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https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#1
Seema A Patil, Raymond K Cross
The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28630018/the-modified-ulaanbaatar-procedure-reduced-complications-and-enhanced-cosmetic-outcome-for-the-most-severe-cases-of-hypospadias
#2
V R Jayanthi, C B Ching, D G DaJusta, D J McLeod, S A Alpert
INTRODUCTION/OBJECTIVE: Proximal hypospadias is one of the most challenging conditions that pediatric urologists have to deal with. Many procedures have been devised over the years, but nothing has been proven to be the best option. Although there have been some attempts at correcting severe hypospadias in one procedure, most have advocated a staged approach. The classic approach - laying penile skin or a graft within a split glans followed by glanuloplasty at the second stage - by definition requires two operations on the glans...
May 18, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28614776/nonsteroidal-anti-inflammatory-drugs-induced-failure-of-lower-esophageal-and-pyloric-sphincter-and-counteraction-of-sphincters-failure-with-stable-gatric-pentadecapeptide-bpc-157-in-rats
#3
S Vitaic, M Stupnisek, D Drmic, L Bauk, A Kokot, R Klicek, A Vcev, K Luetic, S Seiwerth, P Sikiric
The sphincters failure is a part of NSAIDs-toxicity that can be accordingly counteracted. We used a safe stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, MW 1419), LD1 not achieved, since successful in inflammatory bowel disease trials, and counteracts esophagitis, sphincters failure, gastrointestinal ulcer and skin ulcer, external and internal fistulas in rats, and particularly counteracts all NSAIDs-lesions. We assessed lower esophageal sphincter and pyloric sphincter pressure (cmH2O) in rats treated with various NSAIDs regimens, at corresponding time points, known to produce stomach, small intestine lesions, hepatotoxicity and encephalopathy...
April 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28613003/systematic-review-pharmacotherapy-for-high-output-enterostomies-or-enteral-fistulas
#4
REVIEW
F E E de Vries, L F Reeskamp, O van Ruler, I van Arum, W Kuin, G Dijksta, J W Haveman, M A Boermeester, M J Serlie
BACKGROUND: High-output enterocutaneous fistula or enterostomies can cause intestinal failure. There is a wide variety of options in medical management of patients with high output. AIM: To systematically review the literature on available pharmacotherapy to reduce output and to propose an algorithm for standard of care. METHODS: Relevant databases were systematically reviewed to identify studies on pharmacotherapy for reduction in (high-) output enterostomies or fistula...
June 14, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28611519/sonographic-appearance-of-anal-cushions-of-hemorrhoids
#5
Adilijiang Aimaiti, Ma Mu Ti Jiang A Ba Bai Ke Re, Irshat Ibrahim, Hui Chen, Maimaitituerxun Tuerdi, Mayinuer
AIM: To evaluate the diagnostic value of different sonographic methods in hemorrhoids. METHODS: Forty-two healthy volunteers and sixty-two patients with grades I-IV hemorrhoids received two different sonographic examinations from January 2013 to January 2016 at the First and Second Hospitals of Xinjiang Medical University in a prospective way. We analyzed the ultrasonographic findings of these participants and evaluated the outcomes. Resected grades III and IV hemorrhoid tissues were pathologically examined...
May 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28608016/quantitative-assessment-of-pancreatic-texture-using-a-durometer-a-new-tool-to-predict-the-risk-of-developing-a-postoperative-fistula
#6
Giovanni Marchegiani, Roberto Ballarin, Giuseppe Malleo, Stefano Andrianello, Valentina Allegrini, Alessandra Pulvirenti, Marina Paini, Erica Secchettin, Fabrizio Boriero, Fabrizio Di Benedetto, Claudio Bassi, Roberto Salvia
BACKGROUND: Pancreatic texture is one of the key predictors of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD). Currently, the "gold standard" for assessment of pancreatic texture is surgeon's subjective evaluation through manual palpation. AIM: To evaluate a new "durometer" that is able to assess quantitatively the pancreatic stiffness by measuring its elastic module (i.e., the resistance offered by the pancreatic stump when elastically deformed expressed in mPa)...
June 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28607808/concomitant-chemoradiotherapy-associated-oral-lesions-in-patients-with-oral-squamous-cell-carcinoma
#7
Sadia Minhas, Muhammad Kashif, Wasif Altaf, Nadeem Afzal, Abdul Hanan Nagi
OBJECTIVE: : Oral squamous-cell carcinoma (OSCC) accounts for >90% of oral cancers affecting adults mostly between the fourth to seventh decades of life. The most common OSCC treatment is concomitant chemoradiotherapy (CCRT) having both loco-regional and distant control, but CCRT has acute and chronic toxic effects on adjacent normal tissue. This study aimed to determine the side effects of CCRT on the oral mucosa and to characterize the clinicopathology of oral lesions in patients with OSCC...
May 2017: Cancer Biology & Medicine
https://www.readbyqxmd.com/read/28605140/array-based-molecular-karyotyping-in-115-vater-vacterl-and-vater-vacterl-like-patients-identifies-disease-causing-copy-number-variations
#8
Rong Zhang, Florian Marsch, Franziska Kause, Franziska Degenhardt, Eeberhard Schmiedeke, Stefanie Märzheuser, Bernd Hoppe, Haitham Bachour, Thomas M Boemers, Matthias Schäfer, Nicole Spychalski, Jörg Neser, Johannes Leonhardt, Ferdinand Kosch, Benno Ure, Barbara Gómez, Martin Lacher, Oliver J Deffaa, Markus Palta, Boris Wittekindt, Katharina Kleine, Andrea Schmedding, Sabine Grasshoff-Derr, Amelie van der Ven, Stefanie Heilmann-Heimbach, Nadine Zwink, Ekkehart Jenetzky, Michael Ludwig, Heiko Reutter
BACKGROUND: The acronym VATER/VACTERL refers to the rare nonrandom association of the following component features (CF): vertebral defects (V), anorectal malformations (A), cardiac defects (C), tracheoesophageal fistula with or without esophageal atresia, renal malformations (R), and limb defects (L). Patients presenting with at least three CFs are diagnosed as having VATER/VACTERL association while patients presenting with only two CFs are diagnosed as having VATER/VACTERL-like phenotypes...
June 12, 2017: Birth defects research
https://www.readbyqxmd.com/read/28603565/current-concepts-congenital-scoliosis
#9
Agnivesh Tikoo, Manish K Kothari, Kunal Shah, Abhay Nene
BACKGROUND: Congenital scoliosis is one of the 'difficult to treat' scenarios which a spine surgeon has to face. Multiple factors including the age of child at presentation, no definite pattern of deformity and associated anomalies hinder the execution of the ideal treatment plan. All patients of congenital scoliosis need to be investigated in detail. X rays and MRI of spine is usually ordered first. Screening investigations to rule out VACTERL (Visceral, Anorectal, Cardiac, Tracheo-esophageal fistula, Renal and Lung) abnormalities are required...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28601324/predictive-factors-for-recurrence-of-high-transsphincteric-anal-fistula-after-placement-of-seton
#10
Sameh Hany Emile, Hossam Elfeki, Waleed Thabet, Ahmed Sakr, Alaa Magdy, Tito M Abd El-Hamed, Waleed Omar, Wael Khafagy
BACKGROUND: The optimal surgical treatment for high transsphincteric fistula-in-ano (FIA) should attain complete eradication of the fistulous track and, in the same time, not compromising the anal sphincters. The present study aimed to investigate the predictive factors for recurrence of high transsphincteric FIA after placement of draining seton and to evaluate the efficacy and complications of seton treatment for high cryptoglandular anal fistula. MATERIALS AND METHODS: This is a retrospective case-control study of patients with high transsphincteric FIA who were treated with seton placement...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28589547/preoperative-exercise-training-for-patients-with-non-small-cell-lung-cancer
#11
REVIEW
Vinicius Cavalheri, Catherine Granger
BACKGROUND: Surgical resection for early stage non-small cell lung cancer (NSCLC) offers the best chance of cure, but is associated with a risk of postoperative pulmonary complications (i.e. pneumonia (new infiltrate coupled with either fever (> 38º C) and purulent secretions, or fever and white cell count > 11,000), bronchopleural fistula, severe atelectasis that requires chest physiotherapy or bronchoscopy, and prolonged mechanical ventilation (> 48 hours)). It is currently unclear if preoperative exercise training, and the potential resultant improvement in exercise capacity, may also improve postoperative outcomes, such as the risk of developing postoperative pulmonary complications, the length of postoperative intercostal drainage, or the length of hospital stay...
June 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28588070/risk-factors-for-fractures-in-children-hospitalized-in-intensive-and-intermediate-care-units
#12
Ian S Zenlea, Patrice Melvin, Susanna Y Huh, Nilesh Mehta, Suzanne J Reidy, Erinn T Rhodes, Nina S Ma
BACKGROUND AND OBJECTIVES: Fragility fractures are increasingly recognized in hospitalized children. Our study aim was to identify risk factors for fracture in children hospitalized in intensive and intermediate care units. METHODS: We conducted a retrospective, case-control study comparing the clinical characteristics of children with fractures (cases) to children without fractures (controls) matched for age, sex, hospital unit, admission quarter and year, ICU length of stay, severity of illness, and resource utilization...
June 6, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28583543/laparoscopy-assisted-spleen-preserving-distal-pancreatectomy-for-living-donor-pancreas-transplantation
#13
S Date, H Noguchi, K Kaku, K Kurihara, Y Miyasaka, Y Okabe, U Nakamura, T Ohtsuka, M Nakamura
BACKGROUND: Living pancreas transplantation plays an important role in the treatment of patients with severe type 1 diabetes. However, pancreatectomy is very invasive for the donor, and less-invasive surgical procedures are needed. Although some reports have described hand-assisted laparoscopic surgery for distal pancreatectomy in living-donor operations, less-invasive laparoscopy-assisted (LA) procedures are expected to increase the donor pool. We herein report the outcomes of four cases of LA spleen-preserving distal pancreatectomy (Warshaw technique [WT]) in living pancreas donors...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28583202/systematic-review-with-meta-analysis-the-efficacy-and-safety-of-stem-cell-therapy-for-crohn-s-disease
#14
REVIEW
Yun Qiu, Man-Ying Li, Ting Feng, Rui Feng, Ren Mao, Bai-Li Chen, Yao He, Zhi-Rong Zeng, Sheng-Hong Zhang, Min-Hu Chen
BACKGROUND AND AIMS: Stem cell therapy (SCT) for the treatment of Crohn's disease (CD) is still in its infancy, and whether SCT is associated with improved outcomes is unclear. We performed a meta-analysis to evaluate the efficacy and safety of patients receiving SCT. METHODS: Electronic databases were searched for studies that reported the use of stem cells for the treatment of patients with CD. Raw data from included studies were pooled for effect estimates. Subgroup analyses were performed for exploration of heterogeneity regarding all outcomes...
June 6, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28578386/injectable-in-situ-cross-linking-chitosan-hyaluronic-acid-based-hydrogels-for-abdominal-tissue-regeneration
#15
Youming Deng, Jianan Ren, Guopu Chen, Guanwei Li, Xiuwen Wu, Gefei Wang, Guosheng Gu, Jieshou Li
Abdominal wall defect caused by open abdomen (OA) or abdominal trauma is a serious issue since it induces several clinical problems. Although a variety of prosthetic materials are commonly employed, complications occur including host soft tissue response, fistula formation and chronic patient discomfort. Recently, abundant natural polymers have been used for injectable hydrogel synthesis in tissue regeneration. In this study, we produced the chitosan - hyaluronic acid (CS/HA) hydrogel and investigated its effects on abdominal tissue regeneration...
June 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28576531/the-clinical-efficacy-of-early-intervention-for-infected-preauricular-sinus
#16
Oak-Sung Choo, Top Kim, Jeong Hun Jang, Yun-Hoon Choung
OBJECTIVE: The study was designed to evaluate the outcomes of early surgical intervention, and to suggest the accurate operation time and surgical strategies. METHODS: A total of 190 cases (144 patients) of PAS excision were classified into 2 groups according to their time of surgery; early intervention group (n = 53), and non-early intervention group (n = 137). Early intervention was defined as excision performed within 3 weeks from their first hospital visit, and after acute infection control, surgical removal was followed regardless of their infection status...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28576453/epidemiology-of-infections-and-antimicrobial-use-in-australian-haemodialysis-outpatients-findings-from-a-victorian-surveillance-network-2008-2015
#17
Leon J Worth, Tim Spelman, Steven G Holt, Judith A Brett, Ann L Bull, Michael J Richards
BACKGROUND: Patients with chronic renal failure who require haemodialysis are at high risk for infections. The objectives of this study were to determine the burden of bloodstream and local access-related infections and prescribing patterns for intravenous antibiotics in Australian haemodialysis outpatients. METHODS: A surveillance network was established following stakeholder consultation, with voluntary participation by haemodialysis centres and data collation by the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre...
May 30, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28575246/safety-and-feasibility-of-esophageal-self-expandable-metal-stent-placement-without-the-aid-of-fluoroscopy
#18
S Saligram, D Lim, L Pena, M Friedman, C Harris, J Klapman
Self-expandable metal stents (SEMSs) are used for the management of certain esophageal conditions such as strictures, perforations, and fistulae. These can be placed using fluoroscopic control, endoscopic control, or a combination of both. We evaluated our institutional experience of placing a SEMS using only endoscopy without the aid of fluoroscopy to determine safety and feasibility using this technique. A retrospective review was performed to identify all patients who underwent esophageal SEMS from January 2010 to June 2015...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28575240/epidemiology-diagnosis-and-management-of-esophageal-perforations-systematic-review
#19
E Ilias K Sdralis, S Petousis, F Rashid, B Lorenzi, A Charalabopoulos
We performed a systematic review of epidemiological, diagnostic, and therapeutic outcomes of esophageal perforations. A systematic review was performed in PubMed database using the key-phrase 'esophageal perforation'. All studies regarding acute esophageal perforations were reviewed and parameters of epidemiology, diagnosis, and management published in the literature from 2005 up to 2015 were included in the study. Studies of postoperative esophageal leaks were excluded. Two researchers performed individually the research, while quality assessment was performed according to GRADE classification...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28574593/early-versus-delayed-appendicectomy-for-appendiceal-phlegmon-or-abscess
#20
REVIEW
Yao Cheng, Xianze Xiong, Jiong Lu, Sijia Wu, Rongxing Zhou, Nansheng Cheng
BACKGROUND: Appendiceal phlegmon and abscess account for 2% to 10% of acute appendicitis. People with appendiceal phlegmon or abscess usually need an appendicectomy to relieve their symptoms and avoid complications. The timing of appendicectomy for appendiceal phlegmon or abscess is controversial. OBJECTIVES: To assess the effects of early versus delayed appendicectomy for appendiceal phlegmon or abscess, in terms of overall morbidity and mortality. SEARCH METHODS: We searched the Cochrane Library (CENTRAL; 2016, Issue 7), MEDLINE Ovid (1950 to 23 August 2016), Embase Ovid (1974 to 23 August 2016), Science Citation Index Expanded (1900 to 23 August 2016), and the Chinese Biomedical Literature Database (CBM) (1978 to 23 August 2016)...
June 2, 2017: Cochrane Database of Systematic Reviews
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