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https://www.readbyqxmd.com/read/28213202/determinants-of-cough-effectiveness-in-patients-with-respiratory-muscle-weakness
#1
Franco Laghi, Veeranna Maddipati, Timothy Schnell, W Edwin Langbein, Martin J Tobin
Experiments were undertaken to mechanistically define expiratory-muscle contribution to effectiveness of cough while controlling glottic movement. We hypothesized that electrical abdominal-muscle stimulation in patients with respiratory-muscle weakness produces effective coughs only when glottic closure accompanies coughs. In ten spinal-cord-injury patients, esophago-gastric pressure and airflow were recorded during solicited-coughs, coughs augmented by abdominal-muscle stimulation, and passive open-glottis exhalations...
February 14, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28210022/csf-related-complications-after-intradural-spinal-tumor-surgery-utility-of-an-autologous-fat-graft
#2
Kenan I Arnautovic, Marko Kovacevic
OBJECT: The incidence of cerebrospinal fluid (CSF)-related complications after intradural spinal tumor (IST) surgery is high and reported in up to 18% of patients. However, no efficient way to prevent those complications has been reported so far. Treating these complications may require prolonged bed rest, re-exploration, external lumbar drain, use of antibiotics, and possible precipitation of other complications. To alleviate the risk of CSF-related complications, we prospectively adopted the intraoperative use of autologous fat grafting after IST surgery...
December 2016: Medical Archives
https://www.readbyqxmd.com/read/28197793/single-port-laparoscopic-percutaneous-extraperitoneal-closure-of-femoral-hernia-in-children-and-adolescents-case-series
#3
R-B Tröbs, B Yilmaz, M Bahr, G Cernaianu, R M Vahdad
BACKGROUND: Femoral hernias are an often unexpected groin pathology during childhood. However, the pediatric surgeon has to be aware to diagnose femoral hernia and to repair this condition. This is the first report on laparoscopic percutaneous extraperitoneal closure of femoral hernia (LPEF) in children and adolescents. METHODS: Over a 6-year period in a bi-institutional clinical study, we retrospectively identified six children and one young adult who underwent LPEF repair...
February 14, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28197296/an-innovative-solution-to-complex-inguinal-defect-deepithelialized-siea-flap-with-mini-abdominoplasty
#4
Augustine Reid Wilson, Justin Daggett, Michael Harrington, Deniz Dayicioglu
Introduction: We describe a novel technique of contralateral pedicled deepithelialized superficial inferior epigastric artery flaps, followed by abdominal advancement coverage, as an alternative treatment of radiated complicated inguinal or lower abdominal defects, avoiding the donor-site defect typically seen with other methods of coverage. Methods: Two male patients with histories of liposarcoma after excision and radiation to one side of lower abdomen/inguinal area presented with complicated wounds that were reconstructed with this technique...
2017: Eplasty
https://www.readbyqxmd.com/read/28194520/simple-and-safe-technique-for-closure-of-midline-abdominal-wound-dehiscence
#5
M H Abo-Ryia
PURPOSE: The aim of this study was to assess an alternative technique for closure of burst abdomen. METHOD: After reduction of the viscera and toilet of abdominal cavity with debridement of any necrotic tissues in the skin or fascia, the skin was undermined to expose the aponeurosis all-around the defect edges for at least 5-6 cm. The greater omentum is spread in the floor of the wound and fixed to the inner side of the defect. A piece of polypropylene mesh designed according to the size and shape of the defect and sutured to its external edge continuously...
February 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28185628/use-of-bedside-abdominal-ultrasound-to-confirm-intestinal-motility-in-neonates-with-gastroschisis-a-feasibility-study
#6
Lori A Gurien, Deidre L Wyrick, Melvin S Dassinger, Jeffrey M Burford, Steven C Mehl, Marie E Saylors, Samuel D Smith
BACKGROUND: Optimal timing to begin feeds in neonates with gastroschisis remains unclear. We examined if bedside abdominal ultrasound for intestinal motility is a feasible tool to detect return of bowel function in neonates with gastroschisis. METHODS: Neonates born with uncomplicated gastroschisis who underwent closure received daily ultrasound exams. Full motility was defined as peristalsis seen in all quadrants. Average length of time between abdominal wall closure and start of enteral feeds, full ultrasound motility, and clinical characteristics was compared using Student's t-tests...
January 26, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28183146/prenatal-and-postnatal-management-of-gastroschisis-in-german-speaking-countries-is-there-a-standardized-management
#7
Katharina Schib, Marc Schumacher, Martin Meuli, Sasha Tharakan, Ulrike Subotic
Introduction Evidence-based guidelines or protocols regarding the perinatal management of babies born with gastroschisis are lacking. The aim of this work is to evaluate the different current treatment modalities for newborns with gastroschisis during the perinatal period in the German-speaking countries Germany, Austria, and Switzerland. These data could serve as a starting point for the development of a multicenter randomized controlled trial. Materials and Methods A questionnaire was developed with 30 questions divided into five sections: (1) prenatal diagnosis, (2) fetal therapy, (3) mode and timing of delivery, (4) operative management, and (5) postoperative management...
February 9, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28162216/-gradient-treatment-of-acute-superior-mesenteric-venous-thrombosis-clinical-analysis-of-68-cases
#8
K Liu, X X Fan, S F Yang, W W Ding, C S He, X J Wu, J S Li
Objective: To investigate the effect of Gradient treatment for acute superior mesenteric venous thrombosis (ASMVT). Methods: Clinic data of 68 patients of ASMVT admitted in Department of General Surgery, Jinling Hospital, Medical School of Nanjing University from January 2009 to December 2014 were analyzed retrospectively. There were 50 male and 18 female patients with a mean age of (45±12) years. These patients were conducted by the stepwise treatment model (endovascular treatment-damage control surgery-surgical intensive care-intestinal rehabilitation treatment)...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28161873/usefulness-of-a-laparoscopic-approach-for-treatment-of-small-bowel-obstruction-due-to-intersigmoid-hernia-a-case-report
#9
Norisuke Shibuya, Mitsuru Ishizuka, Yoshimi Iwasaki, Kazutoshi Takagi, Hitoshi Nagata, Taku Aoki, Keiichi Kubota
It is well known that intersigmoid hernia (ISH) is a rare condition. Here we describe our experience of laparoscopic surgery for small-bowel obstruction (SBO) due to ISH after sufficient decompression involving long-tube insertion.A 45-year-old woman with no history of abdominal surgery visited our hospital with epigastric pain. She was diagnosed as having SBO and underwent long-tube insertion as conservative therapy. However, her symptoms did not improve. Gastrografin contrast enema via the long-tube demonstrated a beak sign in the lower left abdomen and CT showed incarcerated small bowel was successively covered by sigmoid mesocolon, suggesting that the SBO was due to ISH, and she underwent laparoscopic surgery after sufficient decompression of the dilated small bowel...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28157793/ultrasound-guided-subclavian-vein-cannulation-in-low-birth-weight-neonates
#10
Ulrik Lausten-Thomsen, Zied Merchaoui, Cécile Dubois, Sergio Eleni Dit Trolli, Nolwenn Le Saché, Mostafa Mokhtari, Pierre Tissières
OBJECTIVES: Central venous access in critically ill, small infants remains technically challenging even in experienced hands. Several vascular accesses exist, but the subclavian vein is often preferred for central venous catheter insertion in infants where abdominal malformation and/or closure of the vein preclude the use of umbilical venous catheters, as catheterization of the subclavian vein is easier in very short necks than the internal jugular vein for age-related anatomical reasons...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28157595/the-suture-pullout-characteristics-of-human-and-porcine-linea-alba
#11
Gerard M Cooney, Spencer P Lake, Dominic M Thompson, Ryan M Castile, Des C Winter, Ciaran K Simms
There is a substantial prevalence of post-operative incisional hernia for both laparoscopic and laparotomy procedures, but there have been few attempts at quantifying abdominal wound closure methodology in the literature. One method to ascertain a more robust method of wound closure is the identification of the influence of suture placement parameters on suture pullout force. Current surgical practice involves a recommended bite depth and bite separation of 10mm, but the evidence base for this is not clear...
January 24, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28153601/quantitative-assessment-of-tension-reduction-at-the-midline-closure-during-abdominal-components-separation
#12
Ahmed M Afifi, Emily Hartman, Ahmed Talaat, Ashraf Abo Alfotooh, Omar S Omar, Sayed Mareei, Ruston Sanchez, Steve J Kempton
BACKGROUND: Abdominal component separation is commonly utilized for the closure of midline abdominal wounds. The value of each step in reducing tension has not been studied. Our aim is to test if component separation decreases tension in the midline closure and quantify the value of each procedural step. STUDY DESIGN: Tension required to bring the rectus muscle to midline was measured using tensiometry after subcutaneous dissection (Step 1), external oblique muscle release (Step 2), separation of the internal and external oblique muscles (Step 3), and internal oblique muscle release (Step 4)...
January 31, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28151898/how-much-does-decompressive-laparotomy-reduce-the-mortality-rate-in-primary-abdominal-compartment-syndrome-a-single-center-prospective-study-on-66-patients
#13
Mircea Muresan, Simona Muresan, Klara Brinzaniuc, Septimiu Voidazan, Daniela Sala, Ovidiu Jimborean, Al Husseim Hussam, Tivadar Bara, Gabriel Popescu, Cristian Borz, Radu Neagoe
Contribution of decompressive laparotomy within the framework of the complex therapeutic algorithm of abdominal compartment syndrome (ACS) is cited with an extremely heterogeneous percentage in terms of survival. The purpose of this study was to present new data regarding contribution of each therapeutic step toward decreasing the mortality of this syndrome.This is a longitudinal prospective study including 134 patients with risk factors for ACS. The intra-abdominal pressure was measured every hour indirectly based on transvesical approach and the appearance of organ dysfunction...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28151808/techniques-for-abdominal-wall-reconstruction-in-intestinal-transplantation
#14
Gabriel E Gondolesi, Nicolás F Aguirre
PURPOSE OF REVIEW: One of the most important challenges in the intestinal (ITx) and multivisceral transplant (MVTx) is to achieve a successful abdominal wall closure. RECENT FINDINGS: A tension-free primary closure should be our aim. In most of the cases, we need to perform a component separation technique, alone or combined, to the use of a synthetic mesh. If those options are not feasible, the abdominal wall composite vascularized allograft transplant (AW-CVA) utilizing direct orthotopic vascularization can be considered...
February 1, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28139110/-abdominal-traumatic-evisceration-reconstruction-abdominal-wall-with-biologic-mesh-and-negative-pressure-therapy
#15
M Jiménez Gómez, N Betancor Rivera, J Lima Sánchez, J R Hernández Hernández
INTRODUCTION: Abdominal traumatic evisceration as a result of high energy trauma is uncommon. Once repaired the possible internal damage, an abdominal wall defect of high complexity may exist, whose reconstruction represents a surgical challenge. CASE REPORT: Politraumatized male with important abdominal muculocutaneous avulsion and evisceration. After initial repair, the patient developed a big eventration in which we use a porcine dermis-derived mesh (Permacol(TM)), a safe and effective alternative in abdominal wall repair, thanks to its seamless integration with other tissues, even when exposed...
April 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28139102/-primary-versus-secondary-closure-ventilatory-and-nutritional-differences-in-patients-with-gastrosquisis
#16
M Dore Reyes, P Triana Junco, S Barrena Delfa, J L Encinas, M Romo Muñoz, A Vilanova Sánchez, G Chocarro Amatriain, F Hernández Oliveros, L Martínez Martínez, M López-Santamaría
AIM OF THE STUDY: Optimal surgical treatment of patients with gastroschisis remains controversial. Recent studies suggest better outcomes with secondary closure techniques (surgical or preformed silo). The purpose of the study is to identify differences in outcome of infants treated with traditional primary closure (PC) versus surgical silo (SS). PATIENTS AND METHODS: Retrospective study of patients primarily treated of gastroschisis between 2004 and 2014. Patients were divided in PC and SS according to abdominal wall closure...
April 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28137537/randomized-controlled-trial-evaluating-the-efficacy-of-peritoneal-resuscitation-in-the-management-of-trauma-patients-undergoing-damage-control-surgery
#17
Jason W Smith, Paul J Matheson, Glen A Franklin, Brian G Harbrecht, J David Richardson, R Neal Garrison
BACKGROUND: Peritoneal resuscitation (PR) represents a unique modality of treatment for severely injured trauma patients requiring damage control surgery (DCS). These data represent the outcome of a single institution RCT into the efficacy of PR as a management option in these patients. STUDY DESIGN: From 2011-2015, 103 patients were enrolled in a prospective RCT evaluating the utility of PR in the treatment of patients undergoing DCS compared to conventional resuscitation (CR) alone...
January 27, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28135411/use-of-cryopoor-plasma-for-albumin-replacement-and-continuous-antimicrobial-infusion-for-treatment-of-septic-peritonitis-in-a-dog
#18
Meaghan K Ropski, Julien Guillaumin, Andrea A Monnig, Katy Townsend, Mary A McLoughlin
OBJECTIVE: To report the successful management of a dog with septic peritonitis and septic shock secondary to enterectomy dehiscence using novel techniques for identification of intestinal dehiscence and for septic shock treatment. CASE SUMMARY: A 5-year-old castrated male Bernese Mountain Dog presented for lethargy 6 days following enterotomy for foreign body obstruction. Septic peritonitis was identified due to dehiscence of the enterotomy site, and resection and anastomosis were performed using a gastrointestinal anastomosis and thoracoabdominal stapling device...
January 30, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28133315/-a-case-of-ascending-colon-cancer-with-extensive-abdominal-wall-abscess
#19
Taichi Kuwahara, Yoshihiro Tokuhisa, Nobuaki Suzuki, Shinobu Tomochika, Yuka Inoue, Hironori Tanaka, Mitsuo Nishiyama, Shinsuke Kanekiyo, Michihisa Iida, Kazuhiko Sakamoto, Shigeru Takeda, Tomio Ueno, Shigefumi Yoshino, Shoichi Hazama, Hiroaki Nagano
A 51-year-old woman was seen in our hospital because an ascending colon tumor with extensive abdominal wall abscess was detected on computed tomography(CT). On the same day, we performed open drainage and laparoscopic assisted ileocolostomy. Postoperative day 35, we performed right hemicolectomy with abdominal wall resection and closure of the colostomy as a radical surgery. After surgery, we started(negative pressure wound therapy: NPWT)to the surgical wound site; hence, the abdominal wall defect could be healed without a musculocutaneous flap...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133307/-a-case-of-familial-adenomatous-polyposis-with-a-desmoid-tumor-probably-communicating-to-the-intestinal-lumen-that-was-successfully-treated-with-non-surgical-therapy
#20
Tetsuya Ito, Noriyasu Chika, Azusa Yamamoto, Toshiro Ogura, Kunihiko Amano, Toru Ishiguro, Minoru Fukuchi, Youichi Kumagai, Keiichiro Ishibashi, Hidetaka Eguchi, Yasushi Okazaki, Erito Mochiki, Hideyuki Ishida
A 44-year-old man with familial adenomatous polyposis underwent laparoscopic-assistedtotal proctocolectomy with ilealpouch anal anastomosis(IPAA). Computed tomography conducted 21 months after IPAA demonstrated bilateral hydronephrosis andan intra-abdominal mass with a maximal diameter of 22 cm, leading to a diagnosis of stage IV desmoid disease, according to the classification by Church and associates. Six courses of combination chemotherapy with doxorubicin plus dacarbazine were administered. Computed tomography after chemotherapy demonstrated marked shrinkage of the desmoidtumor with intraabdominal air andfluidcollection extending just below the skin of the ileostomy closure site...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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