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https://www.readbyqxmd.com/read/28342028/disparities-in-knee-and-hip-arthroplasty-outcomes-an-observational-analysis-of-the-acs-nsqip-clinical-registry
#1
Peter Cram, Gillian Hawker, John Matelski, Bheeshma Ravi, Andrew Pugely, Rajiv Gandhi, Timothy Jackson
BACKGROUND: Disparities in total joint arthroplasty (TJA) have largely been studied in single center studies and using administrative data. Our objective was to investigate differences in TJA outcomes in white men, black men, white women, and black women using a large international registry. METHODS: We used 2010-2013 data from the ACS-NSQIP to identify four groups of adults (white men, black men, white women, black women) who underwent primary total knee arthroplasty (TKA) or total hip arthroplasty (THA)...
March 24, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28331144/totally-extraperitoneal-tep-removal-of-an-infected-mesh-by-laparoscopy-after-open-preperitoneal-repair-initial-case-report
#2
Naoto Chihara, Keisuke Mishima, Hideyuki Suzuki, Masanori Watanabe, Tetsutaka Toyoda, Eiji Uchida
Prosthetic mesh infection after open or laparoscopic hernia repair is a rare complication. Superficial wound infection can be resolved by treatment with a combination of antibiotics and wound drainage, whereas deep-seated mesh infection, which can lead to chronic groin sepsis, usually requires removal of the mesh. A 56-year-old Japanese man was admitted to our hospital for the treatment of deep-seated mesh infection. The patient had undergone inguinal hernia repair at another hospital 18 months earlier. The operation was prosthetic mesh repair via an anterior approach...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28331019/extraperitoneal-abscess-originating-from-an-ischorectal-abscess
#3
Eman Hamza, Mirza Faraz Saeed, Amro Salem, Isam Mazin
We describe a case which had ongoing sepsis, despite adequate incision and drainage performed for an ischorectal abscess. The patient was then noted to have an ascending infection reaching the extraperitoneal space of the abdominal cavity. The case reported required multiple episodes of drainage along with lower midline incision for deep-situated abscess. Postoperatively, the abdominal wound was treated with vacuum-assisted closure dressing and antibiotics. The patient was doing well and was discharged with an appointment at the surgical outpatient department...
March 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28323799/a-prospective-randomized-trial-to-assess-oral-versus-intravenous-antibiotics-for-the-treatment-of-postoperative-wound-infection-after-extremity-fractures-poviv-study
#4
William T Obremskey, Andrew H Schmidt, Robert V OʼToole, Jennifer DeSanto, Saam Morshed, Paul Tornetta, Clinton K Murray, Clifford B Jones, Daniel O Scharfstein, Tara J Taylor, Anthony R Carlini, Renan C Castillo
Patients surgically treated for infection after extremity fractures are typically discharged with a 6- to 12-week antibiotic regimen. Intravenous (IV) antibiotics are associated with significant cost and potential complications of deep vein thrombosis, line clotting, and sepsis. Many of the pathogens that cause musculoskeletal infection have both oral (PO) and IV antibiotic options with adequate bioavailability and antibacterial effect, yet IV antibiotics remain the standard of care absent evidence that PO options are clinically as efficacious...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#5
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28320052/soft-tissue-infections-from-fish-spike-wounds-normal-commensal-bacteria-are-more-common-than-marine-pathogens
#6
Hannah Collins, Kin Mun Lee, Paul T-Y Cheng, Sarah Hulme
BACKGROUND: A fish spike injury can be sustained by anyone handling fish; during fishing, meal preparation or in retail. Case reports of fish spikes inoculating victims with virulent marine-specific pathogens and causing systemic illness led us to question whether empirical treatment of these injuries with amoxicillin and clavulanic acid is adequate. METHODS: This 2-year prospective observational study was conducted at Middlemore Hospital, Auckland, New Zealand...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28292986/arginine-is-a-critical-substrate-for-the-pathogenesis-of-pseudomonas-aeruginosa-in-burn-wound-infections
#7
Jake Everett, Keith Turner, Qiuxian Cai, Vernita Gordon, Marvin Whiteley, Kendra Rumbaugh
Environmental conditions affect bacterial behavior and can greatly influence the course of an infection. However, the environmental cues that elicit bacterial responses in specific infection sites are relatively unknown. Pseudomonas aeruginosa is ubiquitous in nature and typically innocuous. However, it is also one of the most prevalent causes of fatal sepsis in burn wound patients. The aim of this study was to determine the impact of environmental factors, specifically the availability of arginine, on the pathogenesis of P...
March 14, 2017: MBio
https://www.readbyqxmd.com/read/28289362/study-on-biofilm-formation-in-burn-wound-infection-in-a-pediatric-hospital-in-chennai-india
#8
M Ramakrishnan, S Putli Bai, M Babu
Infection is one of the major causes of death in pediatric burns in India. This work was conducted in an exclusive Children's Hospital (KKCTH) with a total of 220 beds, of which ten beds in the burn unit and two isolation beds in the 28-bed PICU are for burns patients (more than 20% TBSA burns) with sepsis. In this study, 30 burn wound swab isolates obtained from 14 pediatric burns patients (admitted to the burns ward and transferred to PICU) from November 2013 to March 2014 were investigated. Cultures were done on the first day for all patients and empirical antibiotic administration was started for those with septic burns (14 in total) with piperacillin-tazobactam and vancomycin...
December 31, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28289144/staphylococcus-aureus-survives-in-cystic-fibrosis-macrophages-forming-a-reservoir-for-chronic-pneumonia
#9
Cao Li, Yuqing Wu, Andrea Riehle, Jie Ma, Markus Kamler, Erich Gulbins, Heike Grassmé
Staphylococcus aureus (S. aureus) plays an important role in sepsis, pneumonia, wound infections and cystic fibrosis (CF), which is caused by mutations of the cystic fibrosis transmembrane conductance regulator (Cftr). Pulmonary S. aureus infections in CF often occur very early and prior to colonization with other pathogens, in particular Pseudomonas aeruginosa Here, we demonstrate that CF mice are highly susceptible to pulmonary infections with S. aureus and fail to clear the pathogen during infection. S. aureus is internalized by Cftr-deficient macrophages in the lung, but these macrophages are unable to kill intracellular bacteria...
March 13, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28277439/role-of-laparoscopy-in-patients-with-abdominal-trauma-at-level-i-trauma-center
#10
Purushottam Parajuli, Subodh Kumar, Amit Gupta, Virinder Kumar Bansal, Sushma Sagar, Biplab Mishra, Maneesh Singhal, Atin Kumar, Shivanand Gamangatti, Babita Gupta, Chhavi Sawhney, Mahesh C Misra
INTRODUCTION: Abdominal trauma is one of the preventable causes of death in polytrauma patients. Decision and timing of laparotomy is a major challenge. Rate of nontherapeutic laparotomy is still high. Laparoscopy can avoid nontherapeutic laparotomy and also provide a reliable and accurate diagnosis of injury. MATERIALS AND METHODS: This ambispective observational study was conducted in the division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, All India Institute Medical Sciences, New Delhi...
March 8, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28260769/morbidity-and-mortality-after-pancreatoduodenectomy-a-five-year-experience-in-bangabandhu-sheikh-mujib-medical-university
#11
B C Das, A S Khan, N E Elahi, M S Uddin, B C Debnath, Z R Khan
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28246626/myocutaneous-mucormycosis-in-a-diabetic-burnt-patient-led-to-upper-extremity-amputation-a-case-report
#12
Mehdi Ayaz, Reza Moein
Mucormycosis is a rare opportunistic fungal infection that can implicate cranial sinuses, brain, lungs, gastrointestinal tract and skin. Although it can occur in patients with competent and incompetent immunity such as patients with diabetes mellitus, lymphoma, leukemia and burns, but it has an aggressive, malignant and lethal course in patients with incompetent immunity. To enforce the importance of burn in patients with underlaying diseases such as diabetes, we are going to report a rare case of diabetic burnt patient complicated by right upper extremity myocutaneous mucormycosis...
January 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28240465/comparing-laparoscopic-appendectomy-to-open-appendectomy-in-managing-generalised-purulent-peritonitis-from-complicated-appendicitis-the-uncharted-path
#13
B Ndofor, S Mokotedi, M Koto
BACKGROUND: The objective of the study was to compare the outcomes of patients with generalised purulent peritonitis from complicated appendicitis diagnosed intraoperatively who were managed laparoscopically to those managed via the open approach in a single institution. METHOD: Data were collected from all cases admitted at Sebokeng Hospital, Johannesburg, over the past two years (2008 and 2009) with an intraoperative diagnosis of generalised purulent peritonitis from complicated appendicitis...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28239579/neck-trauma-ent-prospects
#14
Kavita Sachdeva, Aparaajita Upadhyay
Neck trauma is a very important surgical emergency faced by ENT surgeons in day to day practice. They are potentially life threatening conditions due to the presence of many vital structures in this area. Timely presentation to the referral centre and proper multidisciplinary approach towards management plays a pivotal role in the healing pattern of the wound and prevention of serious complication like shock, sepsis, laryngeal stenosis or fistula formation. A retrospective study was done in ENT Department, NSCB Medical College, Jabalpur, Madhya Pradesh, India during the period of 2014-2016...
March 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28228109/fms-like-tyrosine-kinase-3-ligand-increases-resistance-to-burn-wound-infection-through-effects-on-plasmacytoid-dendritic-cells
#15
Leon Bae, Julia K Bohannon, Weihua Cui, Monika Vinish, Tracy Toliver-Kinsky
BACKGROUND: Patients experiencing large thermal injuries are susceptible to opportunistic infections that can delay recovery and lead to sepsis. Dendritic cells (DC) are important for the detection of pathogens and activation of the innate and acquired immune responses. DCs are significantly decreased in burn patients early after injury, and the development of sepsis is associated with persistent DC depletion. In a murine model of burn wound infection, the enhancement of DCs after injury by treatment with the DC growth factor Fms-like tyrosine kinase-3 ligand (FL) enhances neutrophil migration to infection, improves bacterial clearance, and increases survival in a DC-dependent manner...
February 22, 2017: BMC Immunology
https://www.readbyqxmd.com/read/28222984/index-complications-predict-secondary-complications-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#16
Matthew R Peacock, Nishant K Shah, Alik Farber, Su Yeon Lee, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing lower extremity bypass (LEB) are at high risk of perioperative complications that can lead to a cascade of secondary complications. Our goal was to understand the association of index complications with secondary complications after LEB. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012 was used to analyze secondary complications after five index complications after LEB: deep/organ space surgical site infection, urinary tract infection (UTI), myocardial infarction (MI), pneumonia, and acute renal failure (ARF)...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#17
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28220742/calcific-uraemic-arteriolopathy-calciphylaxis-in-patients-on-renal-replacement-therapy
#18
S Sebastian, H F Jordaan, J W Schneider, M R Moosa, M R Davids
BACKGROUND: Calcific uraemic arteriolopathy (calciphylaxis) is an unusual and potentially fatal condition characterised by small-vessel calcification and ischaemic skin necrosis. It mainly affects patients with end-stage renal disease (ESRD) on haemodialysis, but may rarely occur in the absence of ESRD in conditions such as primary hyperparathyroidism, malignancy, alcoholic liver disease and connective tissue disease. METHODS: We reviewed the records of all patients diagnosed with calciphylaxis while on renal replacement therapy at Tygerberg Hospital, Cape Town, South Africa, between 1990 and 2014, to describe its presentation, course and final outcome...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28220264/treatment-of-stage-ii-medication-related-osteonecrosis-of-the-jaw-with-necrosectomy-and-autologous-bone-marrow-mesenchymal-stem-cells
#19
Pit Jacob Voss, Akihiko Matsumoto, Esteban Alvarado, Rainer Schmelzeisen, Fabian Duttenhöfer, Philipp Poxleitner
Treatment strategies for medication-related osteonecrosis of the jaw (MRONJ) remain controversial. Although the AAOMS suggests a conservative approach, a surgical management with necrosectomy is often required when conservative management has failed. Moreover, recent studies have shown promising results using an early stage surgical treatment. Over the past decade, cell-based bone regeneration utilizing bone marrow mesenchymal stem cells (MSCs) received increased attention. MSCs are known to promote wound healing and induce new bone formation in compromised tissue...
February 20, 2017: Odontology
https://www.readbyqxmd.com/read/28207269/a-biocompatible-injectable-hydrogel-with-potent-wound-healing-and-antibacterial-properties
#20
Jiaul Hoque, Relekar G Prakash, Krishnamoorthy Paramanandham, Bibek R Shome, Jayanta Haldar
Two component injectable hydrogels that cross-link in-situ have been used as non-invasive wound-filling devices, i.e., sealants. These materials carry a variety of functions at the wound sites such as seal leaks, cease unwanted bleeding, bind tissues together, and assist in wound healing process. However, commonly used sealants typically lack antibacterial properties. Since bacterial infection at the wound site is very common, bioadhesive materials with intrinsic antibacterial properties are urgently required...
February 16, 2017: Molecular Pharmaceutics
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