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intra abdominal infections

Yun Tae Jung, Jiyeon Jeon, Jung Yun Park, Myung Jun Kim, Seung Hwan Lee, Jae Gil Lee
Background: The quick sequential organ failure assessment (qSOFA) alone has a poor sensitivity for predicting mortality in patients with complicated intra-abdominal infections, and plasma lactate levels have been shown to have a strong association with mortality in critically ill patients. Therefore, this study aimed to compare the performance of qSOFA with a score derived from a combination of qSOFA and serum lactate levels for predicting mortality in surgical patients with complicated intra-abdominal infections...
2018: World Journal of Emergency Surgery: WJES
Hui Zhou, Meihong Deng, Yingjie Liu, Chenxuan Yang, Rosemary Hoffman, Jingjiao Zhou, Patricia A Loughran, Melanie J Scott, Matthew D Neal, Timothy R Billiar
Thrombocytopenia impairs host defense and hemostasis in sepsis. However, the mechanisms of how platelets regulate host defense are not fully understood. High-mobility group box 1 (HMGB1), a danger-associated molecular pattern protein, is released during infection and contributes to the pathogenesis of sepsis. Platelets express HMGB1, which is released on activation and has been shown to play a critical role in thrombosis, monocyte recruitment, and neutrophil extracellular trap (NET) production. However, the contribution of platelet HMGB1 to host defense is unknown...
March 27, 2018: Blood Advances
Nadine Musallam, Diana Altshuler, Cristian Merchan, Bishoy Zakhary, Caitlin Aberle, John Papadopoulos
BACKGROUND: There is little data guiding clinicians on how to discontinue vasopressors among septic shock patients on concomitant norepinephrine (NE) and vasopressin (VP). OBJECTIVE: To determine the incidence of hypotension within 24 hours of discontinuing NE (NE DC first) versus VP (VP DC first) first in septic shock patients. METHODS: This retrospective study evaluated septic shock patients admitted to the medical intensive care unit (MICU) and surgical ICU (SICU) receiving concomitant NE and VP...
March 1, 2018: Annals of Pharmacotherapy
Laura Coremans, Frederik de Clerck
BACKGROUND: Fitz-Hugh-Curtis syndrome or acute perihepatitis is considered a rare complication of pelvic inflammatory disease, mostly associated with chlamydial or gonococcal salpingitis. Peritoneal tuberculosis is a rare site of extra-pulmonary infection caused by Mycobacterium tuberculosis. Infection usually occurs after reactivation of latent tuberculous foci in the peritoneum and more seldom after contiguous spread from tuberculous salpingitis. CASE PRESENTATION: We describe a case of a 21-year old female of Somalian origin diagnosed with Fitz-Hugh Curtis syndrome associated with tuberculous salpingitis and peritonitis, presenting with new onset ascites...
March 20, 2018: BMC Gastroenterology
Juan Camilo Gomez-Ospina, James A Zapata-Copete, Monica Bejarano, Herney Andrés García-Perdomo
OBJECTIVE: To determine the effectiveness and harms of using antibiotic prophylaxis (ABP) versus placebo/no intervention in patients undergoing elective laparoscopic cholecystectomy (eLCC) to prevent surgical site infection (SSI). METHODS: We searched MEDLINE (OVID), EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to October 2017. We included clinical trials which involved adults at low risk undergoing eLCC and compared ABP versus placebo/no intervention...
March 19, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jonathan D Scrafford, Buvana Reddy, Colleen Rivard, Rachel Isaksson Vogel
PURPOSE: To compare the rates of wound-related complications among women undergoing a cesarean section when the surgical team used intra-operative glove changing versus usual care. METHODS: All women undergoing a cesarean section at a single, county hospital were randomized to usual care or intra-operative glove changing prior to abdominal closure. Participants were randomized at the time of decision for cesarean section; surgeons were not blinded to the randomization arm...
March 19, 2018: Archives of Gynecology and Obstetrics
Yoshio Takesue, Shinya Kusachi, Hiroshige Mikamo, Junko Sato, Akira Watanabe, Hiroshi Kiyota, Satoshi Iwata, Mitsuo Kaku, Hideaki Hanaki, Yoshinobu Sumiyama, Yuko Kitagawa, Kazuhiko Nakajima, Takashi Ueda, Motoi Uchino, Toru Mizuguchi, Yoshiyasu Ambo, Masafumi Konosu, Keiichiro Ishibashi, Akihisa Matsuda, Kazuo Hase, Yasushi Harihara, Koji Okabayashi, Shiko Seki, Takuo Hara, Koshi Matsui, Yoichi Matsuo, Minako Kobayashi, Shoji Kubo, Kazuhisa Uchiyama, Junzo Shimizu, Ryohei Kawabata, Hiroki Ohge, Shinji Akagi, Masaaki Oka, Toshiro Wakatsuki, Katsunori Suzuki, Kohji Okamoto, Katsunori Yanagihara
The principle of empirical therapy for patients with intra-abdominal infections (IAI) should include antibiotics with activity against Enterobacteriaceae and Bacteroides fragilis group species. Coverage of Pseudomonas aeruginosa, Enterobacter cloacae, and Enterococcus faecalis is also recommended for hospital-associated IAI. A nationwide survey was conducted to investigate the antimicrobial susceptibility of pathogens isolated from postoperative IAI. All 504 isolates were collected at 26 institutions and referred to a central laboratory for susceptibility testing...
March 16, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Shaina F Bruce, Danielle N Carr, Elizabeth R Burton, Joel I Sorosky, Mark S Shahin, Mary C Naglak, Mitchell I Edelson
OBJECTIVE: Surgical site infections (SSI) are associated with increased morbidity, mortality, and healthcare costs. This study investigated whether implementation of an abdominal closure bundle reduces surgical site infection rates. We aimed to identify sub-populations that would benefit the most from this intervention. METHODS: We conducted a retrospective cohort study of all patients that underwent exploratory laparotomy by a Gynecologic Oncologist from January 1, 2011 to April 1, 2017...
March 14, 2018: Gynecologic Oncology
Hongyan Yu, Esther Ern-Hwei Chan, Pravin Lingam, Jingwen Lee, Winston Wei Liang Woon, Jee Keem Low, Vishal G Shelat
Backgrounds/Aims: Previous studies have evaluated quality of life (QoL) in patients who underwent laparoscopic cholecystectomy (LC) for cholelithiasis. The purpose of this study was to evaluate QoL after index admission LC in patients diagnosed with acute cholecystitis (AC) using the Gastrointestinal Quality of Life Index (GIQLI) questionnaire. Methods: Patients ≥21 years admitted to Tan Tock Seng Hospital, Singapore for AC and who underwent index admission LC between February 2015 and January 2016 were evaluated using the GIQLI questionnaire preoperatively and 30 days postoperatively...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
R Cantón, E Loza, J Aznar, R Barrón-Adúriz, J Calvo, F J Castillo, E Cercenado, R Cisterna, F González-Romo, J L López-Hontangas, A I Suárez-Barrenechea, F Tubau, B Molloy, D López-Mendoza
OBJECTIVE: The SMART (Study for Monitoring Antimicrobial Resistance Trends) surveillance study monitors antimicrobial susceptibility and extended spectrum β-lactamases (ESBLs) in Gram-negative bacilli recovered from intra-abdominal infections (IAI). METHODS: Antimicrobial susceptibility of 5,343 isolates from IAI recovered in 11 centres during the 2011-2015 SMART-Spain program was analysed by standard microdilution (EUCAST criteria) and compared with that from 2002-2010...
March 12, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Kanefumi Yamashita, Daisuke Kato, Takamitsu Sasaki, Hironari Shiwaku, Fuminori Ishii, Shigetoshi Naito, Yuichi Yamashita, Suguru Hasegawa
BACKGROUND: Appropriate bacterial infection control in the perioperative period of a pancreaticoduodenectomy (PD) is important to prevent and manage serious complications including postoperative pancreatic fistula (POPF). In the present study, the clinical impact of bacterial contamination of intra-abdominal discharge on the rate of POPF after PD was analysed retrospectively. MATERIALS AND METHODS: The data for 82 consecutive patients who had undergone PD at our hospital between January 2009 and July 2014 were retrospectively analysed to review patient characteristics and perioperative and postoperative parameters...
March 9, 2018: International Journal of Surgery
Antonella Cotoia, Lucia Mirabella, Sabrina Altamura, Rachele Villani, Flavia Marchese, Giuseppe Ferrara, Karim Mariano, Tullo Livio, Gilda Cinnella
BACKGROUND: Sepsis caused by complicated intra-abdominal infection is associated with high mortality. Loss of endothelial barrier integrity, inflammation, and impaired cellular oxygen have been shown to be primary contributors to sepsis. To date, little is known regarding the pathway for the mobilization of endothelial progenitor cells (EPCs) from the bone marrow in sepsis whereas stromal-cell-derived factor 1a (SDF-1a) and hypoxia inducible factor 1 (HIF-1) seem to have a role in the EPC response to hypoxic microenvironments...
March 12, 2018: Trials
Michail Kornaropoulos, Marinos Makris, Elia Modestou, Vasileios Karatzias, Apostolos Krikelis, Aristomenis Thanopoulos, Artemis Liapi, Apostolos Mitrousias, Dimitris Katsogiannos, Georgios Kokkalas, Andreas Zevlas, Evripidis Gettimis
INTRODUCTION: Lumbar-peritoneal (LP) and ventriculo-peritoneal (VP) shunt placement is the treatment of choice for diversion of cerebrospinal fluid (CSF) from the subarachnoid space into the peritoneal cavity. This invasive procedure has been associated with several complications, most commonly infection and obstruction. Perforation of the bowel is an extremely rare complication. CASE PRESENTATION: We report a case of a 72 old female patient with LP shunt for raised intracranial pressure, who presented with LP shunt catheter protruding from anus...
February 23, 2018: International Journal of Surgery Case Reports
Marc R Matthews, Asia N Quan, Alexandra S Weir, Kevin N Foster, Daniel M Caruso
Introduction: Leaving the abdominal cavity open is a well-described and frequently utilized technique in the treatment of severe intra-abdominal sepsis. Irrigation through a negative pressure wound therapy device is a technique employed to assist in the closure of wounds as well as the reduction of bacterial contamination. Furthermore, hypochlorous acid has been found to be safe and effective in microorganismal elimination from extremity wounds. There is no literature regarding the infusion of hypochlorous solution into the abdominal cavity for intra-abdominal sepsis or mucopurulent abscesses or biofilm...
2018: Eplasty
Peter J Lee, Amareshwar Podugu, Dong Wu, Arier C Lee, Tyler Stevens, John A Windsor
BACKGROUND: Controversy remains about the best pre-operative management of jaundice in patients with resectable pancreatic head cancer (RPC) undergoing planned pancreaticoduodenectomy (PD). OBJECTIVE: The aim of this study was to compare rates of post-operative complications in patients undergoing four pre-operative approaches (POA): preoperative biliary drainage with plastic stent (PBD-PS), metal stent (PBD-MS), and percutaneous transhepatic drain (PBD-PT), or no pre-operative biliary drainage (NPBD)...
March 8, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
M D Bolmers, C C van Rossem, R R Gorter, W A Bemelman, A A W van Geloven, H A Heij
PURPOSE: A laparoscopic approach for emergency appendectomy is increasingly used, in pediatric patients as well. The objective of this study is to audit the current state of diagnostic work-up, surgical techniques and its outcome in children with acute appendicitis. METHODS: A prospective consecutive observational cohort study was carried out in a 2-month study period. All patients under 18 years that were operated for suspected acute appendicitis were included...
March 9, 2018: Pediatric Surgery International
Jennifer Broom, Chin Li Tee, Alex Broom, Mark D Kelly, Tahira Scott, David A Grieve
BACKGROUND: Antimicrobial therapy for intra-abdominal infections is often inappropriately prolonged. An intervention addressing factors influencing the duration of intravenous antibiotic use was undertaken. This study reports the antibiotic prescribing patterns before and after the intervention and a qualitative analysis of the experience of the intervention. METHODS: Quantitative: A retrospective audit of patients with complicated intra-abdominal infection before and after a multifaceted persuasive intervention was performed...
March 6, 2018: ANZ Journal of Surgery
Gabriela Gainaru, Antonios Papadopoulos, Iraklis Tsangaris, Malvina Lada, Evangelos J Giamarellos-Bourboulis, Aikaterini Pistiki
BACKGROUND: Evidence on the changes in the absolute counts of monocyte subpopulations in sepsis is missing. METHODS: Firstly, absolute counts of circulating CD14pos /HLA-DRpos /CD45pos monocytes were measured by flow cytometry in 70 patients with Gram-negative sepsis and in 10 healthy volunteers. In the second phase, immunophenotyping was performed and the absolute count of circulating inflammatory monocytes and of circulating CD14dim /CD16pos /CD45pos patrolling monocytes were measured in another 55 patients and 10 healthy volunteers...
March 3, 2018: Critical Care: the Official Journal of the Critical Care Forum
Daniele Roberto Giacobbe, Matteo Bassetti, Francesco Giuseppe De Rosa, Valerio Del Bono, Paolo Antonio Grossi, Francesco Menichetti, Federico Pea, Gian Maria Rossolini, Mario Tumbarello, Pierluigi Viale, Claudio Viscoli
Ceftolozane/tazobactam (C/T) is a new antibiotic resulting from the combination of a novel cephalosporin, structurally similar to ceftazidime, with tazobactam, a well-known beta-lactamase inhibitor. C/T remains active against extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and multi-drug resistant (MDR) P. aeruginosa, and has been recently approved for the treatment of complicated intra-abdominal infections (cIAI) and complicated urinary tract infections (cUTI). A trial on hospital-acquired pneumonia is ongoing...
March 9, 2018: Expert Review of Anti-infective Therapy
Nan Zhang, Xiangqian Su, Kai Xu
OBJECTIVE: To compare the safety and effectiveness of circular stapler and linear stapler in Billroth II( anastomosis following distal gastrectomy for gastric cancer patients. METHODS: Clinical data of gastric adenocarcinoma patients who received distal gastrectomy with Billroth II( anastomosis at Ward IIII( of Gastrointestinal Cancer Center of Peking University Cancer Hospital from January 2013 to April 2017 were collected retrospectively. EXCLUSION CRITERIA: (1) patients identified as stage IIII( gastric cancer by preoperative clinical and postoperative pathological staging...
February 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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