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https://www.readbyqxmd.com/read/29146218/presentation-and-diagnosis-of-fournier-s-gangrene
#1
REVIEW
Bryan B Voelzke, Judith C Hagedorn
Necrotizing fasciitis is a severe type of necrotizing soft tissue infection involving the superficial fascia and subcutaneous tissues. Fournier's gangrene, a type of necrotizing fasciitis, affects the genitalia and/or perineum. While a rare health condition, Fournier's gangrene can result in significant morbidity and unnecessary mortality following delay in diagnosis and management. We provide a review of relevant presenting features to aid diagnosis and allow timely surgical management of this serious infectious condition...
November 13, 2017: Urology
https://www.readbyqxmd.com/read/29145312/bilateral-femoral-posterior-neurocutaneous-perforater-flap-successfully-treating-fournier-gangrene-a-case-report
#2
Tao Wang, Gang Zhao, Yong-Jun Rui, Jing-Yi Mi
RATIONALE: Necrotizing fasciitis (NF), characterized by widespread fascial necrosis, is a rare disease in clinic. Fournier gangrene (FG) is a special type of NF involved of perineum and scrotum. To our knowledge, no article has reported on bilateral femoral posterior neurocutaneous perforater flap treating for FG. PATIENT CONCERNS: A 61-year-old Chinese male complained of perineal skin necrosis for 19 days. The patient received treatment in other hospital due to chronic bronchitis on April 15th and body temperature ranged from 38 to 39 °C...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136732/-prognosis-factors-for-the-perineal-incision-complications-after-abdominoperineal-resection-for-low-rectal-cancer
#3
S Luo, J W Liang, H T Zhou, W Pei, Z X Zhou, Q Liu, X S Wang
Objective: To evaluate the prognosis factors affecting perineal incision complications after abdominoperineal resection (APR) for the low rectal cancer. Methods: This was a retrospective analysis of 151 consecutive patients with low rectal cancer undergoing APR between January and December 2013 at Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The patients were comprised of 95 males and 56 females. The mean age of the patients was (57...
November 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29135136/-structural-morphological-changes-of-the-connective-tissue-of-the-vaginal-mucosa-and-perineal-skin-in-women-with-stress-urinary-incontinence
#4
V N Pavlov, A G Yashchuk, A A Kazikhinurov, I I Musin, R M Zauinullina, V A Kulavskii, A A Kazikhinurova
AIM: To investigate the morphological and structural changes in the connective tissue of the vaginal mucosa and perineal skin in women with stress urinary incontinence. MATERIALS AND METHODS: From 2010 to 2013, 71 patients of reproductive age with stress incontinence were observed. The control group comprised 80 women, who also underwent biopsy of the vaginal mucosa and perineal skin. The sections of specimens were stained by Van Gieson, Mallory and Weigert. In immunohistochemical studies, rabbit antibodies specific for collagen types I, III, and IV were placed on each section...
October 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/29127963/minimally-invasive-surgery-in-the-management-of-anorectal-malformations
#5
REVIEW
Sarah B Cairo, David H Rothstein, Carroll M Harmon
Imperforate anus, a variant of anorectal malformation (ARM), is a common congenital anomaly requiring surgical attention in the newborn period. It may present with a variety of anatomic configurations, largely dependent on the presence and location of a fistula. The location (or characteristics) of a fistula, which usually lies between the gastrointestinal tract and the genitourinary tract or perineum, is often used in determining the type and timing of operative management. This article discusses the work-up and management, modes of treatment and their postoperative outcomes, and continued controversy regarding the use of minimally invasive surgical approaches to ARM...
December 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/29118550/-horrendoplasty-a-case-of-total-perineal-destruction-by-agricultural-implement
#6
Pedro Simoes de Oliveira, Tiago Ribeiro de Oliveira, David Martinho, Francisco Martins
Although posterior urethral injury occurs almost always in association with pelvic fracture, it may result from severe trauma to the perineum with its associated potential lethality and severe morbidity. Early primary endoscopic realignment over a urethral catheter can be attempted, although an immediate suprapubic tube placement remains the standard of care. Definitive treatment consists of elective open posterior anastomotic urethroplasty through a perineal approach. The authors present a 53-year-old man who sustained total, massive perineal destruction resulting from work accident with an agricultural implement...
October 2017: Urology Annals
https://www.readbyqxmd.com/read/29112640/distance-between-the-distal-rectal-pouch-and-perineum-in-neonates-of-low-birth-weight-with-imperforate-anus
#7
Takahiro Hosokawa, Mayumi Hosokawa, Yutaka Tanami, Hiroaki Takahashi, Shinya Hattori, Yumiko Sato, Yujiro Tanaka, Hiroshi Kawashima, Eiji Oguma, Yoshitake Yamada
This study was to evaluate the correlation between birth weight and the distance between distal rectal pouch and perineum (P-P distance) and to determine a cutoff value for P-P distance to diagnose low-type imperforate anus in neonates with low-birth weight (LBW).We included 15 neonates with LBW (mean weight, 2012 ± 470 g; range, 906-2452 g) and imperforate anus (surgically confirmed: 11 low type and 3/1 intermediate/high type), who underwent ultrasonography on the day after birth. Type of imperforate anus was defined based on the International Classification of Anorectal Anomalies...
November 6, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/29107432/-reconstruction-of-abdo-perineal-resection-by-taylor-flap-about-68-patients
#8
D Boccara, K SerroR, J Lefevre, M Mimoun, M Chaouat
PURPOSES: Healing after abdomino-perineal resection is often difficult, especially in patients who have undergone radiation therapy. Vaginal reconstruction is also an important issue for the women who undergo this surgery. We describe and analyze here our series of perineal reconstructions with modified Taylor flaps. Between 2010 and 2016, 68 patients (52 women, 16 men) with cancer of the anal canal (53), adenocarcinoma of the lower rectum (9), or other malignant neoplasms of the perineum underwent reconstruction with a rectus abdominis myocutaneous (RAM) flap with an inferior pedicle and an oblique skin paddle...
October 26, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29098194/cowper-s-syringocele-in-adolescent-male-case-report
#9
Milena Taskovska, Simon Hawlina
Background: Cowper's syringocele is a rare condition, uncommon in the adult population. It is more common in the pediatric population. Patients could be asymptomatic or present with irritative and/or obstructive symptoms. Ultrasonography (US) of perineal region, pelvis MRI, or urethrography are the most often used diagnostic modalities. Surgical treatment is indicated in all symptomatic patients. Endoscopic approach is preferred over open surgery. Unroofing of syringocele with cold knife or holmium yttrium aluminium garnet (YAG) laser is effective treatment...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29095185/immediate-perineal-reconstruction-after-extralevatory-abdominoperineal-excision-buried-desepidermised-fasciocutaneous-v-y-advancement-flap
#10
Özay Özkaya, Ayça Ergan Şahin, İlker Üsçetin, Hakan Güven, Fazil Sağlam
BACKGROUND: According to National Cancer Institute, there are approximately 39,800 rectal cancer cases per year, 25% of which will need an abdominoperineal resection (APR). The key to avoid most of the complications related to pelvic defect that occurs after APR is choosing an appropriate reconstruction option for perineum. This study aims to introduce an easily applicable flap option for closure to address postoperative pelvic defect in low rectal cancer. METHODS: This is a retrospective evaluation of 9 patients who have undergone perineal reconstruction for pelvic defects after extralevatory abdominoperineal excision with rectal cancer between 2014 and 2016...
October 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29074158/staphylococcus-aureus-colonization-during-military-service-a-prospective-cohort-study
#11
Hege Vangstein Aamot, Petri Kaarlo Juhani Eskonsipo, Silje Bakken Jørgensen, Anita Blomfeldt
OBJECTIVES: Staphylococcus aureus colonization leading to skin and soft tissue infections (SSTI) are known challenges in crowded settings such as the military. The aim of the study was to a) establish and compare the prevalence of S. aureus colonization in recruits at enrolment and discharge after the first year of military service and b) investigate the prevalence of S. aureus SSTI. METHODS: All recruits entering first year of military service in January 2013 to be stationed at three garrisons in the northern part of Norway were invited to join this prospective cohort study...
October 23, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29068541/reproducibility-and-acceptability-of-ultrasound-measurements-of-head-perineum-distance
#12
Sigurlaug Benediktsdottir, Kjell Åsmund Salvesen, Hulda Hjartardottir, Torbjørn Moe Eggebø
INTRODUCTION: We aimed to test reproducibility of head-perineum distance (HPD) measurements using two different ultrasound devices and five examiners, to compare ultrasound measurements and clinical assessments and to study if ultrasound examinations were acceptable for women in labor. MATERIAL AND METHODS: A reproducibility study was performed at Lund University Hospital, Sweden and Landspitali University Hospital, Iceland from February 2015 to February 2017. The study population comprised 40 healthy women in labor...
October 25, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29067426/effect-of-robotic-assisted-vs-conventional-laparoscopic-surgery-on-risk-of-conversion-to-open-laparotomy-among-patients-undergoing-resection-for-rectal-cancer-the-rolarr-randomized-clinical-trial
#13
RANDOMIZED CONTROLLED TRIAL
David Jayne, Alessio Pigazzi, Helen Marshall, Julie Croft, Neil Corrigan, Joanne Copeland, Phil Quirke, Nick West, Tero Rautio, Niels Thomassen, Henry Tilney, Mark Gudgeon, Paolo Pietro Bianchi, Richard Edlin, Claire Hulme, Julia Brown
Importance: Robotic rectal cancer surgery is gaining popularity, but limited data are available regarding safety and efficacy. Objective: To compare robotic-assisted vs conventional laparoscopic surgery for risk of conversion to open laparotomy among patients undergoing resection for rectal cancer. Design, Setting, and Participants: Randomized clinical trial comparing robotic-assisted vs conventional laparoscopic surgery among 471 patients with rectal adenocarcinoma suitable for curative resection conducted at 29 sites across 10 countries, including 40 surgeons...
October 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29066701/-a-case-of-fournier-s-gangrene-due-to-perforation-of-lower-rectal-cancer-during-chemotherapy
#14
Haruhi Fukuhisa, Kenji Baba, Yoshiaki Kita, Hiroshi Tanabe, Tetsuya Ijichi, Shinichiro Mori, Shoji Natsugoe
Fournier's gangrene is a rapidly progressing bacterial infection, involving the subcutaneous and deep fascia. Although intestinal perforation after treatment with bevacizumab is well known, Fournier's gangrene rarely occurs during chemotherapy. A 73-year-old man with unresectable rectal cancer during chemotherapy involving the mFOLFOX6 plus bevacizumab regimen had a consciousness disorder and was admitted to our hospital on emergency. Computed tomography scans indicated a necrotizing soft tissue infection with large amounts of pneumoderma throughout the perineum...
October 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29065235/comparison-of-active-stimulating-electrodes-of-sacral-neuromodulation
#15
Xin Su, Matthew Cutinella, Jason E Agran, David A Dinsmoor
OBJECTIVE: The goal of this study was to compare the motor response to sacral neuromodulation (SNM) with different pairs of stimulating electrodes in anesthetized and awake sheep. MATERIALS AND METHODS: Similar to SNM clinical use in humans, the InterStim(®) quadripolar tined lead was implanted adjacent to the S3 nerve root in sheep and bipolar stimulation was configured with one electrode negative and one electrode positive on the four contacts (0 most distal to device, 1, 2, and 3 most proximal)...
October 24, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29049257/management-of-moisture-associated-skin-damage-a-scoping-review
#16
Kevin Y Woo, Dimitri Beeckman, Debashish Chakravarthy
BACKGROUND: Protecting the skin against moisture-associated damage is an important component of comprehensive skin and wound care. Based on a review of literature, the authors propose key interventions to protect and prevent damage in the skin folds, perineum, and areas surrounding a wound or stoma. OBJECTIVE: The aim of this scoping review is to identify and provide a narrative integration of the existing evidence related to the management and prevention of moisture-associated skin damage (MASD)...
November 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29037545/perineal-length-among-vietnamese-women
#17
Anh T Trinh, Tanya A Nippita, Trang N Dien, Jonathan M Morris, Christine L Roberts
OBJECTIVE: Vietnamese clinicians routinely perform episiotomies in the belief that 3rd-4th degree tears may be prevented, based partly on the view that Vietnamese women have a short perineal length that puts them at increased risk of tears. However, there is no evidence to suggest Vietnamese women have a short perineum compared with other populations. We aimed to determine the mean perineal length among Vietnamese women in early labor and in the second stage, and to compare this to findings from similar studies in other populations...
October 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29022481/intra-and-interobserver-variability-of-intrapartum-transperineal-ultrasound-measurements-with-contraction-and-pushing
#18
José A Sainz, Ana Fernández-Palacín, Carlota Borrero, Adriana Aquise, Zenaida Ramos, José A García-Mejido
The aim of this study was to evaluate the inter- and intraobserver correlation of the different intrapartum-transperineal-ultrasound-parameters(ITU) (angle of progression (AoP), progression-distance (PD), head-direction (HD), midline-angle (MLA) and head-perineum distance (HPD)) with contraction and pushing. We evaluated 28 nulliparous women at full dilatation under epidural analgesia. We performed a transperineal ultrasound evaluating AoP and PD in the longitudinal plane, and MLA and HPD in the transverse plane...
October 12, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28994342/malignant-ectomesenchymoma-series-analysis-of-a-histologically-and-genetically-heterogeneous-tumor
#19
Brannan B Griffin, Pauline M Chou, David George, Lawrence J Jennings, Nicoleta C Arva
AIMS: Malignant ectomesenchymoma is a rare pediatric neoplasm with dual mesenchymal and neuroectodermal elements. Mesenchymal component is usually rhabdomyosarcoma, particularly embryonal subtype, whereas neuroectodermal derivatives are frequently a neuroblastic tumor. Ectomesenchymoma manifests in various sites given the wide migration of neural crest cells during development, though the pelvis/perineum is most often involved. Moreover, no unique unifying molecular abnormality has been determined...
October 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28969197/neglected-necrotizing-fasciitis-a-rare-complication-of-spinal-anaesthesia
#20
Karikal Chakaravarthi, Ashish Gupta, Lileswar Kaman
Necrotizing Fasciitis (NF) is a rare, rapidly progressive severe bacterial soft tissue infection with a high mortality rate. NF classically involves the trunk, groin/perineum, lower limbs, and postoperative wound sites. NF secondary to spinal anaesthesia in a young postpartum female is extremely rare. Here we are describing a young postpartum female who underwent cesarean section for the delivery of child but developed NF of the back starting from the site of spinal needle insertion. She was referred to our center after 21 days of surgery with extensive NF...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
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