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https://www.readbyqxmd.com/read/29787546/selective-non-operative-management-of-pharyngo-esophageal-injuries-secondary-to-penetrating-neck-trauma-a-single-center-review-of-86-cases
#1
Andre S Madsen, George V Oosthuizen, John L Bruce, Wanda Bekker, Grant L Laing, Damian L Clarke
BACKGROUND: This paper describes our experience with penetrating pharyngo-esophageal injuries (PEI) in the light of a selective conservative approach, and has the objective to define criteria for non-operative management (NOM). METHODS: This retrospective single-center review of patients with penetrating neck injury (PNI) treated for confirmed PEI over a 6-year period aimed to test our proposed hypothesis that NOM is safe for hemodynamically stable patients with PEI, who have no competing indications for exploration, have no established sepsis and who have a water-soluble contrast swallow (WS-swallow) either showing no- or a contained extravasation...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29780599/perioperative-blood-transfusion-is-associated-with-post-operative-infectious-complications-in-patients-with-crohn-s-disease
#2
Nan Lan, Luca Stocchi, Yi Li, Bo Shen
Background: We have previously demonstrated that blood transfusion (BT) was associated with post-operative complications in patients undergoing surgery for Crohn's disease (CD), based on our institutional data registry. The aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Methods: All CD patients undergoing surgery between 2005 and 2013 were identified from NSQIP...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#3
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29734459/-application-of-vacuum-wound-therapy-with-split-thickness-skin-grafts-in-the-head-and-neck-area
#4
Julia Thierauf, Paul Severin Wiggenhauser, Thomas Karl Hoffmann, Jens Greve, Marc Scheithauer, Johannes Adrian Veit
OBJECTIVE: In vacuum wound therapy (VAC) a negative pressure can continuously clean effusions and enhance the formation of granulation tissue significantly. In visceral, trauma and burns surgery this technique is used frequently in critical wounds. In the head and neck area there is limited experience and publications. Especially in the combined use of split-thickness-skin grafts (STSG) and VAC there is no published evidence. MATERIAL AND METHODS: A retrospective database analysis was done and resulted in 36 single VAC therapies in 13 patients...
May 7, 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29732433/bowel-injury-in-lumbar-spine-surgery-a-review-of-the-literature
#5
REVIEW
Ioannis Siasios, Kunal Vakharia, Asham Khan, Joshua E Meyers, Samantha Yavorek, John Pollina, Vassilios Dimopoulos
Although rarely documented in the medical literature, bowel perforation injury can be a severe complication of spine surgery. Our goal was to review current literature regarding this complication and study possible methods of avoidance. We conducted a literature search in the PubMed database between January 1960 and March 2016 using the terms abrasion, bowels, bowel, complication, injury, intestine, intra-abdominal sepsis/shock, perforation, lumbar, spine, surgery, visceral. Diagnostic criteria, outcomes, risk factors, surgical approach, and treatment strategy were the parameters extracted from the search results and used for review...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29731960/interleukin-26-il-26-is-a-novel-anti-microbial-peptide-produced-by-t-cells-in-response-to-staphylococcal-enterotoxin
#6
Anders Woetmann, Morten Alhede, Sally Dabelsteen, Thomas Bjarnsholt, Morten Rybtke, Claudia Nastasi, Thorbjørn Krejsgaard, Mads Hald Andersen, Charlotte M Bonefeld, Carsten Geisler, Michael Givskov, Niels Odum
Anti-microbial peptides are produced at outer and inner surfaces by epithelia and innate immune cells in response to bacterial infection. Staphylococcus aureus is an enterotoxin producing, Gram-positive pathogen, which is a major cause of soft tissue infections and life-threatening bacteremia and sepsis. Here we show that (i) skin T cells in chronic wounds infected with S. aureus express interleukin-26 (IL-26) in situ , (ii) staphylococcal enterotoxins (SE) trigger IL-26 expression in T cell lines and primary skin T cells, and (iii) IL-26 triggers death and inhibits biofilm formation and growth of S...
April 13, 2018: Oncotarget
https://www.readbyqxmd.com/read/29730734/robotic-assisted-inguinal-lymphadenectomy-a-systematic-review
#7
REVIEW
Ioannis D Gkegkes, Evelyn Eleni Minis, Christos Iavazzo
BACKGROUND: Lymphadenectomy represents the standard treatment for various types of cancer. The introduction of robotics in lymph node dissection may have an important impact on post-lymphadenectomy complications. METHODS: A systematic literature review was performed. RESULTS: In our review, robotic inguinal lymphadenectomy was performed on 51 patients. Penile squamous cell carcinoma was the most common histological type of the primary neoplasia...
May 5, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29708866/the-characterization-of-monoclonal-antibodies-to-mouse-tlt-1-suggests-that-tlt-1-plays-a-role-in-wound-healing
#8
Barbara Manfredi, Jessica Morales-Ortíz, Lymarie M Díaz-Díaz, Liz Hernandez-Matias, Delmaliz Barreto-Vázquez, Javier Menéndez-Pérez, J Alejandro Rodríguez-Cordero, Juan C Villalobos-Santos, Edgardo Santiago-Rivera, Adriana Rivera-Dompenciel, Eunice L Lozada-Delgado, Madhavi Kuchibhotla, Kelvin Carrasquillo-Carrión, Abiel Roche-Lima, A Valance Washington
Platelets play a vital role in hemostasis and inflammation. The membrane receptor TREM-like transcript-1 (TLT-1) is involved in platelet aggregation, bleeding, and inflammation, and it is localized in the α-granules of platelets. Upon platelet activation, TLT-1 is released from α-granules both in its transmembrane form and as a soluble fragment (sTLT-1). Higher levels of sTLT-1 have been detected in the plasma of patients with acute inflammation or sepsis, suggesting an important role for TLT-1 during inflammation...
April 2018: Monoclonal Antibodies in Immunodiagnosis and Immunotherapy
https://www.readbyqxmd.com/read/29701364/clinical-utility-of-frailty-scales-for-the-prediction-of-postoperative-complications-systematic-review-and-meta-analysis
#9
Vânia Rocha, Filipe Marmelo, Adelino Leite-Moreira, Daniel Moreira-Gonçalves
INTRODUCTION: Frailty can be defined as a biological syndrome of reduced reserve and resistance to stressful events. Evidence suggests that this syndrome is linked to adverse outcomes in various surgical populations. Several instruments have been developed to measure frailty, however there is no consensus about which one is the most useful in the surgical population. Therefore, this study aims to evaluate the utility of different frailty scales in the prediction of postoperative complications in older surgical population...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697685/-ruptures-of-popliteal-artery-aneurysms
#10
I P Mikhaylov, V N Lavrenov, G A Isaev, L S Kokov, E Yu Trofimova
AIM: To improve diagnosis and surgical outcomes in patients with ruptured popliteal artery aneurysm. MATERIAL AND METHODS: Eight patients with ruptured popliteal artery aneurysm have undergone surgery for the period from 1999 to 2015 at the Vascular Surgery Department of Sklifosovsky Research Institute for Emergency Care. Incidence of rupture was 2.9% from total number of popliteal artery aneurysm. 7 patients with rupture had signs of lower limb ischemia (acute form grade I in 2 (25%) cases, grade IIA in 1 (12...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29679726/late-presenting-dural-tear-incidence-risk-factors-and-associated-complications
#11
Wesley M Durand, J Mason DePasse, Eren O Kuris, JaeWon Yang, Alan H Daniels
BACKGROUND CONTEXT: Unrecognized and inadequately repaired intraoperative durotomies may lead to cerebrospinal fluid leak, pseudomeningocele, and other complications. Few studies have investigated durotomy that is unrecognized intraoperatively and requires additional postoperative management (hereafter, late-presenting dural tear [LPDT]), though estimates of LPDT range from 0.6 - 8.3 per 1,000 spinal surgeries. These single-center studies are based on relatively small sample sizes for an event of this rarity, all with <10 patients experiencing LPDT...
April 18, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29678647/post-mortem-retrieval-of-arterial-allografts-preliminary-results
#12
Dorian Verscheure, Julien Gaudric, Jérémie Jayet, Philippe Tresson, Mohamed Jarraya, Pierre Julia, Marc Coggia, Laurent Chiche, Fabien Koskas
OBJECTIVES: Cryopreserved arterial allografts are vascular substitutes used for arterial reconstructions in a septic field. Their use remains however limited by the shortage of donors. One of the possibilities to address this lack of grafts is to multiply the sources of retrieval. The objective of this preliminary study was the evaluation of the early clinical results and the microbiological safety of arterial grafts retrieved after death. MATERIAL AND METHODS: In addition to the standard conditions of arterial sampling the criteria of inclusion for postmortem retrieval comprised the refrigeration of the body of the donor within four hours following the death, a 24-hour time limit from the death, and the availability of an adapted place for retrieval (surgical unit or death chamber respecting the required aseptic conditions)...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29673562/candida-tropicalis-burn-wound-sepsis-a-series-of-histopathology-confirmed-cases
#13
Chunjie Fan, Qingfen Tian, Guobao Huang, Lei Zhang, Qiuhe Wu, Keyan Zhang
Fungal infection in severely burned patients is a serious problem due to various factors, such as the extensive application of antibiotics. In this study, we report on the course of severely burned patients with Candida tropicalis burn wound sepsis. Five such cases were reviewed. The patients were treated with itraconazole intravenously and simultaneous antibiotics to prevent bacterial infections. In addition, dermabrasion was used to excise the eschar and the wound surface was covered immediately with dermatoplasty...
April 16, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29672156/ursodeoxycholic-acid-protects-against-intestinal-barrier-breakdown-by-promoting-enterocyte-migration-via-egfr-and-cox-2-dependent-mechanisms
#14
Jamie M Golden, Oswaldo H Escobar, Michelle Vl Nguyen, Michael U Mallicote, Patil Kavarian, Mark R Frey, Christopher P Gayer
The intestinal barrier is often disrupted in disease states, and intestinal barrier failure leads to sepsis. Ursodeoxycholic acid (UDCA) is a bile acid that may protect the intestinal barrier. We hypothesized that UDCA would protect the intestinal epithelium in injury models. To test this hypothesis, we utilized an in vitro wound healing assay and a mouse model of intestinal barrier injury. We found that UDCA stimulates intestinal epithelial cell migration in vitro, and this migration was blocked by inhibition of COX-2, EGFR, or ERK...
April 19, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29670801/nonoperative-management-of-multiple-penetrating-cardiac-and-colon-wounds-from-a-shotgun-a-case-report-and-literature-review
#15
Paula M Jaramillo, Jaime A Montoya, David A Mejia, Salin Pereira Warr
Introduction: Surgery for cardiac trauma is considered fatal and for wounds of the colon by associated sepsis is normally considered; however, conservative management of many traumatic lesions of different injured organs has progressed over the years. Presentation of the Case: A 65-year-old male patient presented with multiple shotgun wounds on the left upper limb, thorax, and abdomen. On evaluation, he was hemodynamically stable with normal sinus rhythm and normal blood pressure, no dyspnea, or abdominal pain...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29666944/macrophages-play-an-essential-role-in-trauma-induced-sterile-inflammation-and-tissue-repair
#16
REVIEW
Moritz Peiseler, Paul Kubes
Severe trauma is accompanied by a profound activation of the immune system. Patients with polytrauma develop systemic inflammatory response syndrome (SIRS) and often sepsis, which contributes substantially to high mortality of this condition. On a cellular level, necrosis and loss of plasma membrane integrity lead to the release of endogenous "damage-associated molecular patterns" (DAMPs) as danger signals, which in turn activate innate immune cells. Inflammation that occurs in the absence of invading pathogens has been termed sterile inflammation and trauma with tissue damage represents an acute form of sterile inflammation...
April 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29662744/postoperative-complications-associated-with-rhbmp2-use-in-posterior-posterolateral-lumbar-fusion
#17
Nabil Esmail, Zorica Buser, Jeremiah R Cohen, Darrel S Brodke, Hans-Joerg Meisel, Jong-Beom Park, Jim A Youssef, Jeffrey C Wang, S Tim Yoon
Study Design: Retrospective database review. Objective: Posterior/posterolateral lumbar fusion (PLF) is an effective treatment for a variety of spinal disorders; however, variations in surgical technique have different complication profiles. The aim of our study was to quantify the frequency of various complications in patients undergoing PLF with and without human recombinant bone morphogenetic protein 2 (rhBMP2). Methods: We queried the orthopedic subset of the Medicare database (PearlDiver) between 2005 and 2011 for patients undergoing PLF procedures with and without rhBMP2...
April 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29621481/in-inflamed-intestinal-tissues-and-epithelial-cells-interleukin-22-signaling-increases-expression-of-h19-long-noncoding-rna-which-promotes-mucosal-regeneration
#18
Hua Geng, Heng-Fu Bu, Fangyi Liu, Longtao Wu, Karl Pfeifer, Pauline M Chou, Xiao Wang, Jiaren Sun, Lu Lu, Ashutosh Pandey, Marisa S Bartolomei, Isabelle G De Plaen, Peng Wang, Jindan Yu, Jiaming Qian, Xiao-Di Tan
BACKGROUND & AIMS: Inflammation affects regeneration of the intestinal epithelia; long non-coding RNAs (lncRNAs) regulate cell functions such as proliferation, differentiation, and migration. We investigated the mechanisms by which the lncRNA H19, imprinted maternally expressed transcript (H19) regulates regeneration of intestinal epithelium using cell cultures and mouse models of inflammation. METHODS: We performed RNA-seq transcriptome analyses of intestinal tissues from mice with LPS-induced sepsis to identify lncRNAs associated with inflammation; findings were confirmed by quantitative real-time PCR and in situ hybridization analyses of intestinal tissues from mice with sepsis or dextran sulfate sodium (DSS)-induced mucosal wound healing and patients with ulcerative colitis, compared to healthy individuals (controls)...
April 2, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29611159/perioperative-outcomes-and-short-term-complications-following-total-knee-arthroplasty-in-chronically-immunosuppressed-patients
#19
Gannon L Curtis, Morad Chughtai, Anton Khlopas, Jared M Newman, Assem A Sultan, Nipun Sodhi, Wael K Barsoum, Carlos A Higuera, Michael A Mont
BACKGROUND: Although there are studies regarding immunosuppressed patients undergoing total knee arthroplasty (TKA) for inflammatory arthritis or osteonecrosis, there is a paucity of studies evaluating immunosuppressed patients undergoing TKA for diagnoses other than these. MATERIALS AND METHODS: We identified all patients undergoing primary TKA for osteoarthritis from 2008-2014 in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database...
March 29, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29595747/postoperative-infection-in-patients-undergoing-posterior-lumbosacral-spinal-surgery-a-pictorial-guide-for-diagnosis-and-early-treatment
#20
Shih-Hao Chen, Wen-Jer Chen, Meng-Huang Wu, Jen-Chung Liao, Chen-Ju Fu
Surgical site infections after posterior spinal surgery may lead to spondylodiscitis, pseudarthrosis, correction loss, adverse neurological sequelae, sepsis, and poor outcomes if not treated immediately. Infection rates vary depending on the type and extent of operative procedures, use of instrumentation, and patients' risk factors. Image evaluation is crucial for early diagnosis and should be complementary to clinical routes, laboratory survey, and treatment timing. Magnetic resonance imaging detects early inflammatory infiltration into the vertebrae and soft tissues, including hyperemic changes of edematous marrow, vertebral endplate, and abscess or phlegmon accumulation around the intervertebral disk, epidural, and paravertebral spaces...
March 27, 2018: Clinical Spine Surgery
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