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emergency surgical risk

Becher Al-Halabi, Alex Viezel-Mathieu, Zachary Shulman, Marcel A Behr, Omar Fouda Neel
BACKGROUND: Epidemiological evidence of periprosthetic mycobacterial infections (PMIs) is limited. The recent boom in cosmetic surgery tourism has been associated with a rise of surgical site infections (SSIs) in returning patients. This review aims to explore available data, examine trends of documented PMIs and analyze outcomes of management techniques. METHODS: A search in Biosis, Embase, LILACS, Medline, and Web of Science databases from inception until December 2017 for "Breast Implants" and "Mycobacterial Infections" and equivalents was performed...
August 7, 2018: Plastic and Reconstructive Surgery
Michael O Kayatta, Michael E Halkos, John D Puskas
Coronary artery disease (CAD) has typically been treated either medically, with percutaneous coronary intervention (PCI), or with coronary artery bypass grafting (CABG). As advances in stent technology and minimally invasive surgery have developed, a third option has emerged: hybrid coronary revascularization (HCR). In HCR, minimally invasive CABG and PCI are both employed to treat a single patient, often during the same hospital stay. Patients appropriate for this technique vary widely, from low-risk patients with low SYNTAX lesions outside the left anterior descending artery (LAD), to high-risk patients with multiple comorbidities who are felt by the heart team to benefit most by avoiding a sternotomy...
July 2018: Annals of Cardiothoracic Surgery
Bojana Misheva, Roy Hajjar, Frédéric Mercier, Frank Schwenter, Herawaty Sebajang
Rubber-band ligation (RBL) is a safe and cost-effective approach to internal haemorrhoids. Potential side effects include pain, bleeding, urinary retention and occasionally pelvic sepsis and systemic inflammatory response syndrome (SIRS). At-risk patients are mainly those with immunocompromising conditions. Although aggressive surgical debridement or diverting colostomy appear to be obvious options when patients' life is threatened, their superiority to conservative measures has not been proven. We present the case of a 58-year-old female patient who presented 48 h after a RBL with pelvic pain, dysuria and leukocytosis...
August 2018: Journal of Surgical Case Reports
Jean-Marie Freymond, Roland Chautems, Vincent Della Santa, Line Wolter
Hemorrhoids affect up to 85 % of pregnant women during the last two trimesters. The maximum incidence for anal fissure is 20 %. One of the common risk factors is constipation promoted during pregnancy. The history of anal pathology, the length of delivery and the baby's birth weight also promote these two entities. The treatment includes above all hygiene and dietary measures to prevent constipation and conservative measures (local anesthetics, sitz baths). Surgical procedures should be avoided and indicated only in case of failure of conservative treatment...
August 8, 2018: Revue Médicale Suisse
Nicola Creighton, Stuart Purdie, Matthew Soeberg, Richard Walton, Deborah Baker, Jane Young
BACKGROUND: In contrast to aetiological associations, there is little empirical evidence for generalising health service use associations from cohort studies. We compared the health service use of cohort study participants diagnosed with bowel or lung cancer to the source population of people diagnosed with these cancers in New South Wales (NSW), Australia to assess the representativeness of health service use of the cohort study participants. METHODS: Population-based cancer registry data for NSW residents aged ≥45 years at diagnosis of bowel or lung cancer were linked to the 45 and Up Study, a NSW population-based cohort study (N~ 267,000)...
August 8, 2018: BMC Medical Research Methodology
Or Cohen-Inbar, Gil E Sviri
The surgical management of cerebral and skull base lesions has evolved greatly in the last few decades. Still, a complete resection of lesions abutting critical neurovascular structures carries significant morbidity. Stereotactic radiosurgery (SRS) has emerged as an increasingly accepted treatment option. Minimally invasive, SRS results in excellent tumor control and low complication rates in patients with moderate-size tumors. The management of large cerebral and skull base tumors remains a formidable challenge...
July 30, 2018: Rambam Maimonides Medical Journal
Erik Osterman, Bengt Glimelius
BACKGROUND: Developments in the quality of care of patients with colon cancer have improved surgical outcome and thus the need for adjuvant chemotherapy. OBJECTIVE: To investigate the recurrence rate in a large population-based cohort after modern staging, surgery, and pathology have been implemented. DESIGN: This was a retrospective registry study. SETTINGS: Data from patients included in the Swedish Colorectal Cancer Registry covering 99% of all cases and undergoing surgery for colon cancer stages I to III between 2007 and 2012 were obtained...
September 2018: Diseases of the Colon and Rectum
Cristian A Naudy, Juan C Yanez-Siller, Paulo M Mesquita Filho, Matias Gomez G, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
BACKGROUND: The origin of the ophthalmic artery is within the surgical field of endoscopic endonasal approaches (EEAs) to the suprasellar and parasellar regions. However, its anatomy from the endoscopic point-of-view has not been adequately elucidated. OBJECTIVE: To highlight the anatomy of the ophthalmic artery origin from an endoscopic endonasal perspective. METHODS: The origin of the ophthalmic artery was studied bilaterally under endoscopic visualization, after performing transplanum/transtubercular EEAs in 17 cadaveric specimens (34 arteries)...
July 31, 2018: Operative Neurosurgery (Hagerstown, Md.)
Carlos A Mestres, Eduard Quintana, Tomislav Kopjar, Juan Ambrosioni, Manuel Almela, David Fuster, Salvador Ninot, José M Miró
OBJECTIVES: The aim of this study was to analyse outcomes over 2 decades using cryopreserved vascular allografts to treat vascular infection. METHODS: We conducted a retrospective study of patients identified from our institutional database who were treated for primary or secondary vascular infection using implanted allografts. RESULTS: Between October 1992 and May 2014, 54 patients underwent surgery for vascular infection out of 118 patients implanted with cryopreserved vascular allografts...
August 1, 2018: European Journal of Cardio-thoracic Surgery
Martin Salö, Johanna Gudjonsdottir, Erik Omling, Lars Hagander, Pernilla Stenström
Importance: Childhood appendicitis is commonly complicated by gangrene and perforation, yet the causes of complicated appendicitis and how to avoid it remain unknown. Objective: To investigate whether children with IgE-mediated allergy have a lower risk of complicated appendicitis. Design, Setting, and Participants: This retrospective cohort study included all consecutive patients younger than 15 years (hereinafter referred to as children) who underwent appendectomy for acute appendicitis at a tertiary pediatric surgery center in Sweden between January 1, 2007, through July 31, 2017...
August 6, 2018: JAMA Pediatrics
Liam R Harris, Alexandre Arkader, Alexander Broom, John Flynn, Joseph Yellin, Patrick Whitlock, Ashley Miller, Jeffrey Sawyer, John Roaten, David L Skaggs, Paul D Choi
BACKGROUND: Optimal management for a pulseless supracondylar humerus fracture associated with anterior interosseous nerve (AIN) or median nerve injury is unclear. The purpose of this study was to determine the incidence of pulseless supracondylar humerus fractures associated with AIN or median nerve injury, to assess open versus closed surgical management, to determine factors associated with the need for neurovascular intervention, and to report the outcome. METHODS: A retrospective review was performed at 4 pediatric trauma hospitals on all patients who sustained a Gartland III or IV supracondylar humerus fracture with the combination of absent distal palpable pulses and AIN or median nerve injury between 2000 and 2014...
August 4, 2018: Journal of Pediatric Orthopedics
Arnaud Dupuis, Christian Gachet
Inherited platelet disorders are rare bleeding syndromes due to either platelet function abnormalities or thrombocytopenia which may be associated with functional defects. The haemorrhagic symptoms observed in these patients are mostly muco-cutaneous and of highly variable severity. Although 30 to 50% of the platelet disorders are still of unknown origin, the precise diagnosis of these pathologies by specialized laboratories together with haemorrhagic scores enables an assessment of the risk of bleeding in each patient...
August 1, 2018: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
Crîngu Antoniu Ionescu, Alexandra Matei, Dan Navolan, Mihai Dimitriu, Roxana Bohâltea, Adrian Neacsu, Corina Ilinca, Liana Ples
Ovarian masses are one of the most frequently identified entities in gynecological practice. Early differential diagnosis is a key factor in the medical management of each patient. Transvaginal ultrasound along with additional preoperative testing, such as serum cancer antigen 125 (CA-125) levels and the Risk of Ovarian Malignancy Algorithm (ROMA) score, usually provide sufficient information for a presumptive diagnosis. Minimally invasive surgery as a therapeutic approach is the standard procedure for uncomplicated and benign adnexal masses...
August 2018: Medicine (Baltimore)
Rajiv Das, Rishi Puri
Patients with bicuspid aortic valve disease have systematically been excluded from large randomized clinical trials investigating transcatheter aortic valve implantation (TAVI) due to their younger age, lower surgical risk and complex aortic anatomy. The asymmetric nature of the bicuspid valve orifice often accompanied by heavy regional calcification has led to concerns regarding valve positioning and expansion. Bicuspid aortic valve disease patients are at heightened risk of TAVI-related complications including coronary occlusion, aortic dissection and annular rupture, as well as the known risks of progressive aortopathy in these patients...
2018: Frontiers in Cardiovascular Medicine
Gulara Hajiyeva, Saowanee Ngamruengphong
PURPOSE OF REVIEW: Accurate diagnosis of gastrointestinal neuromuscular diseases requires full thickness biopsy for adequate histologic evaluation of the enteric neuromuscular and ancillary cells. Historically, this has been achieved by surgical approaches. An overview of procedure evolution and current techniques of endoscopic full thickness biopsy (EFTB) for diagnosis of gastrointestinal neuromuscular disorders will be presented. RECENT FINDINGS: Emergence and advancement of endoscopic full thickness resection techniques has offered a less invasive, nevertheless an effective modality of tissue acquirement...
September 2018: Current Opinion in Gastroenterology
Nana Hyldig, Christina Anne Vinter, Marie Kruse, Ole Mogensen, Camilla Bille, Jens Ahm Sorensen, Ronald Francis Lamont, Chunsen Wu, Lene Nyhoj Heidemann, Mette Holm Ibsen, Jacob Brink Laursen, Per Glud Ovesen, Christina Rorbye, Mette Tanvig, Jan Stener Joergensen
OBJECTIVE: To evaluate the reduction of surgical site infections by prophylactic incisional Negative Pressure Wound Therapy compared with standard postoperative dressings in obese women giving birth by caesarean section. DESIGN: Randomised multicentre controlled trial. SETTING: Five hospitals in Denmark. POPULATION: Obese women (pre-pregnancy BMI ≥30kg/m2 ) undergoing elective or emergency caesarean section. METHOD: The participants were randomly assigned to incisional Negative Pressure Wound Therapy or a standard dressing after caesarean section and analysed by intention-to-treat...
August 1, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Giuseppe Salamone, Leo Licari, Giovanni Guercio, Sofia Campanella, Nicolò Falco, Gregorio Scerrino, Sebastiano Bonventre, Girolamo Geraci, Gianfranco Cocorullo, Gaspare Gulotta
Background: The incidence rate of abdominal wall hernia is 20-40% in cirrhotic patients. A surgical approach was originally performed only if complication signs and symptoms occurred. Several recent studies have demonstrated the usefulness of elective surgery. During recent decades, the indications for surgical timing have changed. Methods: Cirrhotic patients with abdominal hernia who underwent surgical operation for abdominal wall hernia repair at the Policlinico "Paolo Giaccone" at Palermo University Hospital between January 2010 and September 2016 were identified in a prospective database, and the data collected were retrospectively reviewed; patients' medical and surgical records were collected from charts and surgical and intensive care unit (ICU) registries...
2018: World Journal of Emergency Surgery: WJES
Maciej T Juszczak, Bilal Taib, Jason Rai, Luigi Iazzolino, Nadine Carroll, George A Antoniou, Simon Neequaye, Francesco Torella
BACKGROUND: Analytic morphometry is a novel concept in perioperative risk assessment. Low core muscle mass assessed by morphometry is associated with frailty and has been demonstrated to be an independent predictor of postoperative complications and mortality in oncologic, transplant, and aneurysm surgery. We aimed to study associations between core muscle mass and complication rates, length of hospital stay, and survival after surgical lower limb revascularization. METHODS: In this retrospective cohort study, 263 patients considered for surgical lower limb revascularization between January 2013 and December 2014 underwent cross-sectional imaging...
July 28, 2018: Journal of Vascular Surgery
Michael P Wendel, Kelsey L Shnaekel, Everett F Magann
Importance: Uterine inversion is frequently accompanied by postpartum hemorrhage and hypovolemic shock. Morbidity and mortality occur in as many as 41% of cases. Prompt recognition and management are of utmost importance. Objective: The aim of this review is to describe risk factors, clinical and radiographic diagnostic criteria, and management of this rare but potentially life-threatening complication of pregnancy. Evidence Acquisition: A PubMed, Web of Science, and CINAHL search was undertaken with no limitations on the number of years searched...
July 2018: Obstetrical & Gynecological Survey
Ann-Catrin Blomberg, Birgitta Bisholt, Lillemor Lindwall
Aim: To obtain an understanding of operating theatre nurses' experiences of responsibility for patient care and safety in perioperative practice. Design: A hermeneutic design were used. Method: Data were collected during 2012 from 15 operating theatre nurses who participated in individual interviews. The text was analyzed by hermeneutical text interpretation. Findings: The texts revealed two main themes: A formal external responsibility and personal ethical value...
July 2018: Nursing Open
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