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intra abdominal infections

Jin Qi, Peng Zhang, Yanan Wang, Hao Chen, Yumin Li
BACKGROUND/AIMS: Total gastrectomy (TG) has shown to be superior regarding low risk of recurrence and readmission to distal subtotal gastrectomy (DG) for treatment of distal stomach cancer, but the incidence of postoperative morbidity and mortality in TG cannot be ignored. Therefore, we performed a meta-analysis to compare the effectiveness between TG and DG for distal stomach cancer. METHODOLOGY: A search in PubMed, EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical Database through January 2016 was performed...
2016: PloS One
Shangjie Xiao, Wenyi Yang, Like Yuan, Ying Zhang, Tao Song, Lu Xu, Song Tian, Wuping Ge, Jialiang Zhou, Xiaochun Zhu
OBJECTIVE: To investigate the operation timing of newborns with rectosigmoid Hirschsprung's disease (HD). METHODS: From March 2013 to September 2015, 35 newborns diagnosed as rectosigmoid HD in our department were prospectively and randomly divided into 2 groups: less than 3 months treatment group (18 cases) and more than 3 months treatment group (17 cases, conservative treatment for 3 months). They all underwent laparoscopic-assisted transanal endorectal pull-through (LATEP) (modified Soave) procedure...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Nikolaus Rieber, Roel P Gazendam, Alexandra F Freeman, Amy P Hsu, Amanda L Collar, Janyce A Sugui, Rebecca A Drummond, Chokechai Rongkavilit, Kevin Hoffman, Carolyn Henderson, Lily Clark, Markus Mezger, Muthulekha Swamydas, Maik Engeholm, Rebecca Schüle, Bettina Neumayer, Frank Ebel, Constantinos M Mikelis, Stefania Pittaluga, Vinod K Prasad, Anurag Singh, Joshua D Milner, Kelli W Williams, Jean K Lim, Kyung J Kwon-Chung, Steven M Holland, Dominik Hartl, Taco W Kuijpers, Michail S Lionakis
Invasive pulmonary aspergillosis is a life-threatening mycosis that only affects patients with immunosuppression, chemotherapy-induced neutropenia, transplantation, or congenital immunodeficiency. We studied the clinical, genetic, histological, and immunological features of 2 unrelated patients without known immunodeficiency who developed extrapulmonary invasive aspergillosis at the ages of 8 and 18. One patient died at age 12 with progressive intra-abdominal aspergillosis. The other patient had presented with intra-abdominal candidiasis at age 9, and developed central nervous system aspergillosis at age 18 and intra-abdominal aspergillosis at age 25...
October 20, 2016: JCI Insight
Kang Liao, Yili Chen, Menghe Wang, Penghao Guo, Qiwen Yang, Yuxing Ni, Yunsong Yu, Bijie Hu, Ziyong Sun, Wenxiang Huang, Yong Wang, Anhua Wu, Xianju Feng, Yanping Luo, Zhidong Hu, Yunzhuo Chu, Shulan Chen, Bin Cao, Jianrong Su, Bingdong Gui, Qiong Duan, Shufang Zhang, Haifeng Shao, Haishen Kong, Yingchun Xu
BACKGROUND: Recently, the emergence of multidrug-resistant organisms such as extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has raised considerable concern regarding the appropriate treatment of intra-abdominal infections (IAIs). In this study, we investigated the molecular characteristics of ESBL among clinical isolates of Escherichia coli and Klebsiella pneumoniae causing IAIs and their pattern of antimicrobial resistance, which can provide useful information about the epidemiology and risk factors associated with these infections...
October 7, 2016: Diagnostic Microbiology and Infectious Disease
Maddibande Ramachar Sreevathsa, Khyati Melanta
INTRODUCTION: The most common cause of gas under diaphragm is hollow viscous perforation. In 10% of cases it can be due to rare causes, both abdominal and extra-abdominal, one of them being intra abdominal infection by gas forming organisms. PRESENTATION OF THE CASE: A 51 year old male patient, a poorly controlled diabetic, presented with a second episode of severe pain abdomen and abdominal distention, with lower abdominal tenderness. Plain Xray of the abdomen in erect posture showed gas under the right dome of diaphragm and ultrasound abdomen confirmed gross pneumoperitoneum...
October 14, 2016: International Journal of Surgery Case Reports
Qingbin Wu, Chengwu Jin, Tao Hu, Mingtian Wei, Ziqiang Wang
AIM: To compare intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in laparoscopic right colectomy (LRC) in terms of intraoperative and postoperative outcomes. METHODS: A systematic literature search with no limits was performed in PubMed and Embase. The last search was performed on April 9, 2016. The outcomes of interests included intraoperative outcomes (operative time, blood loss, length of incision, conversion, lymph nodes harvested, and intraoperative complications) and postoperative outcomes (time to first flatus, time to first defecation, time to liquid diet, length of hospital stay, postoperative complications, mortality, ileus, anastomotic leakage, anastomotic bleeding, wound infection, hernia, and intra-abdominal abscess)...
October 21, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Yao Cheng, Jie Xia, Mingliang Lai, Nansheng Cheng, Sirong He
BACKGROUND: The use of surgical drains has been considered mandatory after pancreatic surgery. The role of prophylactic abdominal drainage to reduce postoperative complications after pancreatic surgery is controversial. OBJECTIVES: To assess the benefits and harms of routine abdominal drainage after pancreatic surgery, compare the effects of different types of surgical drains, and evaluate the optimal time for drain removal. SEARCH METHODS: For the initial version of this review, we searched the Cochrane Library (2015, Issue 3), MEDLINE (1946 to 9 April 2015), Embase (1980 to 9 April 2015), Science Citation Index Expanded (1900 to 9 April 2015), and Chinese Biomedical Literature Database (CBM) (1978 to 9 April 2015)...
October 21, 2016: Cochrane Database of Systematic Reviews
Sara A Buckman, Tamara Krekel, Anouk E Muller, John E Mazuski
The treatment of complicated intra-abdominal infections (cIAI) is increasingly challenging due to increased resistance of Gram-negative organisms. These multidrug resistant organisms lead to an increase in morbidity and mortality. This has led to renewed interest in use of older β-lactam antibiotics in combination with newer β-lactamase inhibitors. Ceftazidime-avibactam is one of the newest such combination antibiotics, which has been released for treatment of complicated intra-abdominal infections in combination with metronidazole...
October 19, 2016: Expert Opinion on Pharmacotherapy
Rebeccah B Baucom, Jenny Ousley, Gloria B Beveridge, Sharon E Phillips, Richard A Pierce, Michael D Holzman, Kenneth W Sharp, William H Nealon, Benjamin K Poulose
BACKGROUND: Cancer survivorship focuses largely on improving quality of life. We aimed to determine the rate of ventral incisional hernia (VIH) formation after cancer resection, with implications for survivorship. METHODS: Patients without prior VIH who underwent abdominal malignancy resections at a tertiary center were followed up to 2 years. Patients with a viewable preoperative computed tomography (CT) scan and CT within 2 years postoperatively were included...
October 14, 2016: Annals of Surgical Oncology
Ri-Xing Bai, Wen-Mao Yan, You-Guo Li, Jun Xu, Zhi-Qiang Zhong, Ming Yan
AIM: To evaluate the feasibility of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: Seventy-seven patients received side-to-side anastomosis of the lesser curvature of stomach and jejunum by utilization of linear stapler in LRYGB from April 2012 to July 2015 were retrospectively analyzed. RESULTS: All patients were successfully completed laparoscopic gastric bypass with the side-to-side anastomosis of the lesser curvature of stomach and jejunum...
October 7, 2016: World Journal of Gastroenterology: WJG
Sarah E Petite, Seth R Bauer, Jessica E Bollinger, Christine L Ahrens, Lisa M Harinstein
STUDY OBJECTIVE: It is unknown if beta-lactam monotherapy is sufficient for complicated intra-abdominal infections or if broader coverage is required, such as with vancomycin. This study sought to determine the clinical outcomes of piperacillin/tazobactam monotherapy compared to combination therapy with vancomycin and piperacillin/tazobactam for complicated intra-abdominal infections among patients within a surgical intensive care unit. DESIGN: Retrospective cohort study...
October 11, 2016: Pharmacotherapy
Myra W Popejoy, David L Paterson, Daniel Cloutier, Jennifer A Huntington, Benjamin Miller, Caleb A Bliss, Judith N Steenbergen, Ellie Hershberger, Obiamiwe Umeh, Keith S Kaye
OBJECTIVES: The increase in infections caused by drug-resistant ESBL-producing Enterobacteriaceae (ESBL-ENT) is a global concern. The characteristics and outcomes of patients infected with ESBL-ENT were examined in a pooled analysis of Phase 3 clinical trials of ceftolozane/tazobactam in patients with complicated urinary tract infections (ASPECT-cUTI) and complicated intra-abdominal infections (ASPECT-cIAI). METHODS: Trials were randomized and double blind. The ASPECT-cUTI regimen was 7 days of either intravenous ceftolozane/tazobactam (1...
October 5, 2016: Journal of Antimicrobial Chemotherapy
Hiroshige Mikamo, Akira Yuasa, Keiko Wada, Bruce Crawford, Naomi Sugimoto
Background.  Carbapenem-resistant Enterobacteriaceae has increased dramatically in the last decade, resulting in infections that are difficult to treat and associated with high mortality rates. To prevent further antibacterial resistance, it is necessary to use carbapenem selectively. A combination of metronidazole with an antimicrobial agent active against aerobes is an alternative effective treatment for patients with complicated intra-abdominal infections (cIAIs). This study aimed to compare efficacy and safety of metronidazole combination therapies and carbapenem and to provide clinical evidence regarding the optimal treatment of cIAI...
September 2016: Open Forum Infectious Diseases
Shio-Shin Jean, Po-Ren Hsueh
OBJECTIVES: To investigate the antimicrobial resistance and assess the molecular characteristics of β-lactamases (ESBLs, AmpC β-lactamases and carbapenemases) among Enterobacteriaceae isolates that caused intra-abdominal infections (IAIs) in patients hospitalized in the Asia-Pacific region during 2008-14. METHODS: Multiplex PCR was used to detect the specific types of β-lactamase in 2893 isolates with MICs of ertapenem >0.5 mg/L. In-hospital acquisition times for most isolates were also delineated...
October 4, 2016: Journal of Antimicrobial Chemotherapy
Pierre Maitrias, Gwendoline Deltombe, Valérie Molin, Thierry Reix
OBJECTIVE: Iliofemoral endarterectomy with external iliac artery (EIA) stent grafting can be an alternative to traditional open surgery in patients with severe iliac occlusive disease extending to the common femoral artery. We report the midterm outcomes of this approach. METHODS: Between 2009 and 2015, 108 patients (76% male; median age, 63 years) underwent a total of 127 iliofemoral endarterectomies combined with EIA stent grafting. Indications were claudication in 60%, rest pain in 20%, ulceration in 15%, and acute ischemia in 5%...
September 29, 2016: Journal of Vascular Surgery
B Lipový, H Řihová, M Hanslianová, I Suchánek, P Brychta
Toxic epidermal necrolysis (TEN) is an autoimmune disease which is usually caused by a reaction to drugs. It affects mainly the skin and mucous membranes. It is a rare condition with a high mortality rate. Fatal outcomes in patients with TEN are mostly due to infectious complications. As antimicrobial drugs may induce this syndrome, the management of this condition is very complicated. Tigecycline is still a relatively new antibiotic approved in Europe for use in complicated intra-abdominal infections and complicated skin and soft tissue infections...
2016: Epidemiologie, Mikrobiologie, Imunologie
Charles E Edmiston, David J Leaper
BACKGROUND: Intra-operative surgical site irrigation (lavage) is common practice in surgical procedures in general, with all disciplines advocating some form of irrigation before incision closure. This practice, however, has been neither standardized nor is there compelling evidence that it effectively reduces the risk of surgical site infection (SSI). This narrative review addresses the laboratory and clinical evidence that is available to support the practice of irrigation of the abdominal cavity and superficial/deep incisional tissues, using specific irrigation solutions at the end of an operative procedure to reduce the microbial burden at wound closure...
September 27, 2016: Surgical Infections
Alberto Hernández-Tejedor, Carmen Débora Merino-Vega, Alfredo Martín-Vivas, Rafael Ruiz de Luna-González, Alberto Delgado-Iribarren, Ángeles Gabán-Díez, Ignacio Temprano-Gómez, Natalia de la Calle-Pedrosa, Ana Isabel González-Jiménez, Alejandro Algora-Weber
INTRODUCTION: Ceftolozane/tazobactam is a novel antibiotic approved for the treatment of complicated intra-abdominal and complicated urinary tract infections. CASE DESCRIPTION: We describe the use of off-label ceftolozane/tazobactam in the management of a multidrug-resistant Pseudomonas aeruginosa bacteremia that was already being treated with colistin and amikacin, the only active antibiotics according to the antibiogram.
September 26, 2016: Infection
Rishi Rattan, Casey J Allen, Robert G Sawyer, John Mazuski, Therese M Duane, Reza Askari, Kaysie L Banton, Jeffrey A Claridge, Raul Coimbra, Joseph Cuschieri, E Patchen Dellinger, Heather L Evans, Christopher A Guidry, Preston R Miller, Patrick J O'Neill, Ori D Rotstein, Michaela A West, Kimberley Popovsky, Nicholas Namias
A prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. We hypothesized that patients with specific risk factors for complications also had similar outcomes. Short-course patients with obesity, diabetes, or Acute Physiology and Chronic Health Evaluation II ≥15 from the STOP-IT trial were compared with longer duration patients. Outcomes included incidence of and days to infectious complications, mortality, and length of stay...
September 2016: American Surgeon
Mansi Shah, Clayton T Ellis, Michael R Phillips, Amy Marzinsky, William Adamson, Timothy Weiner, Kimberly Erickson, Sang Lee, Patricia A Lange, Sean E McLean
The role of preoperative bowel prep in the pediatric surgical population is uncertain. We performed a randomized prospective study to evaluate noninferiority between the presence or absence of a preoperative bowel prep in elective pediatric bowel surgery on postoperative outcomes. Patients aged three months to 18 years were recruited and randomized to the bowel prep group or the no bowel prep group. Patients were evaluated in-hospital and at postoperative clinic visits. Thirty-two patients were recruited; 18 in the bowel prep group and 14 in the no bowel prep group...
September 2016: American Surgeon
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