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https://www.readbyqxmd.com/read/29789411/heliox-adjunct-therapy-for-neonates-with-congenital-diaphragmatic-hernia
#1
Audra C Wise, Mallory A Boutin, Ellen M Knodel, James A Proudfoot, Brian P Lane, Marva L Evans, Denise M Suttner, Amy L Kimball
BACKGROUND: Congenital diaphragmatic hernia remains a complex disease with significant morbidity and mortality. Hypercarbia is a common derangement in this population, which often requires escalating ventilator support. By decreasing airway turbulence and enhancing CO2 removal, inhaled helium-oxygen mixture (heliox) has the potential to improve ventilation and thereby decrease ventilator support and its associated lung injury. METHODS: Retrospective cohort review of all neonates with congenital diaphragmatic hernia treated at Rady Children's Hospital San Diego during 2011-2015...
May 22, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29787960/late-presentation-of-ectopia-vesica-with-malignant-transformation-a-case-report-and-review
#2
Sami Eldirdiri, Rehab M Elmushly, Sami G Elazhary
INTRODUCTION: Exstrophy of the bladder is a rare congenital anomaly usually treated in neonatal or childhood period. When combined with renal agenesis and presents for the first time in the adulthood with malignant transformation, is an extreme rarity. CASE PRESENTATION: We present a case of 65 years single male who presented with a right irreducible inguinal hernia and an unreconstructed Ectopia Vesicae with fungating tumor. He was anemic with impaired renal function, left renal agenesis and right sided hydronephrosis, hydroureter and distal ureteric stricture...
May 10, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29768079/the-spectrum-of-surgical-remediation-of-transoral-incisionless-fundoplication-related-failures
#3
Ruchir Puri, C Daniel Smith, Steven P Bowers
AIM: To evaluate outcomes of surgical remediation for symptomatic or anatomic failure after a transoral incisionless fundoplication (TIF). METHODS: This retrospective study was performed on 11 patients who underwent a remedial operation following TIF failure between June 2011 and September 2016 at the Mayo Clinic in Florida for persistent foregut symptoms. Upper gastrointestinal workup characterized 1 patient as having normal post-TIF anatomy and 10 as having anatomic failure...
May 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29754628/approach-to-the-patient-with-chronic-groin-pain
#4
REVIEW
Q Lina Hu, David C Chen
Chronic postoperative inguinal pain has become a primary outcome parameter after elective inguinal hernia repair with significant consequences affecting patient productivity, employment, and quality of life. A systematic and thorough preoperative evaluation is important to identify the etiologies and types of pain. Owing to the complex nature of chronic pain, a multimodal and multidisciplinary treatment approach is recommended. Patients with chronic pain refractory to conservative measures may be considered for surgical intervention...
June 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29754622/umbilical-hernia-repair-overview-of-approaches-and-review-of-literature
#5
REVIEW
Paul W Appleby, Tasha A Martin, William W Hope
Umbilical hernias are ubiquitous, and surgery is indicated in symptomatic patients. Umbilical hernia defects can range from small (<1 cm) to very large/complex hernias, and treatment options should be tailored to the clinical situation. Open, laparoscopic, and robotic options exist for repair, with each having its advantages and disadvantages. In general, mesh should be used for repair, because it has been shown to decrease recurrence rates, even in small hernias. Although outcomes are generally favorable after umbilical hernia repairs, some patients have chronic complaints that are mostly related to recurrences...
June 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29752685/sarcopenia-and-outcomes-in-ventral-hernia-repair-a-preliminary-review
#6
S R Siegal, A R Guimaraes, M R Lasarev, R G Martindale, S B Orenstein
PURPOSE: Sarcopenia, or loss of muscle mass, is associated with increased morbidity and mortality in oncologic resections and several other major surgeries. Complex ventral hernia repairs (VHRs) and abdominal wall reconstruction are often performed in patients at high risk for morbidity and recurrence, though limited data exist on outcomes related to sarcopenia. We aimed to determine if sarcopenia is associated with worse outcomes in patients undergoing VHR. METHODS: We reviewed patients undergoing VHRs from 2014 to 2015...
May 11, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29716450/evaluation-of-surgical-instruments-with-radiofrequency-identification-tags-in-the-operating-room
#7
Kazuhiko Yamashita, Kaori Kusuda, Yoshitomo Ito, Masaru Komino, Kiyohito Tanaka, Satoru Kurokawa, Michitaka Ameya, Daiji Eba, Ken Masamune, Yoshihiro Muragaki, Yuji Ohta, Chugo Rinoie, Kenji Yamada, Yoshiki Sawa
BACKGROUND: Surgical instrument retention and instrument breakage compromise surgery quality and lead to medical malpractice. We developed an instrument tracking system that could alert surgeons to instrument retention during surgery and monitor instrument use to reduce the risk of breakage. METHODS: This prospective, experimental clinical trial included 15 patients undergoing inguinal hernia surgery or lumpectomy under general anesthesia at Saiseikai Kurihashi Hospital...
April 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29714432/extracorporeal-membrane-oxygenation-support-in-neonates-a-single-center-experience-in-turkey
#8
Emel Okulu, F. Begüm Atasay, Gaffari Tunç, Hasan Akduman, Ömer Erdeve, Saadet Arsan, Zeynep Eyileten, Tayfun Uçar, H. Ercan Tutar
Background/aim: Extracorporeal membrane oxygenation (ECMO) is a form of life support for patients with respiratory failure, cardiac failure, or both. The aim of this study was to evaluate neonates supported with ECMO and report our experience as a Turkish neonatal intensive care unit. Materials and methods: We retrospectively reviewed 11 newborn infants treated with ECMO at Ankara University for respiratory and cardiac failure. We reported the demographic, diagnostic, laboratory, and clinical data of the patients...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29712995/postoperative-rehabilitation-may-reduce-the-risk-of-readmission-after-groin-hernia-repair
#9
Grégoire Mercier, Jessica Spence, Christelle Ferreira, Jean-Marc Delay, Charles Meunier, Bertrand Millat, Tri-Long Nguyen, Fabienne Seguret
Thirty-day readmission after surgery has been proposed as a quality-of-care indicator. We explored the effect of postoperative rehabilitation on readmission risk after groin hernia repair. We used the French National Discharge Database to identify all index hospitalizations for groin hernia repair in 2011. Readmissions within 30 days of discharge were clinically classified in terms of their relationship to the index stay. We used logistic regression to adjust the risk of readmission for patient, procedure and hospital factors...
April 30, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29705097/ascites-a-marker-for-increased-surgical-risk-unaccounted-for-by-the-model-for-end-stage-liver-disease-meld-score-for-general-surgical-procedures
#10
Matthew M Fleming, Michael P DeWane, Jiajun Luo, Yawei Zhang, Kevin Y Pei
BACKGROUND: Ascites and the Model for End-Stage Liver Disease score have both been shown to independently correlate with surgical morbidity and mortality. We evaluated if incorporating the presence of ascites changed postoperative risk as assessed by the Model for End-Stage Liver Disease score. METHODS: Data originated from the National Surgical Quality Improvement Program database from 2005-2014. Patients undergoing hernia repair, adhesiolysis, and cholecystectomy were included...
April 25, 2018: Surgery
https://www.readbyqxmd.com/read/29704737/laparoscopic-and-percutaneous-repair-of-a-large-midline-incisional-hernia-extending-to-the-bilateral-subcostal-region-a-case-report
#11
Shingo Tsujinaka, Yukio Nakabayashi, Nao Kakizawa, Rina Kikugawa, Nobuyuki Toyama, Toshiki Rikiyama
INTRODUCTION: Optimal surgery for a midline incisional hernia extending to the subcostal region remains unclear. We report successful hybrid laparoscopic and percutaneous repair for such a complex incisional hernia. PRESENTATION OF CASE: An 85-year-old woman developed a symptomatic incisional hernia after open cholecystectomy. Computed tomography revealed a 14 × 10 cm fascial defect. Four trocars were placed under general anesthesia. Percutaneous defect closure was performed using multiple non-absorbable monofilament threads, i...
April 21, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29679560/developmental-origin-and-morphogenesis-of-the-diaphragm-an-essential-mammalian-muscle
#12
Elizabeth M Sefton, Mirialys Gallardo, Gabrielle Kardon
The diaphragm is a mammalian skeletal muscle essential for respiration and for separating the thoracic and abdominal cavities. Development of the diaphragm requires the coordinated development of muscle, muscle connective tissue, tendon, nerves, and vasculature that derive from different embryonic sources. However, defects in diaphragm development are common and the cause of an often deadly birth defect, Congenital Diaphragmatic Hernia (CDH). Here we comprehensively describe the normal developmental origin and complex spatial-temporal relationship between the different developing tissues to form a functional diaphragm using a developmental series of mouse embryos genetically and immunofluorescently labeled and analyzed in whole mount...
April 18, 2018: Developmental Biology
https://www.readbyqxmd.com/read/29644483/studies-of-abnormalities-of-the-lower-esophageal-sphincter-during-esophageal-emptying-based-on-a-fully-coupled-bolus-esophageal-gastric-model
#13
Wenjun Kou, John E Pandolfino, Peter J Kahrilas, Neelesh A Patankar
The aim of this work was to develop a fully coupled bolus-esophageal-gastric model based on the immersed boundary-finite element method to study the process of esophageal emptying across the esophagogastric junction (EGJ). The model included an esophageal segment, an ellipsoid-shaped stomach, a bolus, and a simple model of the passive and active sphincteric functions of the lower esophageal sphincter (LES). We conducted three sets of case studies: (1) the effect of a non-relaxing LES; (2) the influence of the tissue anisotropy in the form of asymmetrical right- and left-sided compliance of the LES segment; and (3) the influence of LES and gastric wall stiffness on bulge formation of the distal esophageal wall...
April 11, 2018: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/29628208/complex-gastroschisis-clinical-spectrum-and-neonatal-outcomes-at-a-referral-center
#14
Pablo Laje, Maria V Fraga, William H Peranteau, Holly L Hedrick, Nahla Khalek, Juliana S Gebb, Julie S Moldenhauer, Mark P Johnson, Alan W Flake, N Scott Adzick
AIM OF THE STUDY: To evaluate the outcomes of neonates with complex gastroschisis (GC), and correlate outcomes with each type of complication. METHODS: Retrospective review of patients with complex GC owing to prenatal and/or postnatal abdominal complications; 2008-2016. Primary outcomes: time to discontinue parenteral nutrition (off-PN), length of stay (LOS) and neonatal survival. MAIN RESULTS: We treated 58 patients with complex gastroschisis owing to abdominal complications, which were: intestinal necrosis at birth (n=9), intestinal atresia (n=16), medical necrotizing enterocolitis (NEC) (n=15), surgical NEC (n=1), in utero volvulus (n=1), vanishing gastroschisis (n=2), severe intestinal dysmotility (n=1), delayed abdominal closure (n=3), abdominal compartment syndrome (n=2) and hiatal hernia/severe gastroesophageal reflux disease (GERD; n=11)...
March 14, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29624512/gastrointestinal-tract-vasculopathy-clinicopathology-and-description-of-a-possible-new-entity-with-protean-features
#15
Christine Y Louie, Michael A DiMaio, Gregory W Charville, Gerald J Berry, Teri A Longacre
Noninfectious gastrointestinal (GI) vasculopathic disorders are rare and are often overlooked in histopathologic examination or when forming differential diagnoses due to their rarity. However, involvement of the GI tract may lead to serious complications, including ischemia and perforation. Since awareness of the types of vasculopathy that may involve the GI tract is central to arriving at a correct diagnosis, we reviewed our institutional experience with GI tract vasculopathy in order to enhance diagnostic accuracy of these rare lesions...
April 5, 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29618029/the-role-of-frem2-and-fras1-in-the-development-of-congenital-diaphragmatic-hernia
#16
Valerie K Jordan, Tyler F Beck, Andres Hernandez-Garcia, Peter N Kundert, Bum-Jun Kim, Shalini N Jhangiani, Tomasz Gambin, Molly Starkovich, Jaya Punetha, Ingrid S Paine, Jennifer E Posey, Alexander H Li, Donna Muzny, Chih-Wei Hsu, Amber J Lashua, Xin Sun, Caraciolo J Fernandes, Mary E Dickinson, Kevin P Lally, Richard A Gibbs, Eric Boerwinkle, James R Lupski, Daryl A Scott
Congenital diaphragmatic hernia (CDH) has been reported twice in individuals with a clinical diagnosis of Fraser syndrome, a genetic disorder that can be caused by recessive mutations affecting FREM2 and FRAS1. In the extracellular matrix, FREM2 and FRAS1 form a self-stabilizing complex with FREM1, a protein whose deficiency causes sac CDH in humans and mice. By sequencing FREM2 and FRAS1 in a CDH cohort, and searching online databases, we identified five individuals who carried recessive or double heterozygous, putatively deleterious variants in these genes which may represent susceptibility alleles...
March 28, 2018: Human Molecular Genetics
https://www.readbyqxmd.com/read/29594842/associations-between-anxiolytic-medications-and-ventral-hernia-repair
#17
C Neff, C Totten, M Plymale, D R Oyler, D Davenport, J S Roth
PURPOSE: This study examines the relationship between anxiolytic medications (AXM) on outcomes following ventral hernia repair. METHODS: A single-center review of prospectively obtained perioperative and 30-day outcome data, including AXM use at admission, as part of the National Surgery Quality Improvement Program. RESULTS: Sixty-three of the 393 patients who presented for ventral hernia repair were taking an AXM (15.6%). AXM users were more likely to have a higher ASA class, dyspnea, and treated hypertension (p < 0...
March 28, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29594167/first-experiences-with-the-new-senhance%C3%A2-telerobotic-system-in-visceral-surgery
#18
REVIEW
Dietmar Stephan, Heike Sälzer, Frank Willeke
Until recently, robotic-assisted surgery has exclusively been connected to the name DaVinci®. In 2016, a second robotic system, the Senhance®, became available. To introduce the new robotic system into clinical routine, detailed team training and an integration program were useful. Within the first 6 months, 116 cases were performed with this system. The integration program intended to start with simple and well-standardized clinical cases. We chose inguinal hernia repair using the TAPP (transabdominal preperitoneal) technique as the starting procedure...
February 2018: Visceral Medicine
https://www.readbyqxmd.com/read/29588357/successful-treatment-of-persistent-burkholderia-cepacia-complex-bacteremia-with-ceftazidime-avibactam
#19
Pranita D Tamma, Yunfan Fan, Yehudit Bergman, Anna C Sick-Samuels, Alice J Hsu, Winston Timp, Patricia J Simner, Bonnie C Prokesch, David E Greenberg
We report our clinical experience treating a 2-month-old infant with congenital diaphragmatic hernia who experienced prolonged bacteremia with Burkholderia cepacia complex (Bcc) despite conventional antibiotic therapy and appropriate source control measures. The infection resolved after initiation of ceftazidime-avibactam. Whole-genome sequencing revealed that the isolate most closely resembled B. contaminans and identified the mechanism of resistance that likely contributed to clinical cure with this agent...
April 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29582804/laparoscopic-repair-for-parastomal-hernia-with-ongoing-barbed-suture-followed-by-sandwich-technique-sandwich-plus-technique
#20
Reiko Wiessner, Thomas Vorwerk, Alexander Gehring
The incidence of parastomal hernias after a permanent stoma is between 50% and 80% depending on the type of stoma, the definition of the hernia (clinical or radiological), and the length of the follow-up. Surgical therapy is complex and involves several techniques with different recurrence rates. We present three cases where we have closed the hernia gap with continuous, non-resorbable, self-retaining sutures with subsequent use of the sandwich technique ('Sandwich-plus-technique'). There were pronounced parastomal hernias in three female patients (mean age was 72 years and the range was 63-78 years) with permanent colostomata...
March 23, 2018: Journal of Minimal Access Surgery
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