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https://www.readbyqxmd.com/read/28767588/successful-ceftazidime-avibactam-treatment-of-mdr-kpc-positive-klebsiella-pneumoniae-infection-in-a-patient-with-traumatic-brain-injury-a-case-report
#1
Agnese Gugliandolo, Carla Caio, Maria Lina Mezzatesta, Carmela Rifici, Placido Bramanti, Stefania Stefani, Emanuela Mazzon
RATIONALE: Carbapenem-resistant Enterobacteriaceae infections are a serious health care problem, because of the high mortality. Carbapenem resistance is mainly caused by carbapenemases production, including Klebsiella pneumoniae carbapenemase (KPC). Ceftazidime-avibactam is a new cephalosporin/β-lactamase inhibitor combination for the treatment of complicated urinary, intra-abdominal infections, and nosocomial pneumonia caused by gram negative, or other serious gram-negative infections...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28763709/similar-mechanisms-of-traumatic-rectal-injuries-in-patients-who-had-anal-sex-with-animals-to-those-who-were-butt-fisted-by-human-sexual-partner
#2
Damian Jacob Sendler
Sexual pleasure comes in various forms of physical play, for many it involves stimulation of the vagina, while the anus for others; some enjoy both. A recent report by Cappelletti et al.(1) shows a meta-analysis of cases describing anal trauma due to sexual fisting in human partners. This clinical article reports four cases of males diagnosed with zoophilia, and who received anal sex from animals, resulting in injuries. Surgical and psychiatric evaluations are summarized. Unusual etiology of sexual activity with animals caused peri-anal trauma in men who engaged in anal sex with dogs and farm animals...
July 25, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28759327/factors-of-pelvic-infection-and-death-in-patients-with-open-pelvic-fractures-and-rectal-injuries
#3
Wenhao Song, Dongsheng Zhou, Weicheng Xu, Guoming Zhang, Chunhui Wang, Daodi Qiu, Jinlei Dong
BACKGROUND: Open pelvic fractures associated with rectal injuries are uncommon. They often cause serious pelvic infection, even death. This combination of injuries has been reviewed infrequently. Herein, we report factors associated with pelvic infection and death in a group of patients with open pelvic fractures and concurrent rectal injuries. METHODS: We retrospectively reviewed the records of patients with open pelvic fractures and rectal injuries who were treated at our institution from January 2010-April 2014...
July 31, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28748422/safety-and-feasibility-of-umbilical-diverting-loop-ileostomy-for-patients-with-rectal-tumor
#4
Masaaki Miyo, Ichiro Takemasa, Taishi Hata, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
BACKGROUND: Fashioning an ileostomy in the umbilicus and combining the trauma from extraction of colorectum with that from ileostomy should be less invasive and lead to improved cosmetic outcomes. However, there are only a few reports regarding umbilical ileostomy. METHODS: We retrospectively collected data for 121 consecutive patients with rectal tumor who underwent elective laparoscopic rectal resection with diverting loop ileostomy between 2010 and 2015 at Osaka University Hospital, Japan...
July 26, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28677871/well-leg-compartment-syndrome-after-laparoscopic-low-anterior-resection-for-lower-rectal-cancer-in-the-lithotomy-position-a-case-report
#5
Masaya Nishino, Miho Okano, Junji Kawada, Yongkook Kim, Mami Yamada, Toshimasa Tsujinaka
A 64-year-old man underwent laparoscopic low anterior resection for lower rectal cancer. Because he was overweight (BMI, 28.1 kg/m(2) ) with rich visceral fat and a narrow pelvic cavity, the operation was technically difficult and the operation time was 686 min. Postoperatively, the patient immediately complained of pain and swelling of the left lower limb. Laboratory examination showed that serum creatinine kinase was markedly increased and urine myoglobin was positive on postoperative day 1. He was diagnosed with well-leg compartment syndrome and was transported to the trauma and critical care center for emergency fasciotomy...
July 5, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28643681/-magnetic-resonance-neurography-for-the-identification-of-pudendal-neuralgia
#6
Claudia P Cejas, Susana Bordegaray, Nadia I Stefanoff, Cecilia Rollán, Inés T Escobar, Pablo Consigliere Rodríguez
The pudendal nerve entrapment is an entity understudied by diagnosis imaging. Various causes are recognized in relation to difficult labors, rectal, perineal, urological and gynecological surgery, pelvic trauma fracture, bones tumors and compression by tumors or pelvic pseudotumors. Pudendal neuropathy should be clinically suspected, and confirmed by different methods such as electrofisiological testing: evoked potentials, terminal motor latency test and electromyogram, neuronal block and magnetic resonance imaging...
2017: Medicina
https://www.readbyqxmd.com/read/28641982/temporal-artery-and-axillary-thermometry-comparison-with-rectal-thermometry-in-children-presenting-to-the-emergency-department
#7
Adam J Forrest, Michael L Juliano, Sean P Conley, Patrick D Cronyn, Andrea McGlynn, Jonathan D Auten
BACKGROUND: Accurate temperature readings, often obtained rectally, are an important part of the initial evaluation of pediatric patients in the Emergency Department. Temporal artery thermometry (TAT) is one way to noninvasively measure temperature. We sought to compare the accuracy of axillary and temporal artery temperatures compared to rectal. METHODS: This prospective study included children age 0-36months presenting to the Emergency Department of a large military treatment facility...
June 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28536228/clostridium-difficile-extraintestinal-abscess-a-rare-complication
#8
Vamsi Krishna Kantamaneni, Krishna C Gurram, Abhijit Kulkarni
Extraintestinal Clostridium difficile is rare. A 74-year-old man with a history of ulcerative colitis presented after a fall. Trauma work-up showed liver cirrhosis. Two days later he developed abdominal pain, distension, diarrhoea and leucocytosis. Stool tested positive for C. difficile CT abdomen showed pancolitis with toxic megacolon. Total abdominal colectomy and ileostomy with a rectal stump was performed. He was discharged, but was readmitted with sepsis. CT abdomen showed a 10.4×7.2 cm fluid collection in the pelvis...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28534332/-efficacy-comparison-of-robotic-and-laparoscopic-radical-surgery-in-the-treatment-of-middle-low-rectal-cancer
#9
Hairong Zhang, Weitang Yuan, Quanbo Zhou, Xiaoming Gu, Fuqi Wang
OBJECTIVE: To compare the clinical efficacy of robotic and laparoscopic radical surgery in the treatment of middle-low rectal cancers. METHODS: From January 2015 to March 2016, intra-operative and postoperative follow-up data of 30 patients with middle-low rectal cancers who underwent robotic radical resection(robot group) and 32 patients with middle-low rectal cancers who underwent laparoscopic radical resection (laparoscopy group)n in our department were retrospectively collected...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28526917/do-we-know-the-outcome-predictors-for-cauda-equine-syndrome-ces-a-retrospective-single-center-analysis-of-60-patients-with-ces-with-a-suggestion-for-a-new-score-to-measure-severity-of-symptoms
#10
Alexander König, Lisa Amelung, Marco Danne, Ullrich Meier, Johannes Lemcke
OBJECTIVE: Despite the awareness and familiarity of almost every medical professional with the cauda equine compression syndrome (CES), risk factors for a poor prognosis of the disease remain elusive. Even the relationship between subsequent outcome and the time elapsed from the time of appearance of symptoms to surgery taking place remain obscure. The aim of our study, therefore, was to analyze a relatively large population of our own patients studied consecutively, to identify outcome predictors for CES and to propose a clinical score for CES symptoms (Berlin CES score)...
May 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28474610/blunt-rectal-trauma-case-report-and-literature-review
#11
Michele Marini, Giorgio Fratus, Pierluigi D'Amore, Fabio Tagliabue, Pierpaolo Mariani, Luisella Spinelli, Lorenzo Novellino
Blunt colorectal traumas are rare clinical entities with a challenging diagnostic and operative management. We describe the case of a 40-year-old man, victim of an accidental fall from a height of four meters who was subsequently diagnosed to have a blunt rectal trauma. A first CT scan showed fracture of the skull and an extensive subcutaneous haematoma of the lower back associated with a fracture of the left transverse processes of lumbar vertebrae. No other visceral abdominal lesions were recognized and patient was admitted to our department for observational studies...
December 20, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28461988/endoscopic-extraperitoneal-radical-prostatectomy-an-initial-report-following-the-first-30-cases
#12
Bartłomiej Jakóbczyk, Marek Wrona, Marta Wrona-Lis, Elżbieta Oszukowska, Piotr Lipiński, Mariusz Szewczyk, Marek Lipiński, Waldemar Różański
INTRODUCTION: To present initial observations after the first 30 cases of endoscopic extraperitoneal radical prostatectomy carried out at our department, which so far has had no experience with this surgical procedure. MATERIAL AND METHODS: In the period of 15 months a group of 30 patients with organ confined prostate cancer, underwent endoscopic extraperitoneal radical prostatectomy using Montsouris technique. All procedures were performed by the same team of two urologists and one resident...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28441277/symptomatic-epidermoid-cyst-presenting-as-a-paravaginal-mass
#13
Abigail P Davenport, Carl W Zimmerman, Bryan J Hill, Jeffrey Davis
BACKGROUND: Ischioanal fossa epidermoid cysts are uncommon masses of epithelial origin and are believed to be either congenital or the result of trauma. Surgical excision is preferred as opposed to incision and drainage because these masses may enlarge, recur, become infected, or undergo malignant transformation. CASE: This report describes a case of a 62-year-old woman who presented for evaluation of vaginal and perineal discomfort and fullness. Physical examination and computed tomography scan revealed a 7...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28366562/traumatic-colorectal-injuries-in-children-the-national-trauma-database-experience
#14
Pamela M Choi, Michael Wallendorf, Martin S Keller, Adam M Vogel
PURPOSE: We sought to utilize a nationwide database to characterize colorectal injuries in pediatric trauma. METHODS: The National Trauma Database (NTDB) was queried for all patients (age≤14years) with colorectal injuries from 2013 to 2014. We stratified patients by demographics and measured outcomes. We analyzed groups based on mechanism, colon vs rectal injury, as well as colostomy creation. Statistical analysis was conducted using t-test and ANOVA for continuous variables as well as chi-square for continuous variables...
March 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28332921/leaving-the-skin-incision-open-may-not-be-as-beneficial-as-we-have-been-taught
#15
Jack C He, Brenda M Zosa, David Schechtman, Brian Brajcich, Jonathan C Savakus, Amanda L Wojahn, Derek Z Wang, Jeffrey A Claridge
BACKGROUND: Currently, various methods of skin closures are used in contaminated and dirty abdominal wounds without solid, evidence-based guidance. This study investigates whether closure methods affect surgical site infection (SSI) and other incisional complications. We hypothesize that open management of the skin would have the lowest complications, including SSI. PATIENTS AND METHODS: Patients age ≥18 who underwent trauma laparotomy (TL) or damage control laparotomy (DCL) from 2008-2013 and had class III/IV wounds were included...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28323788/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#16
MULTICENTER STUDY
Leah Carey Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura Bruce Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multicenter retrospective cohort study was performed across three Level I trauma centers encompassing traumatic colon injuries from January 2006 through June 2014...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28320053/management-of-colorectal-trauma-a-review
#17
REVIEW
Ju Yong Cheong, Anil Keshava
Traumatic colorectal injuries are common during times of military conflict, and major improvements in their care have arisen in such periods. Since World War II, many classification systems for colorectal trauma have been proposed, including (i) Flint Grading System; (ii) Penetrating Abdominal Trauma Index; (iii) Colonic/Rectal Injury Scale; and (iv) destructive/non-destructive colonic injuries. The primary goal of these classifications was to aid surgical management and, more particularly, to determine whether a primary repair or faecal diversion should be performed...
July 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28292518/the-management-of-penetrating-rectal-and-anal-trauma-a-systematic-review
#18
Daniel P Ahern, Michael E Kelly, Danielle Courtney, Emanuele Rausa, Des C Winter
INTRODUCTION: Traumatic injuries to the lower gastrointestinal tract (rectum and anus) have been largely reported in the military setting with sparse publications from the civilian setting. Additionally, there remains a lack of international consensus regarding definitive treatment pathways. This systematic review aimed to assess the current literature and propose a standardised treatment algorithm to aid management in the civilian setting. METHODS: A systematic review of available literature from 1999 to 2016 that was performed...
June 2017: Injury
https://www.readbyqxmd.com/read/28291521/the-spectrum-of-injuries-in-buttock-stab-wounds
#19
REVIEW
T Campion, S Cross
Buttock stab wounds are a surprisingly common and increasing source of presentations to emergency departments. These injuries can have a significant impact on quality of life, and there are a number of often subtle, but significant, injuries that the radiologist must be alert to when interpreting computed tomography examinations in these patients. In this review, we will examine briefly the sociological reasons for the increase in these injuries, discuss appropriate imaging techniques, and provide imaging examples of the clinically important injuries that may be encountered in this region...
July 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28281483/an-adolescent-with-prolapsed-omentum-per-rectum-spontaneous-rectal-perforation-managed-laparoscopically
#20
Ameet Kumar, Chandra K Jakhmola, Yogesh Kukreja, S S Kumar, Arjun Singh Sandhu
Spontaneous rupture of the rectum is a rare occurrence. A total laparoscopic approach to rectal perforation has only occasionally been reported. We report an unusual case of a young boy who developed a spontaneous rupture of the rectum following a trivial fall. A magnetic resonance imaging revealed a tear in the rectum at the peritoneal reflection with the omentum plugging it. He denied any history of rectal instrumentation or abnormal sexual activity. He had no history of constipation or rectal prolapse. The tear was repaired laparoscopically and a covering loop sigmoid colostomy was added...
April 2017: Journal of Minimal Access Surgery
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