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https://www.readbyqxmd.com/read/28669649/-dress-syndrome-and-agranulocytosis-a-rare-combination
#1
P Lavenant, J-M Roue, F Huet, C Abasq, L Misery, S Rioualen
INTRODUCTION: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe toxidermia that can lead to death from multivisceral failure. We report a case of DRESS associated with febrile agranulocytosis in a child. OBSERVATION: An 8-year-old child was hospitalized for diffuse maculopapular exanthema with edema of the extremities and face associated with cheilitis and febrile agranulocytosis. This symptomatology began 1month after the introduction of carbamazepine for partial epilepsy...
June 29, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28664444/indication-for-en-bloc-pancreatectomy-with-colectomy-when-is-it-safe
#2
Patrick B Schwartz, Alexandra M Roch, Jane S Han, Alex V Vaicius, William P Lancaster, E Molly Kilbane, Michael G House, Nicholas J Zyromski, C Max Schmidt, Atilla Nakeeb, Eugene P Ceppa
INTRODUCTION: Aggressive en bloc resection of adjacent organs is often necessary to resect pancreatic or colonic lesions. However, it is debated whether simultaneous pancreatectomy with colectomy (P+C) is warranted as it potentially increases morbidity and mortality (MM). We hypothesized that MM would be increased in P+C, especially in cases of pancreatitis. METHODS: All patients who underwent pancreatectomy (P) and simultaneous pancreatectomy with colectomy (P+C) at a high-volume center from November 2006 to 2015 were prospectively collected using ACS-NSQIP at our institution...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28638216/role-of-surgery-in-pancreatic-cancer
#3
EDITORIAL
Trond A Buanes
Treatment of pancreatic cancer is multimodal and surgery is an essential part, mandatory for curative potential. Also chemotherapy is essential, and serious postoperative complications or rapid disease progression may preclude completion of multimodal treatment. The sequence of treatment interventions has therefore become an important concern, and numerous ongoing randomized controlled trials compare clinical outcome after upfront surgery and neoadjuvant treatment with subsequent resection. In previous years, borderline resectable and locally advanced pancreatic cancer was most often considered unresectable...
June 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28622838/do-patients-requiring-a-multivisceral-resection-for-rectal-cancer-have-worse-oncologic-outcomes-than-patients-undergoing-only-abdominoperineal-resection
#4
Eslam M G Dosokey, Justin T Brady, Ruel Neupane, Murad A Jabir, Sharon L Stein, Harry L Reynolds, Conor P Delaney, Scott R Steele
INTRODUCTION: Abdominoperineal Resection (APR) remains an important option for patients with advanced rectal cancer though some may require multivisceral resection (MVR) in addition to APR. We hypothesized that oncological outcomes would be worse with MVR. METHODS: A retrospective review from 2006 to 2015 of 161 patients undergoing APR or MVR for rectal cancer, of whom 118 underwent curative APR or APR with MVR. Perioperative, oncologic and survival metrics were evaluated...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28614192/perioperative-antibiotic-prophylaxis-to-prevent-surgical-site-infections-in-solid-organ-transplantation
#5
Judith A Anesi, Emily A Blumberg, Lilian M Abbo
Antibiotic prophylaxis in the perioperative period is the standard of care for nearly all surgical procedures and routinely prescribed during solid organ transplantation (SOT). The primary goal of perioperative antibiotic prophylaxis is to minimize postoperative surgical site infections (SSIs). SSIs are a significant issue in SOT. Depending on the organ transplanted, SSIs occur in 3 to 53% of patients, with the highest rates observed in small bowel/multivisceral, liver, and pancreas transplant recipients. SOT recipients are also at increased risk of developing SSIs with antimicrobial-resistant organisms...
June 13, 2017: Transplantation
https://www.readbyqxmd.com/read/28600659/a-meta-analysis-of-clinical-outcome-of-intestinal-transplantation-in-patients-with-total-intestinal-aganglionosis
#6
Hiroki Nakamura, Davina Henderson, Prem Puri
AIM OF THE STUDY: Total intestinal aganglionosis (TIA) occurs in less than 1% of patients with Hirschsprung disease (HD), and TIA is the most severe form of HD. Survival has improved with the advent of parenteral nutrition and intestinal transplantation (ITx). The field of ITx has rapidly progressed in the last two decades and has now become an established treatment for patients with intestinal failure. The purpose of this meta-analysis was to determine the clinical outcome of ITx in patients with TIA...
August 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28595816/impact-of-body-mass-index-on-the-short-term-outcomes-of-resected-gastrointestinal-stromal-tumors
#7
Zachary E Stiles, Tyler M Rist, Paxton V Dickson, Evan S Glazer, Martin D Fleming, David Shibata, Jeremiah L Deneve
BACKGROUND: Potentially curative treatment for gastrointestinal stromal tumors (GIST) involves resection with selective utilization of tyrosine kinase inhibitors. A potential association between obesity and GIST has been postulated as GIST is among the most common incidental findings during gastric resection for bariatric procedures. The purpose of this study is to investigate the relationship and impact of obesity on the pathologic and short-term outcomes in patients with GIST. METHODS: We performed a retrospective review of patients with resected GIST...
May 10, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28591336/prognostic-factors-affecting-outcomes-in-multivisceral-en-bloc-resection-for-colorectal-cancer
#8
Caio Sergio Rizkallah Nahas, Sergio Carlos Nahas, Ulysses Ribeiro-Junior, Leonardo Bustamante-Lopez, Carlos Frederico Sparapan Marques, Rodrigo Ambar Pinto, Antonio Rocco Imperiale, Guilherme Cutait Cotti, William Carlos Nahas, Daher Cezar Chade, Dariane Sampaio Piato, Fabio Busnardo, Ivan Cecconello
OBJECTIVES: This study sought to determine the clinical and pathological factors associated with perioperative morbidity, mortality and oncological outcomes after multivisceral en bloc resection in patients with colorectal cancer. METHODS: Between January 2009 and February 2014, 105 patients with primary colorectal cancer selected for multivisceral resection were identified from a prospective database. Clinical and pathological factors, perioperative morbidity and mortality and outcomes were obtained from medical records...
May 2017: Clinics
https://www.readbyqxmd.com/read/28583558/successful-treatment-of-a-patient-with-diffuse-portosplenomesenteric-thrombosis-using-a-pericholedochal-varix-for-portal-flow-reconstruction-during-deceased-donor-liver-transplantation-a-case-report
#9
Y-D Yu, D-S Kim, J-H Han, Y-I Yoon
Portal vein thrombosis remains a challenging issue in liver transplantation. When thrombectomy is not feasible due to diffuse portosplenomesenteric thrombosis, other modalities are adapted such as the use of a jump graft or portal tributaries or even multivisceral transplantation. For patients with diffuse thrombosis of the splanchnic venous system, a large pericholedochal varix can be a useful vessel for providing splanchnic blood flow to the graft and for relieving portal hypertension. We report our experience of successfully treating a patient with diffuse portosplenomesenteric thrombosis using a pericholedochal varix for portal flow reconstruction during deceased donor liver transplantation and eventually preventing unnecessary multivisceral transplantation...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28565894/contemporary-strategies-to-improve-the-outcome-in-locally-advanced-pancreatic-cancer
#10
Rick Schneider, Christoph Späth, Ulrich Nitsche, Mert Erkan, Jörg Kleeff
Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with an overall 5-year survival rate of less than 7%. After many years of basic and clinical research efforts, pancreatic cancer patients presenting with locally advanced, unresectable tumors remain a therapeutic challenge. Despite the lack of high quality randomized controlled trials, perioperative/ neoadjuvant treatment strategies seem to be beneficial in these patients. At present the FOLFIRINOX regimen, which was established in the palliative setting, is increasingly recognized as the backbone of neoadjuvant therapy for locally advanced PDAC...
May 30, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28553630/choice-of-allograft-in-patients-requiring-intestinal-transplantation-a-critical-review
#11
REVIEW
Genevieve Huard, Thomas Schiano, Jang Moon, Kishore Iyer
Intestinal transplantation (ITx) is indicated in patients with irreversible intestinal failure (IF) and life-threatening complications related to total parenteral nutrition (TPN). ITx can be classified into three main types. Isolated intestinal transplantation (IITx), that is, transplantation of the jejunoileum, is indicated in patients with preserved liver function. Combined liver-intestine transplantation (L-ITx), that is, transplantation of the liver and the jejunoileum, is indicated in patients with liver failure related to TPN...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#12
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28538578/total-abdominal-wall-transplantation-an-anatomical-study-and-classification-system
#13
David Light, Neilendu Kundu, Risal Djohan, Cristiano Quintini, Namita Gandhi, Brian R Gastman, Richard Drake, Maria Siemionow, James E Zins
BACKGROUND: Candidates for multivisceral transplantation present with complex defects often beyond traditional reconstructive options. In this study, the authors describe a dissection technique for a total abdominal wall vascularized composite flap. In addition, the authors suggest a classification system for complex abdominal wall defects. METHODS: Forty fresh, cadaveric hemiabdomens were dissected, with care taken to preserve the iliofemoral, deep circumflex iliac, superficial circumflex iliac, deep inferior epigastric, and superficial inferior epigastric arteries and corresponding veins...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28510798/total-laparoscopic-management-for-stage-iv-colorectal-cancer-requiring-multivisceral-resection
#14
Y Nancy You, Hironori Shiozaki, Jeffrey E Lee, Guillaume Passot, Claire Goumard, Masayuki Okuno, Thomas A Aloia, Cathy Eng, George Chang, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: Surgical resection of all sites of disease, in combination with effective systemic chemotherapy, offers the only potential chance for cure for patients with stage IV colorectal cancer (CRC). Coordinated multistage resection using a minimally invasive approach may provide optimal oncologic outcome while potentially offering the benefit of decreased morbidity. PATIENT: A 66-year-old women presented with transverse colon cancer and synchronous metastasis (CRLM) in segment IV involving the middle hepatic vein and main left portal pedicle, as well as the left adrenal gland...
May 16, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28481070/-negative-pressure-system-in-the-treatment-of-enterocutaneous-fistulas-in-the-pediatric-population
#15
V Núñez Cerezo, M I Romo Muñoz, M V Amesty Morello, A Vilanova Sánchez, M Dore Reyes, M Gómez Cervantes, A M Andrés Moreno, E Martínez-Ojinaga Nodal, L Martínez Martínez, M López Santamaría
AIM OF THE STUDY: The management of children with enterocutaneous fistulas (EF) along with large abdominal wall defects secondary to multiple surgical interventions can be difficult and sometimes lead to intestinal failure (IF). The aim of this study is to present the results of negative pressure systems and their properties (edema reduction angiogenesis promotion and granulation tissue formation) in children with enterocutaneous fistulas (EF) and their prognosis. MATERIALS AND METHODS: A retrospective analysis of children with refractory, high output EF treated with NPS between 2008-2014...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28457853/two-dimensional-electrophoresis-highlights-haptoglobin-beta-chain-as-an-additional-biomarker-of-congenital-disorders-of-glycosylation
#16
Arnaud Bruneel, Florence Habarou, Tanya Stojkovic, Grégory Plouviez, Laure Bougas, Fanny Guillemet, Nadine Brient, Dominique Henry, Thierry Dupré, Sandrine Vuillaumier-Barrot, Nathalie Seta
Congenital disorders of glycosylation (CDGs) are rare inherited disorders affecting glycosylation of proteins and lipids and sharing very heterogeneous multivisceral symptoms. The biochemical screening of these diseases is currently limited to electrophoresis or HPLC separation/quantification of serum transferrin glycoforms and is relatively frequently hampered by genetic polymorphism. Further, it has been shown that transferrin glycosylation can be very poorly affected in confirmed CDGs. We developed a fast and simple two-dimensional (2-DE) Western-blot analysis applied to the simultaneous detection of various serum glycoproteins, i...
July 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28434656/an-overview-of-eu-and-usa-intestinal-transplant-current-activity
#17
A Lauro, F Panaro, K R Iyer
AIM OF THE STUDY: To report the current activity of intestinal transplantation in Europe (EU) and Unites States of America (USA), underlining outcomes in the last 5 years and discussing possible trends. PATIENTS AND METHODS: Data review of results was performed through analysis of ITR and UNOS registries, Eurotransplant and newsletter transplant reports, congress abstracts, international published literature, personal communications and hospital web sites. RESULTS: The absence in Europe of a sole organization collecting donors and the presence of many low-volume centers (less than 5 cases/year) makes the difference with USA: in the last 5 years (2010-2014), 222 intestinal/multivisceral transplants have been performed in EU countries (most of them in the UK), while in USA, the number of transplants achieved 634 procedures in the same period of time...
April 20, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28432461/laparoscopic-surgery-for-t4-colon-cancer-a-systematic-review-and-meta-analysis
#18
Charlotte E L Klaver, Tijmen M Kappen, Wernard A A Borstlap, Willem A Bemelman, Pieter J Tanis
BACKGROUND: In colon cancer, T4 stage is still assumed to be a relative contraindication for laparoscopic surgery considering the oncological safety. The aim of this systematic review with meta-analysis was to evaluate short- and long-term oncological outcomes after laparoscopic surgery for T4 colon cancer, and to compare these with open surgery. METHODS: Using systematic review of literature, studies reporting on radicality of resection, disease-free survival (DFS), and/or overall survival (OS) after laparoscopic surgery for T4 colon cancer were identified, with or without a control group of open surgery...
April 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28422396/a-simplified-multivisceral-transplantation-procedure-for-patients-with-combined-end-stage-liver-disease-and-type-2-diabetes-mellitus
#19
Xiao-Shun He, Shun-Jun Fu, Qiang Zhao, Xiao-Feng Zhu, Dong-Ping Wang, Ming Han, Wei-Qiang Ju, Yi Ma, Jiao Xing-Yuan, Xiao-Peng Yuan, An-Bin Hu, Zhi-Yong Guo
In liver transplant patients with type 2 diabetes mellitus (DM), the disease worsens after transplantation because of long-term use of diabetogenic immunosuppressive drugs, making management of those patients a great challenge. The objective of our study was to evaluate the safety and efficacy of a simplified multivisceral transplantation (SMT) procedure for the treatment of patients with end-stage liver disease and concurrent type 2 DM. Forty-four patients who had pretransplant type 2 DM were included. Twenty-three patients received SMT and 21 patients received orthotopic liver transplantation (OLT)...
April 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28395758/prevention-of-5-fluorouracil-induced-early-severe-toxicity-by-pre-therapeutic-dihydropyrimidine-dehydrogenase-deficiency-screening-assessment-of-a-multiparametric-approach
#20
RANDOMIZED CONTROLLED TRIAL
Michele Boisdron-Celle, Olivier Capitain, Roger Faroux, Christophe Borg, Jean Philippe Metges, Marie Pierre Galais, Mehdi Kaassis, Jaafar Bennouna, Karine Bouhier-Leporrier, Eric Francois, Isabelle Baumgaertner, Véronique Guerin-Meyer, Oana Cojocarasu, Celia Roemer-Becuwe, Claire Stampfli, Ludovic Rosenfeld, Thierry Lecompte, Virginie Berger, Alain Morel, Erick Gamelin
5-Fluorouracil (5-FU)-based treatments can lead to early-onset severe (4%-5%) even fatal (0.3%) toxicities in patients with dihydropyrimidine dehydrogenase (DPD) deficiency. This multicenter prospective cohort study aimed to assess the clinical benefit of pretherapeutic screening for DPD deficiency using a multiparametric approach. Two parallel cohorts of patients treated with 5-FU-based chemotherapy for colorectal carcinoma were compared in a prospective nonrandomized study. In arm A, patients had DPD deficiency screening before treatment, whereas in arm B no pretherapy screening was performed...
February 2017: Seminars in Oncology
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