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Abdominal infections guidelines

David A Talan, Darin J Saltzman, Daniel A DeUgarte, Gregory J Moran
BACKGROUND: Meta-analyses and a recent guideline acknowledge that conservative management of uncomplicated appendicitis with antibiotics can be successful for patients who wish to avoid surgery. However, guidance as to specific management does not exist. METHODS: PUBMED and EMBASE search of trials describing methods of conservative treatment was conducted according to PRISMA guidelines. RESULTS: Thirty-four studies involving 2944 antibiotic-treated participants were identified...
December 3, 2018: Journal of Trauma and Acute Care Surgery
Liliana Clara, Viviana M Rodríguez, Pablo Saúl, Cecilia Domínguez, Mercedes Esteban
Intra-abdominal infections represent a group of intra and retroperitoneal processes, ranging from localized infections to complicated ones, sepsis and septic shock, associated with a significant mortality rate. They are the third most commonly identified cause of sepsis and the second cause of death in the intensive care unit. Although antimicrobial therapy must be started as soon as possible, especially in critically ill patients, the source control procedure is highly relevant. On account of the importance of this subject, members of the Argentine Society of Infectious Diseases (SADI) and intensive care specialists joined to develop recommendations on diagnosis, treatment, and prevention of intra-abdominal infections...
2018: Medicina
Elodie Bonin, Valérie Bridoux, Rachid Chati, Sabrina Kermiche, Julien Coget, Jean Jacques Tuech, Horace Roman
OBJECTIVE: Deep endometriosis may simultaneously infiltrate the vagina and the rectosigmoid, which associated resection may increase the risk of postoperative complications. Among these complications, rectovaginal fistula is one of the worst. To reduce the risk of rectovaginal fistula and related complications, surgeons may employ diverting stoma. The literature is rich in data concerning the usefulness of stoma in patients managed for low rectal cancer. However, extrapolation of these data to patients managed for rectal endometriosis is disputable...
November 6, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Gaik S Quah, Guy D Eslick, Michael R Cox
PURPOSE: Over the last 3 decades, laparoscopic procedures have emerged as the standard treatment for many elective and emergency surgical conditions. Despite the increased use of laparoscopic surgery, the role of laparoscopic repair for perforated peptic ulcer remains controversial among general surgeons. The aim of this study was to compare the outcomes of laparoscopic versus open repair for perforated peptic ulcer. METHODS: A systemic literature review was conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines...
November 21, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Li-Na Zhang, Wei Guo, Ji-Hong Zhu, Yang Guo
Herein we report a case of acute liver failure (ALF) and hemophagocytic lymphohistiocytosis (HLH) induced by varicella infection, successfully rescued by a combination therapy of acyclovir, supportive care, and immunosuppression with dexamethasone and etoposide. A previously healthy 16-year-old boy presented with generalized rash, fever, severe abdominal pain, and abnormal liver function within 4 d. Chickenpox was suspected, and acyclovir and intravenous immunoglobulin were started on admission. However, the patient's condition deteriorated overnight with soaring transaminases, severe coagulopathy and encephalopathy...
November 6, 2018: World Journal of Clinical Cases
Caitlin R Finley, Derek S Chan, Scott Garrison, Christina Korownyk, Michael R Kolber, Sandra Campbell, Dean T Eurich, Adrienne J Lindblad, Ben Vandermeer, G Michael Allan
OBJECTIVE: To identify the most commonly presenting conditions in primary care globally, and to compare common reasons for visits (RFVs) as reported by clinicians and patients, as well as among countries of different economic classifications. DATA SOURCES: Twelve scientific databases were searched up to January 2016, and a dual independent review was performed to select primary care studies. STUDY SELECTION: Studies were included if they contained 20 000 visits or more (or equivalent volume by patient-clinician interactions) and listed 10 or more RFVs...
November 2018: Canadian Family Physician Médecin de Famille Canadien
F Vidal, L Paret, T Linet, Y Tanguy le Gac, P Guerby
OBJECTIVE: To provide national clinical guidelines focusing on intrauterine contraception. METHODS: A systematic review of available literature was performed using Pubmed and Cochrane libraries. American, British and Canadian guidelines were considered as well. RESULTS: Intrauterine contraception (IUC) displays a wide panel of indications, including adolescents, nulliparous, patients living with HIV before AIDS (Grade B) and women with history of ectopic pregnancy (Grade C)...
November 11, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Toar J M Lalisang, Nurhayat Usman, Iswanto Hendrawidjaya, Adeodatus Y Handaya, Safruddin Nasution, Rofi Y Saunar, Tonny Loho, Anis Karuniawati, Yefta Moenadjat, Indah S Widyahening
BACKGROUND: The occurrence of complicated intra-abdominal infections (cIAI) remains high despite system improvement in accordance with Joint Commission International because of heterogeneity of management. However, published clinical practice guidelines (CPGs) were not feasible to be implemented because these guidelines were not specific to Indonesian characteristics. Thus, a national CPG should be developed to minimize heterogeneity in the management of cIAI in Indonesia. METHODS: We developed a CPG on cIAI through the adaptation of published CPGs...
November 14, 2018: Surgical Infections
Charles Walker, Katelyn Young, Ali Moosavi, Nicholas Molacek, James Dove, Marie Hunsinger, Joseph Blansfield, Kenneth Widom, Denise Torres, James Gregory, Jeffrey Wild
BACKGROUND: Current guidelines do not specifically address optimal antibiotic duration following cholecystostomy. This study compares outcomes for short-course (<7 days) and long-course (≥7 days) antibiotics post-cholecystostomy. METHODS: This was a retrospective review of cholecystostomy patients (≥18 years) admitted (1/1/2007-12/31/2017) to one healthcare system. RESULTS: Overall, 214 patients were studied. Demographics were similar, except short-course patients had higher Charlson Comorbidity Index (p < 0...
October 29, 2018: American Journal of Surgery
David Boulée, Sarathi Kalra, Alison Haddock, T David Johnson, W Frank Peacock
BACKGROUND: Stethoscopes can be microorganism reservoirs. The US Centers for Disease Control and Prevention (CDC) has published medical equipment disinfection guidelines to minimize infection transmission risk, but studies of guideline adherence have been predominately survey based, with little direct observation of disinfection practices. METHODS: We performed an observational, cross-sectional, anonymous study of patient-provider interactions, assessing practitioners' frequency and methods of stethoscope and hand disinfection practices...
November 2, 2018: American Journal of Infection Control
Man Zhang, Mishal Mendiratta-Lala, Katherine E Maturen, Ashish P Wasnik, Sherry S Wang, Hadeel Assad, Jonathan M Rubin
OBJECTIVES: The purpose of this study was to compare hepatic stiffness on ultrasound (US) shear wave elastography (SWE) in patients with chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation versus patients with no underlying liver disease. METHODS: We performed a retrospective analysis of 4901 patients who underwent abdominal US examinations with adjunctive liver SWE between August 2014 and December 2016. Each patient was scanned supine with gentle breath holding on LOGIQ E9 (GE Healthcare, Waukesha, WI) or Epiq (Philips Healthcare, Andover, MA) US machines (3-6 MHz)...
October 23, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
S van Steensel, A Bloemen, L C L van den Hil, J van den Bos, G J Kleinrensink, N D Bouvy
PURPOSE: The lumbar abdominal wall hernia is a rare hernia in which abdominal contents protrude through a defect in the dorsal abdominal wall, which can be of iatrogenic, congenital, or traumatic origin. Two anatomical locations are known: the superior and the inferior lumbar triangle. The aim of this systematic review is to provide a clear overview of the existing literature and make practical clinical recommendations for proper diagnosis and treatment of the primary lumbar hernia. METHODS: The systematic review was conducted according to the PRISMA guidelines...
October 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
B E Zucker, C Simillis, P Tekkis, C Kontovounisios
BACKGROUND: There are many options and little guiding evidence when choosing suture types with which to close the abdominal wall fascia. This network meta-analysis investigated the effect of suture materials on surgical site infection, hernia, wound dehiscence and sinus/fistula occurrence after abdominal surgery. The aim was to provide clarity on whether previous recommendations on suture choice could be followed with confidence. METHODS AND METHODS: In February 2017, the Cochrane Central Register of Controlled Trials, Medline, EMBASE and Science Citation Index Expanded were searched for randomised controlled trials investigating the effect of suture choice on these four complications in closing the abdomen...
October 5, 2018: Annals of the Royal College of Surgeons of England
D J Tubre, A D Schroeder, J Estes, J Eisenga, R J Fitzgibbons
PURPOSE: Surgical site infection is the most common hospital-acquired infection in surgical patients. Recently, public health organizations have updated prevention guidelines. This review discusses surgical site infections as a complication of abdominal wall reconstruction. METHODS: The authors reviewed guidelines on prevention of surgical site infections from the Center for Disease Control and Prevention, World Health Organization, and National Institute for Health and Care Excellence and put them into context with the relevant abdominal wall reconstruction literature...
December 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Shaheel Mohammad Sahebally, Kevin McKevitt, Ian Stephens, Fidelma Fitzpatrick, Joseph Deasy, John Patrick Burke, Deborah McNamara
Importance: Surgical site infections (SSIs) are common after laparotomy wounds and are associated with a significant economic burden. The use of negative pressure wound therapy (NPWT) has recently been broadened to closed surgical incisions. Objective: To evaluate the association of prophylactic NPWT with SSI rates in closed laparotomy incisions performed for general and colorectal surgery in elective and emergency settings. Data Sources: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched without language restrictions for relevant articles from inception until December 2017...
November 1, 2018: JAMA Surgery
Micaela Piccoli, Ferdinando Agresta, Grazia Maria Attinà, Dalia Amabile, Domenico Marchi
To date, there is no shared consensus on a definition of a complex abdominal wall in elective surgery and in the emergency, on indications, technical details, complications, and follow-up. The purpose of the conference was to lay the foundations for a homogeneous approach to the complex abdominal wall with the primary intent being to attain the following objectives: (1) to develop evidence-based recommendations to define "complex abdominal wall"; (2) indications in emergency and in elective cases; (3) management of "complex abdominal wall"; (4) techniques for temporary abdominal closure...
September 25, 2018: Updates in Surgery
Heather Lusby, Aaron Brooks, Eden Hamayoun, Amanda Finley
A 44-year-old Caucasian female with a history of endometriosis is admitted to the intensive care unit due to severe left lower quadrant abdominal pain, nausea and vomiting. With patients' positive chandelier sign on pelvic examination, leucocytosis, elevated erythrocyte sedimentation rate and elevated C-reactive protein indicated that she had pelvic inflammatory disease (PID). PCR tests were negative for Neisseria gonorrhoeae and Chlamydia trachomatis ; however, her blood and urine cultures grew Group A streptococci (GAS) with a negative rapid Streptococcus throat swab and no known exposure to Streptococcus On further review, patient met criteria for GAS toxic shock syndrome based on diagnostic guidelines...
September 23, 2018: BMJ Case Reports
Kambiz Diba, Khadijeh Makhdoomi, Elahe Nasri, Afsane Vaezi, Javad Javidnia, Davood Jabbari Gharabagh, Nima Hosseni Jazani, Ali Reza Chavshin, Parisa Badiee, Hamid Badali, Hamed Fakhim
Candidiasis is a major challenge among renal transplant recipients (RTRs) worldwide and is associated with high morbidity and mortality rates. Fluconazole is the most commonly used agent for Candida infections. However, frequent relapse and treatment failure are still reported among patients affected with this infection. In the present study, Candida species obtained from RTRs were characterized based on conventional and molecular assays. Furthermore, the antifungal susceptibility profiles of these species were determined...
September 18, 2018: Microbial Pathogenesis
Jamie Furlong-Dillard, Alaina Neary, Jennifer Marietta, Courtney Jones, Grace Jeffers, Lindsey Gakenheimer, Michael Puchalski, Aaron Eckauser, Claudia Delgado-Corcoran
Introduction: Feeding difficulties and malnutrition are important challenges when caring for newborns with critical congenital heart disease (CCHD) without clear available guidelines for providers. This study describes the utilization of a feeding protocol with the focus on standardization, feeding modality, and total parenteral nutrition (TPN) utilization postoperatively. Methods: Patients included neonates with CCHD undergoing complex biventricular repair using cardiopulmonary bypass...
May 2018: Pediatric quality & safety
Frank Bloos, Jürgen Held, Peter Schlattmann, Nicole Brillinger, Oliver Kurzai, Oliver A Cornely, Daniel Thomas-Rüddel
BACKGROUND: The time to diagnosis of invasive Candida infection (ICI) is often too long to initiate timely antifungal therapy in patients with sepsis. Elevated serum (1,3)-β-D-glucan (BDG) concentrations have a high diagnostic sensitivity for detecting ICI. However, the clinical significance of elevated BDG concentrations is unclear in critically ill patients. The goal of this study is to investigate whether measurement of BDG in patients with sepsis and a high risk for ICI can be used to decrease the time to empiric antifungal therapy and thus, increase survival...
September 4, 2018: Trials
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