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https://www.readbyqxmd.com/read/27919836/concomitant-hiatal-hernia-repair-with-laparoscopic-sleeve-gastrectomy-is-safe-analysis-of-the-acs-nsqip-database
#1
Hanaa N Dakour Aridi, Hani Tamim, Aurelie Mailhac, Bassem Y Safadi
BACKGROUND: Gastroesophageal acid reflux disease (GERD) is prevalent after laparoscopic sleeve gastrectomy (LSG), a common bariatric surgical procedure worldwide. Some studies have suggested that concomitant hiatal hernia repair (HHR) during LSG reduces the risk of GERD, but this has not been substantiated. Little is known about the safety of adding an HHR in this setting. The present study aims to compare 30-day morbidity and mortality and length of hospital stay between patients undergoing LSG alone and those undergoing LSG with HHR...
October 5, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27916444/influence-of-weight-at-enterostomy-reversal-on-surgical-outcomes-in-infants-after-emergent-neonatal-stoma-creation
#2
Lindsay J Talbot, Robert D Sinyard, Kristy L Rialon, Brian R Englum, Elizabeth T Tracy, Henry E Rice, Obinna O Adibe
PURPOSE: Neonates after emergent enterostomy creation frequently require reversal at low weight because of complications including cholestasis, dehydration, dumping, failure to thrive, and failure to achieve enteral independence. We investigated whether stoma reversal at low weight (< 2.5kg) is associated with poor surgical outcomes. METHODS: Patients who underwent enterostomy reversal from 2005 to 2013 at less than 6months old were identified in our institutional database...
October 25, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27909820/genomic-analysis-reveals-the-presence-of-a-class-d-beta-lactamase-with-broad-substrate-specificity-in-animal-bite-associated-capnocytophaga-species
#3
S Zangenah, A F Andersson, V Özenci, P Bergman
Capnocytophga canimorsus and Capnocytophga cynodegmi can be transmitted from cats and dogs to humans, and can cause a wide range of infections including wound infections, sepsis, or endocarditis. We and others recently discovered two new Capnocytophaga species, C. canis and C. stomatis, mainly associated with wound infections. The first-line treatment of animal bite related infections is penicillin, and in case of allergy, doxycycline and trimethoprim/sulfamethoxazole. However, there is a lack of antibiotic susceptibility patterns for animal bite associated Capnocytophaga species...
December 1, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27898352/management-of-the-open-abdomen-using-negative-pressure-wound-therapy-with-instillation-in-severe-abdominal-sepsis-a-review-of-48-cases-in-hospital-mexico-costa-rica
#4
Pablo Sibaja, Alfredo Sanchez, Guillermo Villegas, Alvaro Apestegui, Esteban Mora
INTRODUCTION: Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27893639/surgical-rescue-the-next-pillar-of-acute-care-surgery
#5
Matthew E Kutcher, Jason L Sperry, Matthew R Rosengart, Deepika Mohan, Marcus K Hoffman, Matthew D Neal, Louis H Alarcon, Gregory A Watson, Juan Carlos Puyana, Graciela M Bauzá, Vaishali D Schuchert, Anisleidy Fombona, Tianhua Zhou, Samuel Zolin, Robert D Becher, Timothy R Billiar, Raquel M Forsythe, Brian S Zuckerbraun, Andrew B Peitzman
BACKGROUND: The evolving field of Acute Care Surgery (ACS) traditionally includes trauma, emergency general surgery, and critical care. However, the critical role of ACS in the rescue of patients with a surgical complication has not been explored. We here describe the role of 'surgical rescue' in the practice of Acute Care Surgery (ACS). METHODS: A prospective, electronic medical record-based ACS registry spanning January 2013 to May 2014 at a large urban academic medical center was screened by ICD-9 codes for acute surgical complications of an operative or interventional procedure...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#6
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27882755/prague-1337-the-first-successful-caesarean-section-in-which-both-mother-and-child-survived-may-have-occurred-in-the-court-of-john-of-luxembourg-king-of-bohemia
#7
A Pařízek, V Drška, M Říhová
OBJECTIVE: An interdisciplinary historical-medical study, analysis of historical sources, and critical interpretation of the indirect evidence surrounding the childbirth of Beatrice of Bourbon, the second wife of the Bohemian King John of Luxembourg. STUDY TYPE: A material-based study founded on a comparative analysis of available private and public sources, particularly surviving letters, and narrative sources. The conclusions are reached based on a textual interpretation according to historical methods...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27862040/central-extracorporeal-life-support-with-left-ventricular-decompression-to-berlin-heart-excor-a-reliable-bridge-to-bridge-strategy-in-crash-and-burn-patients
#8
Alexander Weymann, Mina Farag, Anton Sabashnikov, Javid Fatullayev, Mohamed Zeriouh, Bastian Schmack, Rawa Arif, Florian Müller, Christina Alt, Philip Raake, Nikhil Prakash Patil, Aron-Frederik Popov, Andre Rüdiger Simon, Matthias Karck, Arjang Ruhparwar
The aim of this study was to compare patients with severe biventricular heart failure who underwent Berlin Heart Excor implantation with (cardiogenic shock [CS] status) or without the need for preoperative extracorporeal life support (ECLS) as a bridge to long-term device. A total of 40 consecutive patients with severe biventricular heart failure underwent Berlin Heart Excor implantation with (CS status, n = 20, 50%) or without (control, n = 20, 50%) the need for preoperative ECLS as a bridge to long-term device from March 2007 to May 2015 at our institution...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27846299/hyperglycemia-induces-skin-barrier-dysfunctions-with-impairment-of-epidermal-integrity-in-non-wounded-skin-of-type-1-diabetic-mice
#9
Junko Okano, Hideto Kojima, Miwako Katagi, Takahiko Nakagawa, Yuki Nakae, Tomoya Terashima, Takeshi Kurakane, Mamoru Kubota, Hiroshi Maegawa, Jun Udagawa
Diabetes causes skin complications, including xerosis and foot ulcers. Ulcers complicated by infections exacerbate skin conditions, and in severe cases, limb/toe amputations are required to prevent the development of sepsis. Here, we hypothesize that hyperglycemia induces skin barrier dysfunction with alterations of epidermal integrity. The effects of hyperglycemia on the epidermis were examined in streptozotocin-induced diabetic mice with/without insulin therapy. The results showed that dye leakages were prominent, and transepidermal water loss after tape stripping was exacerbated in diabetic mice...
2016: PloS One
https://www.readbyqxmd.com/read/27842634/a-review-of-the-peri-operative-management-of-paediatric-burns-identifying-adverse-events
#10
H Rode, C Brink, K Bester, M P Coleman, T Baisey, R Martinez
BACKGROUND: Burn injuries are common in poverty-stricken countries. The majority of patients with large and complex burns are referred to burn centres. Of the children who qualify for admission, according to burn admission criteria, about half require some kind of surgical procedure to obtain skin cover. These range from massive full-thickness fire burns to skin grafts for small, residual unhealed wounds. Burn anaesthetic procedures are of the most difficult to perform and are known for high complication rates...
November 2, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27836310/effects-of-perioperative-supplementation-with-pro-synbiotics-on-clinical-outcomes-in-surgical-patients-a-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#11
Xiang-Dong Wu, Meng-Meng Liu, Xi Liang, Ning Hu, Wei Huang
BACKGROUND & AIMS: The Potential benefits and possible risks of perioperative supplementation with probiotics/synbiotics in surgical patients are not fully understood. Recent evidence has rapidly evolved and conveys conflicting results. Thus, we undertook a meta-analysis of randomized controlled trials (RCTs) to valuate the effectiveness, safety, cost-effectiveness and quality of life of perioperative supplementation with pro-/synbiotics. METHODS: We systematically searched PubMed, Embase and the Cochrane Library through October 2015 to identify RCTs that assessed the effects of perioperative supplementation with pro-/synbiotics in surgical patients...
October 26, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27827282/primary-wound-closure-of-diabetic-foot-ulcers-by-debridement-and-stitching
#12
M E Ahmed, M S Mohammed, S I Mahadi
OBJECTIVE: The role of stitching in healing diabetic foot ulcers (DFUs) has little attention, with few reports published on the technique. This study aimed to report on the role of stitching in healing of neuropathic DFUs. METHOD: This comparative study was between patients with diabetes with neuropathic foot ulcers who had undergone wound stitching and those on conventional wound care. The study was carried in Jabir Abu Eliz Diabetic Center Khartoum (JADC) during between January 1 2011 and January 1 2013...
November 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27822733/-cutaneous-manifestations-in-renal-diseases
#13
M Schmid-Simbeck, A Udvardi, B Volc-Platzer
In addition to general skin changes like pallor or dryness and the frequent, often excruciating nephrogenic pruritus, specific diseases in patients with renal failure may occur. Acquired perforating dermatoses are usually also highly pruritic. Calciphylaxis is a severe disease with poor prognosis. Nonhealing wounds with superinfection and progression to sepsis are characteristic. Bullous lesions can be caused by disturbances in porphyrin metabolism. Nephrogenic systemic fibrosis is a disease which was first described in 2000...
December 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/27812810/-local-fixation-of-antibiotics-by-fibrin-spray-in-bone-defects-with-soft-tissue-involvement
#14
Maren Janko, Christoph Nau, Ingo Marzi, Johannes Frank
In acute and chronic bone infections with concomitant soft tissue involvement the current gold standard is radical surgical debridement including explantation of the infected prosthetic devices. This is followed by initiation of systemic antibiotic therapy appropriate for the antibiogram. Several revision operations are often necessary to achieve complete healing. Additional treatment with local antibiotics or antibiotic-containing substances is routinely used in bone surgery. Apart from the typical procedures with commercially available products, we have conducted a study with 21 patients by application of local antibiotic treatment in combination with the fibrin glue spray technique and evaluated the results...
November 3, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27811344/evaluating-the-effectivenes-of-antiseptic-solution-decasan-in-treatment-of-necrotic-soft-tisue-diseases
#15
Julia Fuss, Victor Palii, Anna Voloboyeva
: Sepsis is a severe generalised infection caused usually by pathogenic bacteria. It is often the cause of hospitalization and death in patients treated in intensive care and other hospital wards. Latest research brought to better understanding of patomechanisms, took place significant development of therapy heading to improvement of general patients condition treated as a basis and additionally supported by local therapy. The aim of the study was to evaluate the possibility of using the solution Decasan in the comprehensive treatment of patients necrosis of soft tissues...
October 1, 2016: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/27805961/intraoperative-adverse-events-in-abdominal-surgery-what-happens-in-the-operating-room-does-not-stay-in-the-operating-room
#16
Jordan D Bohnen, Michael N Mavros, Elie P Ramly, Yuchiao Chang, D Dante Yeh, Jarone Lee, Marc de Moya, David R King, Peter J Fagenholz, Kathryn Butler, George C Velmahos, Haytham M A Kaafarani
OBJECTIVE: We sought to assess the impact of intraoperative adverse events (iAEs) on 30-day postoperative mortality, 30-day postoperative morbidity, and postoperative length of stay (LOS) among patients undergoing abdominal surgery. We hypothesized that iAEs would be associated with significant increases in each outcome. SUMMARY OF BACKGROUND DATA: The relationship between iAEs and postoperative clinical outcomes remains largely unknown. METHODS: The 2007 to 2012 institutional ACS-NSQIP and administrative databases for abdominal surgeries were matched then screened for iAEs using the Agency for Healthcare Research and Quality's 15 Patient Safety Indicator, "Accidental Puncture/Laceration"...
November 1, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27803955/open-repair-of-aaa-in-a-high-volume-center
#17
Lazar B Davidovic, Milanko Maksic, Igor Koncar, Nikola Ilic, Marko Dragas, Nikola Fatic, Miroslav Markovic, Igor Banzic, Perica Mutavdzic
OBJECTIVE: To assess results of open repair (OR) of AAA in a single high volume center. METHODS: We analyzed prospectively collected data of 450 patients who underwent elective OR of AAA at the Clinic for Vascular and Endovascular Surgery of the Serbian Clinical Centre in the period between January 2013 and September 2014. RESULTS: Postoperative death occurred in seven patients (1. 55%) during the first 30 postoperative days. The mortality was caused by: uncontrolled bleeding-1, acute myocardial infarction-1, ischemic colitis-2, MOFS-2, sepsis due to infection and dehiscence of laparotomy wound-1...
November 1, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27803084/severe-soft-tissue-infection-masquerading-as-necrotising-fasciitis-in-a-31-year-old-woman-with-a-background-of-right-thigh-arteriovenous-malformation
#18
Pennylouise Hever, Naveen Cavale, Paul Harnett
A 31-year-old woman with a history of a right thigh arteriovenous malformation presented with an acute history of right thigh pain and swelling. This rapidly progressed to gross sepsis. She was intubated, requiring inotropic support and renal replacement therapy. She was considered disproportionately unwell, with the impression one of necrotising fasciitis (NF). She was taken to theatre for emergency exploration and debridement. There was no evidence of NF to note in theatre. Tissue samples cultured group C Streptococcus, with histopathological examination confirming group C Streptococcal soft tissue infection...
November 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27798649/vibrio-vulnificus-type-6-secretion-system-1-contains-anti-bacterial-properties
#19
Selina R Church, Thomas Lux, Craig Baker-Austin, Sam P Buddington, Stephen Ll Michell
Vibrio vulnificus is a bacterium responsible for severe gastroenteritis, sepsis and wound infections. Gastroenteritis and sepsis are commonly associated with the consumption of raw oysters, whereas wound infection is often associated with the handling of contaminated fish. Although classical virulence factors of this emerging pathogen are well characterised, there remains a paucity of knowledge regarding the general biology of this species. To investigate the presence of previously unreported virulence factors, we applied whole genome sequencing to a panel of ten V...
2016: PloS One
https://www.readbyqxmd.com/read/27796667/lymphocyte-integrin-expression-differences-between-sirs-and-sepsis-patients
#20
D S Heffernan, S F Monaghan, Alfred Ayala
BACKGROUND: Systemic Inflammatory Response Syndrome (SIRS) and sepsis remain leading causes of death. Despite many similarities, the two entities are very distinct clinically and immunologically. T-Lymphocytes play a key pivotal role in the pathogenesis and ultimately outcome following both SIRS and sepsis. Integrins are essential in the trafficking and migration of lymphocytes. They also serve vital roles in efficient wound healing and clearance of infections. Here, we investigate whether integrin expression, specifically β1 (CD29) and β2 (CD18), are disrupted in SIRS and sepsis, and assess differences in integrin expression between these two critically ill clinical categories...
October 31, 2016: Irish Journal of Medical Science
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