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clean surgery

Natalia Pascuali, Leopoldina Scotti, Mariana Di Pietro, Gonzalo Oubiña, Diana Bas, María May, Antonio Gómez Muñoz, Patricia S Cuasnicú, Débora J Cohen, Marta Tesone, Dalhia Abramovich, Fernanda Parborell
STUDY QUESTION: Is ceramide-1-phosphate (C1P) an ovarian protective agent during alkylating chemotherapy? SUMMARY ANSWER: Local administration of C1P drastically reduces ovarian damage induced by cyclophosphamide (Cy) via protection of follicular reserve, restoration of hormone levels, inhibition of apoptosis and improvement of stromal vasculature, while protecting fertility, oocyte quality and uterine morphology. WHAT IS KNOWN ALREADY: Cancer-directed therapies cause accelerated loss of ovarian reserve and lead to premature ovarian failure (POF)...
March 9, 2018: Human Reproduction
Simon Laurent, Olivier Martinet, Helene Cuq, Alain Rind, Philippe Durasnel, Claire Lenne, Renaud Blondé
Stingray injuries to the chest are rare but potentially life-threatening. They may occur in remote areas where advanced emergency healthcare services are unavailable. We describe the case of a 24-year-old man with tension pneumothorax due to a Himantura fai stingray injury to the left chest. The chest wound was unremarkable, with no external bleeding or evidence of a foreign body. Decompression was performed at the scene with an improvised knife procedure and a hollow writing pen, which served as a chest tube...
March 9, 2018: Wilderness & Environmental Medicine
Samir Sorour Sorour, Nasser Nagieb Mohamed, Magdy M Abdel Fattah, Mohammad El-Sayed Abd Elbary, Mohammad Waheed El-Anwar
BACKGROUND: Canal wall down (CWD) mastoidectomy has many drawbacks including chronic otorrhea, granulations, dizziness on exposure to cold or hot water and tendency of debris accumulation in the mastoid cavity demanding periodic cleaning. Many of these problems can be solved by reconstruction of the posterior meatal wall (PMW). OBJECTIVES: To assess the results of PMW reconstruction after CWD mastoidectomy for cholesteatoma using bioactive glass (BAG) that is fabricated and built up intraoperatively...
March 6, 2018: American Journal of Otolaryngology
Reda Mohamed
The aim of this study was to determine the morphometric values of the skull and the mandible of the common opossum from the Caribbean island of Trinidad and Tobago. The skulls and mandibles were obtained from ten opossums captured for research purposes. The skulls and mandibles were prepared and cleaned using standard method. Some anatomical landmarks of the skulls and mandibles were identified and measured. The results were important for identification of the common opossum via comparison and discussion of our results with that of other marsupial species...
March 9, 2018: Veterinary Sciences
Sheran Seneviratne, Gary Hoffman, Hemalatha Varadhan, Jane Kitcher, Daron Cope
PURPOSE: The study was designed to assess the difference in microbiological colonisation and growth that may occur in drains, in the setting of clean-contaminated compared to clean head and neck surgery. METHODS: A prospective observational cohort study was performed. Surgical drain tips upon removal were sent for bacterial culture and the culture results were compared between clean-contaminated and clean procedures using mixed effects logistic regression. In all statistical analyses, a priori, p < 0...
March 8, 2018: European Archives of Oto-rhino-laryngology
Sang Won Kim, Jun Nyung Lee, Hyun Tae Kim, Eun Sang Yoo
A vesicocutaneous fistula (VCF) is a tract that is formed abnormally between the bladder and the external surface of the body. VCF results in a great deal of inconvenience, discomfort, and physical disability for the affected patient. This condition can be caused by extensive trauma with pelvic bone fracture, radical pelvic surgery, irradiation of pelvic malignancies, hip arthroplasty, a large bladder calculus, and various other pathologies. The management of VCF should be approached on a case-by-case basis because of the complexity of the disease...
March 2018: Turkish Journal of Urology
Joshua P Totty, Amy E Harwood, Tom Wallace, George E Smith, Ian C Chetter
OBJECTIVE: This study aims to assess whether a clinician reviewing photographs of a wound was an acceptable substitute for clinical review in order to identify or exclude surgical site infection (SSI). METHOD: We undertook a mixed methods study consisting of a qualitative public involvement exercise and a prospective, non-randomised, single-centre study of patients undergoing clean or clean-contaminated vascular surgery. For the qualitative study, two semi-structured focus group interviews were conducted...
March 2, 2018: Journal of Wound Care
Hirokazu Shoji, Toru Hirano, Kei Watanabe, Masayuki Ohashi, Tatsuki Mizouchi, Naoto Endo
BACKGROUND: In spinal instrumentation surgeries, surgical site infection (SSI) is one of the complications to be avoided. However, spinal instrumentation surgeries have a higher rate of SSI than other clean orthopedic surgeries. The purpose of this study was to investigate the risk factors for SSI following spinal instrumentation surgeries and contribute to the prevention of SSIs by identifying high-risk patients. METHODS: Records of 431 patients who underwent spinal instrumentation surgeries from 2011 to 2014 with a minimum follow-up period of 90 days were retrospectively reviewed...
March 2, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
I Floris, J Lechner, B Lejeune
Regulated-on-activation, normal T cell expressed and secreted (also called RANTES, CCL5 or R/C) is a chemotactic cytokine that plays a key role in recruiting immune cells to inflammatory sites. R/C is involved in the pathogenesis of many systemic immune-mediated diseases (SIDs) and is upregulated in fatty-degenerative osteolysis jawbone (FDOJ) cavitations. Surgical cleaning of degenerative areas reduces the source of chronic R/C but might not be sufficient to re-establish the altered immunological patterns...
January 2018: Journal of Biological Regulators and Homeostatic Agents
A J Rensing, B M Whittam, K H Chan, M P Cain, A E Carroll, W E Bennett
INTRODUCTION: Surgeons frequently use surgical antibiotic prophylaxis (SAP), despite limited evidence to support its efficacy. Potential adverse events associated with antibiotic use include allergic reaction (including anaphylaxis), Clostridium difficile infection, and selecting for resistant bacteria. Surgical site infections (SSI) are very rare in patients undergoing clean pediatric urologic procedures. Current guidelines are unclear about the efficacy of surgical antibiotic prophylaxis for prevention of SSI in the pediatric population...
February 21, 2018: Journal of Pediatric Urology
Jun-Yi Wang, Dian-Qiang Wang, Xiao-Lin Qi, Jun Cheng, Li-Xin Xie
AIM: To evaluate the efficacy of modified corneal ulcer debridement in superficial fungal keratitis unresponsive to medications. METHODS: A total of 209 patients (209 eyes) with fungal keratitis, involving no more than 50% of the stromal depth and not responding to antifungal agents for 2wk, were recruited in this retrospective, noncomparative study. The patients were treated with modified corneal ulcer debridement. All visible corneal infiltrates were removed under an operating microscope to obtain a clean stromal bed and smooth incised edges...
2018: International Journal of Ophthalmology
Ken Catchpole, Ann Bisantz, M Susan Hallbeck, Matthias Weigl, Rebecca Randell, Merrick Kossack, Jennifer T Anger
This article reviews studies conducted "in the wild" that explore the "ironies of automation" in Robotic Assisted Surgery (RAS). Workload may be reduced for the surgeon, but increased for other team members, with postural stress relocated rather than reduced, and the introduction of a range of new challenges, for example, in the need to control multiple arms, with multiple instruments; and the increased demands of being physically separated from the team. Workflow disruptions were not compared with other surgeries; however, the prevalence of equipment and training disruptions differs from other types of surgeries...
February 22, 2018: Applied Ergonomics
Juyuan Liu, Na Li, Jinjuan Hao, Yanming Li, Anlei Liu, Yinghong Wu, Meng Cai
BACKGROUND: Surgical site infections (SSIs) are the leading cause of hospital-acquired infections and are associated with substantial healthcare costs, with increased morbidity and mortality. To investigate the effects of the antibiotic stewardship program on prevention and control of SSI during clean surgery, we investigated this situation in our institution. PATIENTS AND METHODS: We performed a quasi-experimental study to compare the effect before and after the antibiotic stewardship program intervention...
February 20, 2018: Surgical Infections
Songyu Chen, Xin Zhang, Fuxin Lin, Shujun Xu, Xingang Li, Xiangyu Ma
Clean and fast craniotomy and closure (CAC) is a fundamental part of modern microneurosurgery, and is an essential technique that young neurosurgeons shall master. The hemostatic instruments of CAC have evolved from forceps to raney clips. Thanks to the wide application of bipolar coagulation, local infiltration anesthesia combined with cauterization is become an effective method of hemostasis. The authors worked out a standard operating procedure (SOP) of CAC assisted by fishhooks without the application of raney clips...
February 14, 2018: Journal of Craniofacial Surgery
Olive Fast, Christina Fast, Dan Fast, Suzanne Veltjens, Zouliha Salami, Michelle White
Background: Proper sterile processing is fundamental to safe surgical practice and optimal patient outcomes. Sterile processing practices in low and middle-income countries often fall short of recommended standards. The impact of education and training on sterile processing practices in low and middle-income countries is unknown. We designed a sterile processing education course, including mentoring, and aimed to evaluate the impact on participants' personal knowledge, skills, and practices...
2018: Antimicrobial Resistance and Infection Control
You Qin, Yanwei Lu, Liduan Zheng, Hong Liu
RATIONALE: Ghost cell odontogenic carcinoma (GCOC) is a rare malignant odontogenic tumor with aggressive growth characteristics. PATIENT CONCERNS: A 41-year-old Chinese male visited our hospital in 2013, with a 4-month history of bloody purulent rhinorrhea with a peculiar smell in the right nasal cavity. DIAGNOSES: The patient suffered from recurrent GCOC with suspected cholesterol granuloma of the maxillary sinus. The patient was incorrectly diagnosed with a calcifying epithelial odontogenic tumor at his first recurrence...
February 2018: Medicine (Baltimore)
Montserrat Juvany, Carlos Hoyuela, Miguel Trias, Fernando Carvajal, Jordi Ardid, Antoni Martrat
BACKGROUND: Although incisional hernia repair is classified as a clean surgery, it still has a high incidence of surgical site infection (SSI) (0.7%-26.6%). The presence of an SSI could increase early recurrence rates after incisional hernia repair. PATIENTS AND METHODS: Patients undergoing elective incisional hernia repair with no bowel contamination between January and December 2015 were assessed prospectively. Demographic and surgical data, local post-operative complications, and one-year recurrence rates in patients with and without SSI were compared...
February 13, 2018: Surgical Infections
Zheng-Chen Li, Ying-Ping Jia, Yuan Wang, Jin-Lian Qi, Xue-Ping Han
Brain‑derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) serves a significant role in neural protection by activating the phosphatidylinositol 3‑kinase (PI3K)/Akt signaling pathway, which also was associated with the neuroprotective the treatment with dexmedetomidine (DEX). The present study aimed to further explore whether treatment with DEX post‑IR increased the expression level of BDNF and VEGF in the rat brain. A total of 30 healthy, clean male Wistar rats were randomly divided into 3 experimental groups: Control group, ischemia/reperfusion (I/R) group and DEX treatment group...
February 13, 2018: Molecular Medicine Reports
Kevin Li, Tanmaya D Sambare, Sam Y Jiang, Emily J Shearer, Nathan P Douglass, Robin N Kamal
BACKGROUND: Antibiotic prophylaxis is a common but controversial practice for clean soft tissue procedures of the hand, such as carpal tunnel release or trigger finger release. Previous studies report no substantial reduction in the risk of surgical site infection (SSI) after antibiotic prophylaxis, yet are limited in power by low sample sizes and low overall rates of postoperative infection. QUESTIONS/PURPOSES: Is there evidence that antibiotic prophylaxis decreases the risk of SSI after soft tissue hand surgery when using propensity score matching to control for potential confounding variables such as demographics, procedure type, medication use, existing comorbidities, and postoperative events? METHODS: This retrospective analysis used the Truven Health MarketScan databases, large, multistate commercial insurance claims databases corresponding to inpatient and outpatient services and outpatient drug claims made between January 2007 and December 2014...
February 8, 2018: Clinical Orthopaedics and related Research
Marc-David Leclair, Sébastien Faraj, Thierry Villemagne, Julie Carrouget, Alexis Arnaud, Yves Heloury
OBJECTIVES: Primary female epispadias encompasses a spectrum of disease, presenting with a variable degree of incontinence. We hypothesized that although perineal urethrocervicoplasty can be a successful first-line procedure in patients with normal bladder, a more radical reconstruction was necessary to achieve continence in cases lying at the most severe end of the spectrum. Our aim was to assess the results of a surgical management using perineal approach in girls with normal bladder capacity, and Kelly radical soft-tissue mobilization (RSTM) in patients with inadequate bladder, based on the assumption that bladder capacity (BC) is a reliable marker of epispadias severity...
October 9, 2017: Journal of Pediatric Urology
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