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https://www.readbyqxmd.com/read/28937303/palliative-coverage-of-cranial-defect-following-failed-cranial-flap-for-advanced-squamous-cell-carcinoma-case-report
#1
Vyacheslav Makler, Jeffrey S Litt, N Scott Litofsky
INTRODUCTION: With advanced-stage head and neck cancers, patients may develop large and/or complex wounds despite multiple reconstruction attempts. Wound coverage may require novel approaches to palliate the patient. METHOD: We present the case of a 56-year-old female with advanced squamous cell carcinoma of the scalp and skull who required multiple surgical interventions. Despite our best reconstructive efforts, the patient subsequently developed scalp infection and sepsis, necessitating further debridement for source control...
September 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28933370/a-case-of-systemic-infection-caused-by-streptococcus-pyogenes-oral-infection-in-an-edentulous-patient
#2
Yumi Inagaki, Masanobu Abe, Ryoko Inaki, Liang Zong, Hideyuki Suenaga, Takahiro Abe, Kazuto Hoshi
BACKGROUND: Infections in the oral and maxillofacial region can sometimes extend beyond the oral cavity, with serious consequences. Most oral infections are odontogenic, occurring through the root apex of the tooth or the periodontal pocket. It thus makes sense that edentulous patients have a much lower risk of oral bacterial infection. For this reason, while there are many reports on systemic infections caused by oral infections, few of these describe such infections in edentulous patients...
August 18, 2017: Diseases (Basel)
https://www.readbyqxmd.com/read/28930569/the-biology-of-the-platelet-with-special-reference-to-inflammation-wound-healing-and-immunity
#3
Alan T Nurden
While platelets have long been known to be essential for maintaining hemostasis in the vasculature, their role in tissue repair, inflammation and innate and adaptive immunity is a more recent science. The ability of platelets to attach to the vessel wall, form aggregates and promote fibrin formation, key elements of blood clotting, has been said to both favor and dampen inflammation, to fight infection and to assure an adequate immune response. To fulfill their different roles platelets often synchronize with leukocytes and cells of the immune system...
January 1, 2018: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28926879/-systematic-evaluation-on-effectiveness-and-safety-of-recombinant-human-growth-hormone-in-treating-adult-patients-with-severe-burn
#4
F Y Tian, B Wu, T Xu, X H Jiang
Objective: To systcmatically evaluate the effectiveness and safety of recombinant human growth hormone (rhGH) in treating adults with severe burn. Methods: Databases including PubMed, Cochrane Library, and Embase were searched using key words " burns, thermal, human growth hormone, growth hormone, hGH, and somatropin (human)" , and China Biology Medicine disc, Chinese Journals Full-text Database, VIP Database, and Wanfang Database were searched using key words in Chinese version "," to obtain the randomized controlled trials about rhGH in the treatment of adults with severe burn from the establishment of each database to December 2016...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28918465/congenital-lumbar-kyphosis-with-skin-ulceration-and-osteomyelitis-in-a-myelomeningocele-child-a-case-report
#5
Benoit Vibert, Marco Turati, Pierre-Yves Rabattu, Marco Bigoni, Ahmad Eid, Aurélien Courvoisier
INTRODUCTION: Kyphosis is a frequent problem in children with spina bifida, and this deformity may cause different complications as respiratory insufficiency, bowel dysfunction, and skin ulcers. CASE REPORT: We report on a 13-year-old myelomeningocele male with a lumbar kyphoscoliosis associated to a septic skin ulceration that resulted in an acute sepsis. An X-ray revealed a kyphosis of 110° and a scoliosis of 25° between T9 and L5. The wound and blood cultures showed Staphylococcus aureus colonization, and an appropriate antibiotic therapy was started...
September 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28902473/preoperative-biliary-drainage-for-malignant-biliary-obstruction-results-from-a-national-database
#6
Yasser Shaib, Mahmoud A Rahal, Mohammad O Rammal, Aurelie Mailhac, Hani Tamim
INTRODUCTION: The impact of preoperative biliary drainage (PBD) on postoperative morbidity and mortality in patients with malignant biliary obstruction is still unclear. We examined short-term surgical outcomes among drained and non-drained patients. METHODS: We identified patients who underwent surgical resection for their malignancies with biliary obstruction using the American College of Surgeons National Surgical Quality Improvement Program Participant Use Files, from 2014 to 2015...
September 13, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28900830/transhiatal-vs-transthoracic-esophagectomy-a-nsqip-analysis-of-postoperative-outcomes-and-risk-factors-for-morbidity
#7
Francisco Schlottmann, Paula D Strassle, Marco G Patti
BACKGROUND: Both transhiatal esophagectomy (THE) and transthoracic esophagectomy (TTE) are accepted procedures for esophageal resection. We aimed to compare postoperative outcomes between these procedures and identify risk factors for morbidity. METHODS: A retrospective analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program database. Adult patients who underwent THE or TTE between 2005 and 2014 were included. Postoperative morbidity, length of stay, and 30-day mortality were compared...
September 12, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28894682/frailty-is-predictive-of-adverse-postoperative-events-in-patients-undergoing-lumbar-fusion
#8
Dante M Leven, Nathan J Lee, Jun S Kim, Parth Kothari, Jeremy Steinberger, Javier Guzman, Branko Skovrlj, John I Shin, Kevin Phan, John M Caridi, Samuel K Cho
STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVE: To analyze the modified frailty index (mFI) as a predictor of adverse postoperative events following posterior lumbar fusion. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database including all adult patients undergoing posterior lumbar interbody fusion or transforaminal lumbar interbody fusion between 2005 and 2012...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28887240/temporal-trends-determinants-and-outcomes-of-inpatient-versus-outpatient-arteriovenous-fistula-operations
#9
Caitlin W Hicks, Michael Bronsert, Karl E Hammermeister, William G Henderson, Douglas R Gibula, James H Black, Natalia O Glebova
ObjectivesAs high health care costs are increasing scrutinized, a movement toward reducing patient hospital admissions and lengths of stay has emerged, particularly for operations that may be performed safely in the outpatient setting. Our aim is to describe recent temporal trends in the proportion of dialysis access procedures performed on an inpatient vs. outpatient basis, and to determine the effects of these changes on perioperative morbidity and mortality. MethodsThe 2005-2008 ACS NSQIP database was queried for all primary arteriovenous fistula (AVF) procedures using CPT codes...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28876695/the-role-of-procalcitonin-as-a-diagnostic-marker-of-bacterial-sepsis-in-burns
#10
D L Wineberg, D Kruger
BACKGROUND: Patients with burn wounds are at high risk of infection. Since sepsis contributes significantly to morbidity and mortality, early diagnosis is essential. Procalcitonin (PCT) is a biomarker released in response to inflammation and specifically bacterial infection. It may therefore be a useful biomarker for sepsis in burns. METHOD: All adult patients admitted to two Burns Intensive Care Units in Johannesburg were included in a retrospective data review...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876688/management-of-myelomeningocele-in-the-province-of-kwazulu-natal-south-africa
#11
M N Mnguni, B Enicker, T E Madiba
BACKGROUND: Spina bifida is the most common of congenital anomalies of the central nervous system that are compatible with life. The most frequent form is myelomeningocele. METHOD: Setting: Neurosurgery Unit, Inkosi Albert Luthuli Central Hospital. Patients: Consecutive children with diagnosis myelomeningocele who were managed at from January 2006 to December 2014. Design: Retrospective analysis of children with myelomeningocele. Multiple logistic regression analysis identified clinical, demographic and surgical variables that were associated with outcome...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876642/outcome-of-liver-resection-for-carcinoid-neuroendocrine-metastases
#12
M D Polkinghorne, J E J Krige, E Jonas, U K Kotze, M M Bernon
BACKGROUND: Gastrointestinal carcinoid tumours, despite their low malignant potential, frequently metastasize to the liver. While liver resection improves survival and provides symptomatic relief, multifocal bilobar disease complicates surgical management. METHOD: All patients with carcinoid liver secondaries managed by resection from 1990-2015 were identified from a prospective departmental database. Demographic data, operative management, morbidity using the Accordion classification and mortality were analysed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876574/holding-the-torch-up-high-a-medical-historical-evaluation-of-surgical-advances-during-the-great-war-1914-1918-in-memory-of-those-that-served-and-fell
#13
G Scharf
"How wide and varied is the experience of the battlefield and how fertile the blood of warriors in raising good surgeons" Sir Clifford Allbutt (1898). With these sentiments of the medical lessons learned in war and conflict, with the background of the poem of "In Flanders Field", written by a doctor who had South African War connections, reasons (the Somme and third Ypres battles) will be given that this was indeed a "GREAT WAR" as the world history, weapons, strategy, tactics and wounding patterns had changed dramatically...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28873411/preoperative-asymptomatic-leukocytosis-and-postoperative-outcome-in-cardiac-surgery-patients
#14
Eitezaz Mahmood, Ziyad O Knio, Feroze Mahmood, Rabia Amir, Sajid Shahul, Bilal Mahmood, Yanick Baribeau, Ariel Mueller, Robina Matyal
BACKGROUND: Despite showing a prognostic value in general surgical patients, preoperative asymptomatic elevated white blood cell (WBC) count is not considered a risk factor for cardiac surgery. Whereas there is sporadic evidence of its value as a preoperative risk marker, it has not been looked at methodically as a specific index of outcome during cardiac surgery. Using a national database we sought to determine the relationship between preoperative WBC count and postoperative outcome in cardiac surgical patients...
2017: PloS One
https://www.readbyqxmd.com/read/28871817/cytotoxicity-in-vitro-anti-leishmanial-and-fingerprint-hplc-photodiode-array-analysis-of-the-roots-of-trillium-govanianum
#15
Kashif Maqbool Khan, Lutfun Nahar, Abdul Mannan, Ihsan Ul-Haq, Muhammad Arfan, Ghazanfar Ali Khan, Izhar Hussain, Satyajit D Sarker
Trillium govanianum Wall. ex D. Don (Melanthiaceae alt. Trilliaceae), commonly known as 'nagchhatry' or 'teen patra', distributed from Pakistan to Bhutan about 2500-3800 m altitude is indigenous to Himalayas region. In folk medicine the plant has been reported for the treatment of wound healing, sepsis and in various sexual disorders. This paper reports, for the first time, to evaluate the cytotoxicity, in vitro anti-leishmanial (promastigotes) and fingerprint HPLC-photodiode array analysis of the MeOH extract of the roots of T...
September 5, 2017: Natural Product Research
https://www.readbyqxmd.com/read/28865996/comparative-perioperative-outcomes-in-septuagenarians-and-octogenarians-undergoing-radical-cystectomy-for-bladder-cancer-do-outcomes-differ
#16
Tyler D Haden, Megan C Prunty, Alexander B Jones, Chelsea B Deroche, Katie S Murray, Naveen Pokala
BACKGROUND: Treatment choice for muscle invasive bladder cancer continues to be radical cystectomy. However, radical cystectomy carries a relatively high risk of morbidity and mortality compared with other urological procedures. OBJECTIVE: To compare surgical complications following radical cystectomy in septuagenarians and octogenarians. DESIGN, SETTING, AND PARTICIPANTS: The National Surgical Quality Improvement Program database (2009-2013) was used to identify patients who were 70 yr and older and underwent radical cystectomy...
August 30, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28857797/a-comparison-of-3-frailty-indices-in-predicting-morbidity-and-mortality-after-on-pump-aortic-valve-replacement
#17
Gary Esses, Evie Andreopoulos, Hung-Mo Lin, Shipra Arya, Stacie Deiner
BACKGROUND: Aortic valve replacement is a high-risk surgery (3%-5%, 30-day mortality) performed on approximately 30,000 elderly patients a year in the United States. Currently, preoperative risk assessment is based on a composite of medical examination and a subjective evaluation for frailty ("eyeball test"). Objective frailty assessment using validated indices has the potential to improve risk stratification. The purpose of this study was to (1) establish whether frailty can predict 30-day mortality and composite morbidity in patients undergoing aortic valve replacement and (2) compare the predictive ability of 3 frailty indices in this population...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28856354/severity-weighting-of-postoperative-adverse-events-in-orthopedic-surgery
#18
Daniel D Bohl, Junyoung Ahn, Adam M Lukasiewicz, Andre M Samuel, Matthew L Webb, Bryce A Basques, Nicholas S Golinvaux, Kern Singh, Jonathan N Grauer
Studies of adverse events (AEs) after orthopedic surgery commonly use composite AE outcomes. An example of such an outcome is any AE. These types of outcomes treat AEs with different clinical significance (eg, death, urinary tract infection) similarly. We conducted a study to address this shortcoming in research methodology by creating a single severity-weighted outcome that can be used to characterize the overall severity of a given patient's postoperative course. All orthopedic faculty members at 2 academic institutions were invited to complete a severity-weighting exercise in which AEs were assigned a percentage severity of death...
July 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28855778/older-age-comorbid-illnesses-and-injury-severity-affect-immediate-outcome-in-elderly-trauma-patients
#19
Dvora Kirshenbom, Zila Ben-Zaken, Nehama Albilya, Eva Niyibizi, Miklosh Bala
INTRODUCTION: Trauma in elderly population is frequent and is associated with significant mortality, not only due to age but also due to complicated factors such as the severity of injury, preexisting comorbidity, and incomplete general assessment. Our primary aim was to determine whether age, Injury Severity Score (ISS), and preexisting comorbidities had an adverse effect on the outcome in patients aged 65 years and above following blunt trauma. METHODS: We included 1027 patients aged ≥65 years who were admitted to our Level I Trauma Center following blunt trauma...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28852877/first-report-of-postoperative-intracranial-weeksella-virosa-infection
#20
Sebastian M Toescu, Sandra Lacey, Hu Liang Low
A 49-year-old female underwent multiple craniotomies for resection of recurrent malignant meningiomata (WHO grade III). She re-presented with sepsis due to a ventricular empyema. The craniotomy wound was urgently debrided, and isolates of the gram-negative rod, Weeksella virosa, were identified on 16S PCR. This species is most commonly found as a genitourinary commensal. We present the first documented intracranial infection by Weeksella virosa and its successful treatment with oral β-lactam antibiotics.
August 29, 2017: Acta Neurochirurgica
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