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Emergent surgery

Pedro Teixeira Castro, Ana Paula Pinho Matos, Osvaldo Luiz Aranda, Edson Marchiori, Haimon Diniz Lopes Alves, Alessandra Silveira Machado, Ricardo Tadeu Lopes, Heron Werner, Edward Araujo Júnior
OBJECTIVE: The aim of this study was to provide a three-dimensional (3D) microscopic reconstruction of morphological modifications of the fallopian tube (FT) following surgical sterilization (including tuboperitoneal fistula) and ectopic pregnancy (EP) using confocal microtomography (micro-CT). METHODS: Six specimens of FT from elective and emergency surgeries were selected: three remnants of the FT (RFT) from surgical sterilization, including one presenting tuboperitoneal fistula, and three FTs with EP...
March 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
Dimos Karangelis, Apostolos Roubelakis, Dimitris Mikroulis, Matthew Panagiotou
Aortic arch pathologies such as acute aortic dissection and aneurysmal disease represent surgical challenges. Various emerging techniques and surgical prostheses have expanded the therapeutic armamentarium over the last years with one principal objective; to simplify the operation and reduce the surgical time. Besides the classic elephant trunk which has been regarded as an evolutionary leap in the treatment of extensive thoracic disease, other novel surgical approaches such as the frozen elephant trunk, the thoracic endovascular aortic repair (TEVAR) and the hybrid open branched stent grafts have been introduced...
March 20, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Harissou Adamou, Ibrahim Amadou Magagi, Oumarou Habou, Ousseini Adakal, Kabirou Ganiou, Magagi Amadou
Background: To describe the aetiological and prognostic aspects of acute mechanical intestinal obstruction (AMIO) in children at Zinder National Hospital (Niger). Materials and Methods: This was a cross-sectional study on a period to January 2013-June 2015. The database included all children under 15 years of age with a surgical diagnosis of mechanical intestinal obstruction. P < 0.05 was considered statistically significant for analysis. Results: AMIOs represent 21...
July 2017: African Journal of Paediatric Surgery: AJPS
Adam B King, Matthew D Spann, Patrick Jablonski, Jonathan P Wanderer, Warren S Sandberg, Matthew D McEvoy
BACKGROUND: Patients frequently remain in the hospital after bariatric surgery due to pain, nausea, and inability to tolerate oral intake. Enhanced recovery after surgery (ERAS) concepts address these perioperative complications and therefore improve length of stay for bariatric surgery patients. OBJECTIVES: To determine if ERAS concepts increase the proportion of patients discharged on postoperative day 1. Secondary objectives included mean length of stay, perioperative opioid use, emergency department visits, and readmissions...
February 13, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Geoffrey A Anderson, Peter Kayima, Lenka Ilcisin, Noralis Portal Benitez, Katherine H Albutt, Susan M Briggs, Deepika Nehra
OBJECTIVE: The goal of this project was to create a multitiered trauma training curriculum that was designed specifically for the low-resource setting. DESIGN: We developed 2 courses designed to teach principles and skills necessary for trauma care. The first course, "Emergency Ward Management of Trauma (EWMT)," is designed to teach interns the initial assessment and stabilization of trauma patients in the emergency ward. The second course for mid-level surgical residents, "Surgical Techniques and Repairs in Trauma for the Low-resource Environment" (STaRTLE), is a cadaver-based operative trauma course designed to teach surgical exposures and techniques...
March 16, 2018: Journal of Surgical Education
Gerdine C I von Meijenfeldt, Tryfon Vainas, George A Mistiotis, Sarah L Gans, Clark J Zeebregts, Maarten J van der Laan
BACKGROUND: Colonic ischaemia (CI) is a devastating complication after abdominal aortic aneurysm (AAA) surgery. The aim of this review was to evaluate the diagnostic test accuracy of routine endoscopy in diagnosing CI after treatment for elective and acute AAA. PATIENTS AND METHODS: The Pubmed and Embase database searches resulted in 1188 articles. Prospective studies describing routine post-operative colonoscopy or sigmoidoscopy after elective or emergency AAA repair were included...
March 16, 2018: European Journal of Vascular and Endovascular Surgery
Wieneke Dijk, Sophie Schutte, Edo O Aarts, Ignace M C Janssen, Lydia Afman, Sander Kersten
BACKGROUND: Elevated plasma triglycerides are increasingly viewed as a causal risk factor for coronary artery disease. One protein that raises plasma triglyceride levels and that has emerged as a modulator of coronary artery disease risk is angiopoietin-like 4 (ANGPTL4). ANGPTL4 raises plasma triglyceride levels by inhibiting lipoprotein lipase (LPL), the enzyme that catalyzes the hydrolysis of circulating triglycerides on the capillary endothelium. OBJECTIVE: The objective of the present study was to assess the association between ANGPTL4 and LPL in human adipose tissue, and to examine the influence of nutritional status on ANGPTL4 expression...
February 17, 2018: Journal of Clinical Lipidology
Richard Sola, Valerie A Waddell, Shawn D St Peter, Pablo Aguayo, David Juang
INTRODUCTION: Non-accidental trauma (NAT) has significant societal and health care implications. Standardized care has been shown to improve outcomes. The purpose of our study was to survey trauma centers and elucidate the continued variable management of NAT. METHODS: After institutional review board approval, an email survey was sent to Level 1 and 2 ACS verified trauma centers along with general and pediatric surgery training programs. Trauma hospital characteristics and NAT management were analyzed...
March 10, 2018: Injury
Bing-Sheng Lin, Yan-Shen Shan, Wan-Chen Liu, Chin-Han Wu, Pei-Ying Wu, Keng-Fu Hsu
BACKGROUND: Obesity is a risk factor for the development of endometrial cancer and abdominal wall hernias. We report a case of tension pneumoperitoneum that developed after gynecological surgery and mesh repair of a ventral hernia. CASE PRESENTATION: A 57-year-old Asian Taiwanese woman with a body mass index of 52.9 (kg/m2 ) underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy due to endometrial cancer, and ventral herniorrhaphy with mesh due to ventral hernia...
March 20, 2018: Journal of Medical Case Reports
Tom Kreft, Thomas Hachenberg
Traditionally the double-lumen-tube (DLT) is considered the gold standard for lung separation. Despite being equally feasible for standard situations, there are special populations and circumstances requiring the use of a bronchial blocker (BB) to establish one-lung ventilation. Children under 8 years of age and patients without a patent orotracheal airway necessitate the use of a bronchial blocker in most cases, as well as those requiring selective lobar blockade or a rapid sequence induction. Surgery with predicted postoperative mechanical ventilation or in tracheotomized patients at least favors their use by avoiding the complications of a tube exchange...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Anupama Rajanbabu, Reshu Agarwal
OBJECTIVE: Sentinel node mapping is emerging as the alternative to lymphadenectomy in endometrial cancer. The objective of our study is to validate of the sentinel node mapping surgical algorithm and also to compare the performance of the algorithm against endometrial cancer risk subtypes DESIGN: This is a prospective interventional study carried out at a Single University teaching hospital. All patients with apparent early stage endometrial cancer who underwent robotic assisted surgical staging were included...
March 13, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Morgan L Cox, Brian C Gulack, Dylan P Thibault, Xia He, Matthew L Williams, Vinod H Thourani, Jeffery P Jacobs, J Matthew Brennan, Mani A Daneshmand, Deepak Acharya
OBJECTIVES: Previous studies have demonstrated a 20% mortality rate among patients undergoing isolated coronary artery bypass grafting (CABG) for cardiogenic shock. However, outcomes following CABG for cardiogenic shock in patients who are neurologically unresponsive preoperatively are unknown. METHODS: Utilizing the Society of Thoracic Surgeons Adult Cardiac Surgery Database between July 2011 and December 2013, patients undergoing urgent or emergent CABG within 7 days of an acute myocardial infarction complicated by cardiogenic shock were identified...
March 14, 2018: European Journal of Cardio-thoracic Surgery
Diana Vargas, Carolina López, Edward Acero, Edgar Benitez, Angélica Wintaco, Jaime Camacho, Marisol Carreño, Juan Umaña, Daniela Jimenez, Said Díaz, Fernando Lizcano
The anatomical location of adipose tissue might have direct implications for its functionality and risk of cardiovascular disease. Adipose tissue surrounding blood vessels may be thermogenically more active in specific areas of the body, releasing substances that regulate vascular metabolism. In humans, the phenotypic characteristics of adipose tissue surrounding the aorta and the cardiovascular disease risk that it might entail remain largely unknown. Here, we compared thermogenesis-related molecular features of human periaortic adipose tissue samples with those of subcutaneous adipose tissue, obtained by sternotomy from 42 patients undergoing cardiovascular surgery...
2018: PloS One
Matthew J Martin, Andrea M Pakula
No abstract text is available yet for this article.
March 16, 2018: Journal of Trauma and Acute Care Surgery
Derek B Wall, Carlos Ortega
BACKGROUND: Even in metropolitan areas, on-call pediatric surgeons may not always be immediately available for surgical care of appendicitis, potentially leading to delays in care. In 2012, the in-house trauma group at a suburban Level 1 trauma center (none with formal pediatric fellowship training) assumed surgical care of 5-10 year-old children with appendicitis, who had previously been cared for by pediatric surgeons. We propose to compare the outcomes of the trauma and pediatric surgery groups...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Satoshi Suzuki, Yuko Mihara, Yukiko Hikasa, Shuji Okahara, Takuma Ishihara, Ayumi Shintani, Hiroshi Morimatsu, Akiko Sato, Sachio Kusume, Hidekuni Hidaka, Hidehiko Yatsuzuka, Masahiro Okawa, Makoto Takatori, Shinsei Saeki, Takeshi Samuta, Hiroaki Tokioka, Toshiaki Kurasako, Masato Maeda, Mamoru Takeuchi, Akihito Hirasaki, Michio Kitaura, Hideki Kajiki, Osamu Kobayashi, Hiroshi Katayama, Hideki Nakatsuka, Satoshi Mizobuchi, Seiji Sugimoto, Masataka Yokoyama, Kazuhito Kusudo, Kensuke Shiraishi, Toshio Iwaki, Tatsuhiko Komatsu, Yasuo Hirai, Tetsufumi Sato, Masakazu Kimura, Takeshi Yasukawa, Motonobu Kimura, Masahiro Taniguchi, Yutaka Shimoda, Yoji Kobayashi, Mitsunori Tsukioki, Nobuki Manabe, Eiji Ando, Makoto Kosaka, Takashi Tsukiji, Chika Tokura, Yasuhiro Asao, Masatoshi Sugiyama, Kozo Seto
BACKGROUND: Intraoperative oxygen management is poorly understood. It was hypothesized that potentially preventable hyperoxemia and substantial oxygen exposure would be common during general anesthesia. METHODS: A multicenter, cross-sectional study was conducted to describe current ventilator management, particularly oxygen management, during general anesthesia in Japan. All adult patients (16 yr old or older) who received general anesthesia over 5 consecutive days in 2015 at 43 participating hospitals were identified...
March 19, 2018: Anesthesiology
Daniel Katzman, Daniel H Sterman
PURPOSE OF REVIEW: This review article describes current diagnostic and treatment modalities for malignant pleural mesothelioma (MPM). RECENT FINDINGS: Few randomized trials in MPM have demonstrated improved survival with current therapies. A randomized trial of first-line chemotherapy with and without bevacizumab in unresectable MPM is the only randomized trial of a new treatment regimen to demonstrate a survival benefit since cisplatin with pemetrexed became the standard of care for unresectable MPM in 2003...
March 16, 2018: Current Opinion in Pulmonary Medicine
Fabian Grass, Matthieu Cachemaille, David Martin, Nicolas Fournier, Dieter Hahnloser, Catherine Blanc, Nicolas Demartines, Martin Hübner
The purpose of this prospective cohort study was to compare multimodal pain management and pain perception after open vs. laparoscopic colorectal surgery within enhanced recovery care. Pain scores at rest and at mobilization were prospectively assessed in consecutive patients using Visual Analog Scales (VAS 0-10) and consumption of different analgesics was recorded daily until 96 hours postoperatively. Uni- and multivariate risk factors for pain peaks (≥ 4/10) were identified by logistic regression and compared between two propensity score matched groups (open vs...
2018: Bioscience Trends
Luciano Tarantino, Aurelio Nasto, Giuseppina Busto, Vincenzo Iovino, Raffaele Fristachi, Sara Bortone
Introduction: Solid pseudopapillary Carcinoma (SPC) is a rare pancreatic Tumor with variable, usually low, malignancy potential. Howewer, several SPC are associated with aggressive behavior, local vascular infiltration, organ invasion, distant metastasis, and can be unresectable. Irreversible Electroporation (IRE) is an emerging non-thermal ablation technique for the treatment of locally advanced pancreatic carcinoma. We report the results of four year disease-free follow-up in a case of locally advanced unresectable SPC treated with IRE...
April 2018: Annals of Medicine and Surgery
Melissa Rochon, Julian We Jarman, Joseph Gabriel, Lisa Butcher, Carlos Morais, Martin Still, Ishtiaq Ahmed, Mario Petrou, Richard Trimlett, Anthony DeSouza, Rashmi Yadav, Shahzad G Raja
Background: Previously, we reported that the Brompton Harefield Infection Score (BHIS) accurately predicts surgical site infection (SSI) after coronary artery bypass grafting (CABG). The BHIS was developed using two-centre data and stratifies SSI risk into three groups based on female gender, diabetes or HbA1c > 7.5%, body mass index ≥ 35, left ventricular ejection fraction < 45% and emergency surgery. The purpose of this study was to prospectively evaluate BHIS internally as well as externally...
March 2018: Journal of Infection Prevention
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