 2016: Annals of Medicine and Surgery
Kyohei Kanematsu, Hironori Tsujimoto, Shinsuke Nomura, Hiroyuki Horiguchi, Nozomi Ito, Kenji Yamazaki, Shuichi Hiraki, Suefumi Aosasa, Junji Yamamoto, Kazuo Hase
A 57-year-old woman was admitted to National Defense Medical College hospital for treatment of gastric cancer with pyloric stenosis. She had been diagnosed with chronic kidney disease (CKD) 10 years prior, but received no hemodialysis. Because of peritoneal dissemination, a palliative distal gastrectomy was performed. In consideration of renal dysfunction, we decided for chemotherapy with paclitaxel, but not S-1 plus cisplatin regimen which is renal toxic agents. On the 29th postoperative day, chemotherapy using paclitaxel was initiated at a dose of 80 mg/m(2)...
November 2016: Annals of Medicine and Surgery
Mina Guerges, Eliza Slama, Bashar Maskoni, Sherwin Imlay, Malik McKany
BACKGROUND: Gangliocytic paragangliomas are rare, and typically benign neuroendocrine neoplasms usually found in the second portion of the duodenum. Though recurrence is rare, metastatic cases have been noted. A standardized treatment has not been determined. An endoscopic resection can be carried out, unless metastasis has been noted. We present the case of a patient who underwent an ampullectomy, with successful removal of the tumor, and no recurrence on follow-up. CASE SUMMARY: We present a case involving a 58-year-old gentleman, who presented with dysphagia, and ultimately diagnosed with a periampullary mass proven to be a gangliocytic paraganglioma...
November 2016: Annals of Medicine and Surgery
Efstathios Antoniou, Georgios Antonios Margonis, Anastasios Angelou, Anastasia Pikouli, Paraskevi Argiri, Ioannis Karavokyros, Apostolos Papalois, Emmanouil Pikoulis
BACKGROUND: Despite recent advances the pathogenesis of Crohn's disease remains incompletely understood. A variety of animal models have been utilized in an effort to provide further insights and develop more therapeutic options. In order to simulate, to an extent, the pathogenesis and the clinical course of the disease, TNBS induced colitis is often used. Various approaches for inducing TNBS -colitis have been described in the literature. METHODS/RESULTS: In this review, we sought to present the animal model of TNBS induced colitis and outline the pathogenesis, pathophysiology, clinical course and pathological characteristics of the model...
November 2016: Annals of Medicine and Surgery
Mohammed Saif Sait, Robin Som, Cynthia Michelle Borg, Avril Chang, Sasindran Ramar
A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In morbidly obese patients undergoing bariatric surgery, when a ventral hernia is picked up in clinic or intraoperatively is concurrent repair of the hernia better than delayed repair after weight loss with regards to complication rates? Using the reported search, 179 papers were found. 5 studies were deemed to be suitable to answer the question. All 5 studies assessed were non randomised studies either retrospective or prospective and the overall quality of these studies was poor...
November 2016: Annals of Medicine and Surgery
Tommaso Maria Manzia, Laura Fazzolari, Matteo Manuelli, Marco Pellicciaro, Leonardo Baiocchi, Giuseppe Tisone
INTRODUCTION: Due to the complexity of the surgical procedure portal vein thrombosis (PVT) has long been considered an absolute contraindication to liver transplantation (LT). The presence of a large splenorenal shunt (SRS) could make portal anastomosis a valid option. PRESENTATION OF CASE: We report the case of a 37-year-old female patient with Grade III PVT and a large SRS, who underwent orthotopic LT. Liver was implanted using a 1992-Belghiti piggyback technique and portal anastomosis was performed using the large spleno-renal shunt...
November 2016: Annals of Medicine and Surgery
Arianeb Mehrabi, Katrin Hoffmann, Karl Heinz Weiss, Carolin Mogler, Peter Schemmer, Markus W Büchler, Ingo Alldinger
BACKGROUND: Primary Hepatic Epithelioid Hemangioendothelioma is an extremely rare tumor of vascular origin. PATIENTS: In this work we present clinical data and long term results of eight patients who were surgically treated in our institution. Liver transplantation was performed in five patients (four cadaveric and one living related) and major liver resection in three patients. Three patients are alive with recurrent tumor. After a median follow-up of 100 months (48-266) all patients are alive...
November 2016: Annals of Medicine and Surgery
Daniyal J Jafree, Katharine Whitehurst, Shivanchan Rajmohan
In this article, we use our experiences to provide tips for contacting potential supervisors, what to expect from them and how to approach them for research opportunities. With appropriate planning, you will be surprised by the number of prestigious academics who would be willing for you to join their research group, and to get you involved in a research project.
September 2016: Annals of Medicine and Surgery
Navnit Makaram, Iskander H Chaudhry, Makaram S Srinivasan
INTRODUCTION: Mucous cyst is the commonest soft tissue tumor in the dorsum of the distal interphalangeal joint (DIPJ) of the finger. We report the first case of a recurring eccrine tumor (nodular hidradenoma), mimicking a mucous/ganglion cyst, on the dorsum of the DIPJ. CASE REPORT: A 54 year old man presented with painless, hemispherical, colored swelling on the dorsum of his right middle finger (dominant hand), which appeared to have recurred from a previous surgery...
September 2016: Annals of Medicine and Surgery
Suman B Koganti, Ravikanth Kongara, Sateesh Boddepalli, Naushad Shaik Mohammad, Venumadhav Thumma, Bheerappa Nagari, R A Sastry
INTRODUCTION: Although surgery is the preferred treatment for grade III&IV pancreatic trauma, there is a growing movement for non-operative management. in blunt pancreatic trauma. Very few studies compare operative versus non-operative management in adult patients. METHODS: Retrospective analysis of a prospectively maintained database was performed from 2004 to 2013 in the department of gastrointestinal surgery, NIMS, Hyderabad. Comparative analysis was performed between patients who failed versus those who were successfully managed with non-operative management...
September 2016: Annals of Medicine and Surgery
Hilmi Bozkurt, Oktay İrkörücü, Mehmet Aziret, Enver Reyhan, Mehmet Kemal Okuyan
BACKGROUND: Thyroid nodules are commonly encountered problems in clinical practice. For patients who have a thyroid nodule, the fine-needle aspiration biopsy (FNAB) is the most important test, as it is the most reliable diagnostic method for distinguishing between benign thyroid nodules and cancerous nodules. FNAB is able to be performed either via an ultrasound (USG) or alone and is the first choice when it comes to diagnosing thyroid nodules, given that it is cheap, safe and provides accurate results...
September 2016: Annals of Medicine and Surgery
Rohit Singh, Akshay Malhotra, Gillian Cribb, Paul Cool, Stuart Hay
Impingement syndrome is usually caused by irritation of the rotator cuff within the sub acromial space and this includes the coraco-acromial arch (Acromion and Coraco-acromial ligament), the acromio-clavicular joint and occasionally the coracoid. Iatrogenic causes such as sutures, pins, plates or wires left from previous surgery can cause similar symptoms. We present a series of four cases mimicking "classical" impingement symptoms/signs in which the causal pathology was identified outside the sub-acromial space...
September 2016: Annals of Medicine and Surgery
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