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Anthony A Iwuafor, Folasade T Ogunsola, Rita O Oladele, Oyin O Oduyebo, Ibironke Desalu, Chukwudi C Egwuatu, Agwu U Nnachi, Comfort N Akujobi, Ita O Ita, Godwin I Ogban
BACKGROUND: Infections are common complications in critically ill patients with associated significant morbidity and mortality. AIM: This study determined the prevalence, risk factors, clinical outcome and microbiological profile of hospital-acquired infections in the intensive care unit of a Nigerian tertiary hospital. MATERIALS AND METHODS: This was a prospective cohort study, patients were recruited and followed up between September 2011 and July 2012 until they were either discharged from the ICU or died...
2016: PloS One
N Albertos Mira-Marcelí, N Gallego Mellado, P Deltell Colomer, J Mira Navarro, A Encinas Goenechea, O Sánchez París, E Liceras Liceras, F González López, M E Martín Hortigüela, C Navarro de la Calzada, J Gonzálvez Piñera
OBJECTIVE: To compare the results of laparoscopic versus open adhesiolysis in children affected by postoperative bowel obstruction. METHODS: Retrospective study reviewing charts of all patients who were operated on due to postoperative adhesions in our Department. Demographic data, clinical characteristics and postoperative data were collected. RESULTS: During the last 8 years, 37 patients were operated on for postoperative intestinal obstructions...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
E Calleja Aguayo, A Moreno Montero, A García Baglietto, A E Hernández Calvarro, J Bregante Ucedo, C Marhuenda Irastorza
OBJECTIVE: The water-soluble contrast has shown its effectiveness for the resolution of adhesive small bowel obstruction (SBO) in adults. The objective of this study is to compare the value of water-soluble contrast in children with SBO versus control group. METHODS: We conducted a case-control trial. Patients with a history of abdominal surgery and SBO diagnosed between 2008 and 2013 were included as controls. Conservative treatment or surgery depending on clinical evolution was performed in control group...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
A García Baglietto, C Barceló Cañellas, C Marhuenda Irastorza
INTRODUCTION: Stump appendicitis is the remaining appendicular tissue inflammation after a variable length of time. It is a very infrequent pathology with a paucity in pediatric publications, and given the fact that a delay in its diagnosis could lead to an increased morbidity, this is the reason of its clinical relevance. CLINICAL CASE: A 10 years old girl who had laparoscopic excision of a flemonous-gangrenous appendicitis and who 45 days after surgery showed new clinical symptoms compatible with a diagnosis of acute appendicitis...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Valentine Nfonsam, Hassan Aziz, Viraj Pandit, Mazhar Khalil, Jana Jandova, Bellal Joseph
INTRODUCTION: Optimization of surgical outcomes after colectomy continues to be actively studied, but most studies group right-sided and left-sided colectomies together. The aim of our study was to determine whether the complication rate differs between right-sided and left-sided colectomies for cancer. METHODS: We identified patients who underwent laparoscopic colectomy for colon cancer between 2005 and 2010 in the American College of Surgeons National Surgical Quality Improvement Program database and stratified cases by right and left side...
2016: Cancer Treatment Communications
Alexander J Sweidan, Navneet K Singh, Natasha Dang, Vinh Lam, Jyoti Datta
INTRODUCTION: Amiodarone is often used in the suppression of tachyarrhythmias. One of the more serious adverse effects includes amiodarone pulmonary toxicity (APT). Several pulmonary diseases can manifest including interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary nodules or masses, and pleural effusion. Incidence of APT varies from 5-15% and is correlated to dosage, age of the patient, and preexisting lung disease...
2016: Clinical Medicine Insights. Case Reports
Yasuhiro Sasaki, Ayumi Kanamaru, Hisae Uchida, Masataka Yano, Hiroshi Tada
An 51-year-old man had undergone surgery for Rathke's cleft cyst by transsphenoidal approach on October 2015. After the surgery, cerebrospinal fluid (CSF) rhinorrhea arose. Surgical treatment of CSF rhinorrhea was performed by the same approach. Ten days after reoperation, he suffered from severe headache, high fever, and nuchal rigidity. CSF findings indicated bacterial meningitis. CSF culture showed methicillin-resistant Staphylococcus lugdunensis. He received vancomycin intravenously for 19 days and recovered from the bacterial meningitis with no serious complication...
October 21, 2016: Rinshō Shinkeigaku, Clinical Neurology
N Didbaridze, N Lomidze, T Abuladze, G Qiliptari, T Didbaridze, I Gvasalia, Z Mkervalishvili, N Gogokhia
Anaerobic clostridial infection is the most severe form of paraproctitis. The incubation period is very short, from 3 to 6 hours, sometimes lasting for 1-2 days. Clostridial infection spreads rapidly and induces gas gangrene, causes destruction of cells and other intermediate substances, and impedes blood circulation. This paper presents a case study of an extremely severe form of anaerobic infection with spontaneous gas gangrene, cellulitis, fasciomyositic necrosis, severe intoxication and septic shock on the abdominal front and lateral surfaces...
September 2016: Georgian Medical News
C Nos, K B Clough, P Bonnier, S Lasry, G Le Bouedec, B Flipo, J-M Classe, M-C Missana, V Doridot, S Giard, H Charitansky, A Charles-Nelson, A-S Bats, C Ngo
BACKGROUND: Two thirds of node-positive breast cancer patients have limited pN1 disease and could benefit from a less extensive axillary lymph node dissection (ALND). METHODS: 172 breast cancers patients requiring an ALND were prospectively enrolled in the Sentibras Protocol of Axillary Reverse Mapping (ARM). Radioisotope was injected in the ipsilateral hand the day before surgery. ALND was standard. Removed lymph nodes were classified into non radioactive nodes and radioactive nodes (ARM nodes)...
August 26, 2016: European Journal of Surgical Oncology
A Kanashiro, J M Gaya, J Palou, L Gausa, H Villavicencio
OBJECTIVES: To review our experience in robot-assisted radical cystectomy, assessing the complications and oncological and functional results. MATERIALS AND METHODS: From 2007 to 2014, we performed 67 robot-assisted radical cystectomies combined with lymphadenectomy in 61 cases. The operations were performed on 37 patients due to muscle-invasive tumours and on 30 due to high-risk nonmuscle-invasive tumours. Urinary diversion was conducted extracorporeally, using a Studer neobladder in 47 cases...
October 18, 2016: Actas Urologicas Españolas
Michael X Repka, Trevano W Dean, Elizabeth L Lazar, Kimberly G Yen, Phoebe D Lenhart, Sharon F Freedman, Denise Hug, Bahram Rahmani, Serena X Wang, Raymond T Kraker, David K Wallace
OBJECTIVE: To describe baseline characteristics, initial postoperative refractive errors, operative complications, and magnitude of the intraocular lens (IOL) prediction error for refractive outcome in children undergoing lensectomy largely in North America. DESIGN: Prospective registry study of children from birth to <13 years of age who underwent lensectomy for any reason within 45 days preceding enrollment. PARTICIPANTS: Total of 1266 eyes of 994 children; 49% female and 59% white...
October 18, 2016: Ophthalmology
Ahmed Almashrafi, Laura Vanderbloemen
BACKGROUND: Postoperative adverse events are known to increase length of stay and cost. However, research on how adverse events affect patient flow and operational performance has been relatively limited to date. Moreover, there is paucity of studies on the use of simulation in understanding the effect of complications on care processes and resources. In hospitals with scarcity of resources, postoperative complications can exert a substantial influence on hospital throughputs. METHODS: This paper describes an evaluation method for assessing the effect of complications on patient flow within a cardiac surgical department...
October 21, 2016: BMC Medical Informatics and Decision Making
S Pscherer, A Nüssler, C Bahrs, M Reumann, C Ihle, U Stöckle, S Ehnert, T Freude, B G Ochs, I Flesch, P Ziegler
Background: The increasing incidence of diabetes mellitus is also reflected in the patient population of a trauma and orthopaedic centre. Diabetics also exhibit more comorbidities than non-diabetics. In addition to surgical problems in these patients, hospitalisation is often accompanied by complications, which can prolong treatment and increase costs. The aim of this retrospective study is to analyse hospitalisation of diabetics compared to non-diabetics, as well as differences in treatment costs, depending on associated age and comorbidities...
October 21, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Vincenzo Vindigni, Carlotta Scarpa, Erica Dalla Venezia, Franco Bassetto
INTRODUCTION: Fournier's gangrene is a rare disease that affects the genital, abdominal, and perineal regions and leads to death if not treated promptly. CASE REPORT: A 42-year-old, obese woman presented to the authors' department affected by Fournier's gangrene. In order to treat her abdominal and genital regions, the authors performed a surgical debridement followed by combined therapy with antibiotics and topical negative pressure wound therapy (NPWT) with instillation plus saline solution...
October 2016: Wounds: a Compendium of Clinical Research and Practice
David E Rosow, Jamal Ahmed
Importance: Adult laryngotracheal stenosis (LTS) is typically managed surgically, but some patients fail treatment because of rapid restenosis or granulation tissue formation. The need for frequent surgery or tracheostomy reduces the quality of life in these patients and poses a significant challenge for the treating physician. New adjuvant treatments are required to reduce the surgical burden of this condition. Objective: To examine whether patients with rapidly recurrent nonvasculitic LTS who fail surgical management of their stenosis (ie, requiring dilation more frequently than every 6 months) experience longer intervals between surgical procedures when receiving adjuvant treatment with low-dose methotrexate...
October 20, 2016: JAMA Otolaryngology—Head & Neck Surgery
Helen J Sims-Williams, Hugh P Sims-Williams, Edith Mbabazi Kabachelor, James Fotheringham, Benjamin C Warf
OBJECTIVE Myelomeningocele (MM) is a neural tube defect complicated by neurological deficits below the level of the spinal lesion and, in many cases, hydrocephalus. Long-term survival of infants treated for MM in a low- and middle-income country has never been reported. This retrospective cohort study reports 10-year outcomes and factors affecting survival for infants undergoing MM repair at CURE Children's Hospital of Uganda. METHODS Patients were traced by telephone or home visit. Survival was estimated using the Kaplan-Meier method...
October 21, 2016: Journal of Neurosurgery. Pediatrics
Alexander A Theologis, Gregory M Mundis, Stacie Nguyen, David O Okonkwo, Praveen V Mummaneni, Justin S Smith, Christopher I Shaffrey, Richard Fessler, Shay Bess, Frank Schwab, Bassel G Diebo, Douglas Burton, Robert Hart, Vedat Deviren, Christopher Ames
OBJECTIVE The aim of this study was to evaluate the utility of supplementing long thoracolumbar posterior instrumented fusion (posterior spinal fusion, PSF) with lateral interbody fusion (LIF) of the lumbar/thoracolumbar coronal curve apex in adult spinal deformity (ASD). METHODS Two multicenter databases were evaluated. Adults who had undergone multilevel LIF of the coronal curve apex in addition to PSF with L5-S1 interbody fusion (LS+Apex group) were matched by number of posterior levels fused with patients who had undergone PSF with L5-S1 interbody fusion without LIF (LS-Only group)...
October 21, 2016: Journal of Neurosurgery. Spine
Catherine M Chan, Courtney H Zwahlen, Louis-Philippe de Lorimier, Stephen M Yeomans, Karon L Hoffmann, Antony S Moore
CASE DESCRIPTION 4 dogs with a slow-growing mass in the cervical region were evaluated. CLINICAL FINDINGS All dogs had no clinical signs at the time of the evaluation. There was no apparent evidence of visceral metastases or other primary tumor based on available CT or MRI data for any dog. TREATMENT AND OUTCOME For each dog, surgery to remove the mass was performed. Histologic examination of the excised tissue revealed a completely excised grade 1 or 2 lymph node hemangiosarcoma. All dogs received adjuvant chemotherapy; 2 dogs underwent curative intent chemotherapy, 1 dog underwent metronomic treatment with cyclophosphamide, and 1 dog underwent metronomic treatment with chlorambucil...
November 1, 2016: Journal of the American Veterinary Medical Association
Sarah Wills, Hugues Beaufrère, Gwyneth Watrous, Michelle L Oblak, Dale A Smith
CASE DESCRIPTION A 13-year-old female green iguana (Iguana iguana) was examined because of a 6-day history of vomiting, anorexia, and lethargy and a 4-day history of decreased fecal and urate output. CLINICAL FINDINGS Physical examination revealed a distended abdomen, signs of depression, pallor, tachycardia, harsh lung sounds, and vomiting. Abdominal radiographs revealed gas distention of the stomach and small intestine with fluid lines evident on the lateral view. Plasma biochemical analysis indicated hypochloremic metabolic alkalosis, hyperglycemia, and hyperuricemia...
November 1, 2016: Journal of the American Veterinary Medical Association
Si Zhang, Hexiang Zhao, Hao Li, Chao You, Xuhui Hui
OBJECTIVE Decompressive craniectomy (DC) is a life-saving treatment for severe hemorrhagic cerebral venous thrombosis (CVT). However, the correlations between the clinicoradiological features and surgical outcomes of this disease are not well established. Therefore, the authors endeavored to analyze the potential risk factors for this more severe subtype of CVT and to provide more evidence regarding the benefits of DC in patients with hemorrhagic CVT. METHODS The clinical features, radiological findings, and surgical outcomes of patients with severe hemorrhagic CVT who had undergone DC treatment in the period from January 2005 to March 2015 were retrospectively analyzed, and the risk factors for this disease were evaluated...
October 21, 2016: Journal of Neurosurgery
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