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https://www.readbyqxmd.com/read/29240005/efficacy-of-a-dual-ring-wound-protector-for-prevention-of-surgical-site-infections-after-pancreaticoduodenectomy-in-patients-with-intrabiliary-stents-a-randomized-clinical-trial
#1
Alexsander K Bressan, Jean-Michel Aubin, Guillaume Martel, Elijah Dixon, Oliver F Bathe, Francis R Sutherland, Fady Balaa, Richard Mimeault, Janet P Edwards, Sean C Grondin, Susan Isherwood, Keith D Lillemoe, Sara Saeed, Chad G Ball
OBJECTIVE: To evaluate the efficacy of a dual-ring wound protector for preventing incisional surgical site infection (SSI) among patients with preoperative biliary stents undergoing pancreaticoduodenectomy (PD). METHODS AND ANALYSIS: This study was a parallel, dual-arm, double-blind randomized controlled trial. Adult patients with a biliary stent undergoing elective PD at 2 tertiary care institutions were included (February 2013 to May 2016). Patients were randomly assigned to receive a surgical dual-ring wound protector or no wound protector, and also the current standard of care...
December 12, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29236278/head-and-neck-surgical-reconstruction-in-operation-iraqi-freedom-and-operation-enduring-freedom-afghanistan-a-systematic-review
#2
Samantha J Mikals, Joshua M Jabaut, Art A Ambrosio
Historically, head and neck injuries constituted 16 to 20% of all nonfatal combat injuries. However, advances in body and vehicle armor in the context of the use of ambushes and improvised explosive devices by enemy combatants have resulted in fewer fatalities from head and neck wounds, and thus the incidence of nonfatal head and neck injuries has risen to as high as 52%. Despite this increase, data regarding specific injury distributions, surgical cases, and approaches to repair are lacking in the current literature...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29234966/efficacy-and-feasibility-of-a-collaborative-multidisciplinary-program-for-antibiotic-prophylaxis-in-clean-wound-surgery
#3
Xinyu Li, Hong Chen, Shenyin Zhu, Yu Liu, Jiadan Yang, Zhe Yuan, Gaoqun Yao, Feng Qiu
Background Despite national and international guidelines and recommendations, inappropriate prophylactic antibiotic use for clean wound surgery remains a common phenomenon in many Chinese hospitals, causing higher medical costs and bacterial resistance. Objective To improve the prescribing behavior for antibiotic prophylaxis and decrease antibiotic abuse and/or misuse in clean wound surgery. Setting The teaching hospital of a medical university in Southwest China. Methods A collaborative multidisciplinary program involving educational, technical, and administrative strategies was undertaken...
December 12, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29232537/laparoscopic-versus-conventional-open-surgery-in-intersphincteric-resection-for-low-rectal-cancer-a-systematic-review-and-meta-analysis
#4
Xubing Zhang, Qingbin Wu, Tao Hu, Chaoyang Gu, Liang Bi, Ziqiang Wang
AIM: This meta-analysis aims at comparing laparoscopic intersphincteric resection (LISR) with conventional open ISR (OISR) for low rectal cancer (LRC) in terms of intraoperative, postoperative, pathological, and survival outcomes. MATERIALS AND METHODS: A systematic literature search with no limits was performed in PubMed and Ovid. The last search was performed on May 27, 2017. The outcomes of interests included intraoperative outcomes: operative time and blood loss; postoperative outcomes: hospital day, postoperative hospital day, time to first flatus, time to normal diet, ileus, intra-abdominal abscess, anastomotic leakage, anastomotic stricture, wound infection, pneumonia, urinary complication, morbidity, and mortality; pathological outcomes: lymph node harvested, R0 resection rate, distance of proximal resection margin, distal resection margin and circumferential resection margin (CRM), and positive CRM; survival outcomes: 3-year overall survival (OS), 3-year disease-free survival (DFS), 5-year OS, and 5-year DFS...
December 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29227118/complex-suicide-involving-pyrethroid-ingestion-mosquito-coils-and-fatal-self-wounding-by-sharp-force
#5
Maria -Valeria Karakasi, Pavlos Pavlidis, Epameinondas Vasilikos, Doxakis Anestakis, Nikolaos Raikos
"Complex suicide" is a term referring to the suicidal pattern in which more than one suicidal method is applied in the purpose of inducing death. The present paper aims to review complex suicide literature shortly and investigate an unusual planned complex suicide incident, the rarity of which is attributable to the combination of suicide methods as well as the type and quantity of substances applied to induce poisoning. A 33-year-old man with a history of psychotic depression was found dead in his bedroom lying within a large quantity of blood...
2017: Soudní Lékarství
https://www.readbyqxmd.com/read/29227052/laparoscopy-or-clinical-follow-up-to-detect-occult-diaphragm-injuries-following-left-sided-thoracoabdominal-stab-wounds-a-pilot-randomized-controlled-trial
#6
G F Malherbe, P H Navsaria, A J Nicol, S Edu, S Chowdhury
BACKGROUND: The purpose of this study was to determine whether patients with left-sided thoracoabdominal (TA) stab wounds can be safely treated with clinical and chest X-ray follow up. METHOD: A prospective, randomized control study was conducted at Groote Schuur Hospital from September 2009 through to November 2014. Patients with asymptomatic left TA stab wounds included in the trial were randomized into two groups. Group A underwent diagnostic laparoscopy and Group B underwent clinical and radiological follow-up...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29223633/effectiveness-of-irrigation-with-chlorhexidine-after-removal-of-mandibular-third-molars-a-randomised-controlled-trial
#7
H Cho, M C David, A J Lynham, E Hsu
To evaluate the effect of postoperative irrigation with chlorhexidine on inflammatory complications after the extraction of lower third molars under local anaesthesia, we recruited 100 patients to participate in a controlled, single-blind, randomised clinical trial. They were assigned to one of two groups: the intervention group (postoperative irrigation of the surgical site with chlorhexidine for seven days) or the control group (postoperative chlorhexidine mouth rinse for seven days). The primary outcome variables were pain, swelling, trismus, infection, and alveolar osteitis...
December 6, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29223421/a-prospective-multi-institutional-cohort-study-of-mediastinal-infections-after-cardiac-operations
#8
Louis P Perrault, Katherine A Kirkwood, Helena L Chang, John C Mullen, Brian C Gulack, Michael Argenziano, Annetine C Gelijns, Ravi K Ghanta, Bryan A Whitson, Deborah L Williams, Nancy M Sledz-Joyce, Brian Lima, Giampaolo Greco, Nishit Fumakia, Eric A Rose, John D Puskas, Eugene H Blackstone, Richard D Weisel, Michael E Bowdish
BACKGROUND: Mediastinal infections are a potentially devastating complication of cardiac operations. This study analyzed the frequency, risk factors, and perioperative outcomes of mediastinal infections after cardiac operations. METHODS: In 2010, 5,158 patients enrolled in a prospective study evaluating infections after cardiac operations and their effect on readmissions and mortality for up to 65 days after the procedure. Clinical and demographic characteristics, operative variables, management practices, and outcomes were compared for patients with and without mediastinal infections, defined as deep sternal wound infection, myocarditis, pericarditis, or mediastinitis...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29221299/surgical-site-infections-after-lung-resection-a-prospective-study-of-risk-factors-in-1-091-consecutive-patients
#9
Andrea Imperatori, Elisa Nardecchia, Lorenzo Dominioni, Daniele Sambucci, Sebastiano Spampatti, Giancarlo Feliciotti, Nicola Rotolo
Background: To assess incidence and risk factors of surgical site infections (SSI) (wound infection, pneumonia, empyema) in a monocentric series of patients undergoing lung resection over a decade. Methods: All patients undergoing lung resection at our institution in 2006-2015 [wedge resection, n=579; lobectomy, n=472 (12% after chemo/radiotherapy); pneumonectomy, n=40 (47% after chemo/radiotherapy)], were prospectively enrolled. Perioperative SSI risk factors were recorded: age, gender, blood haemoglobin, lymphocyte count, serum albumin, forced expiratory volume in 1 second percentage (FEV1%) of predicted, antibiotic prophylaxis, length of stay, diabetes, malignancy, steroid therapy, induction chemo/radiotherapy, resection in 2006-2010/2011-2015, urgent/elective procedure, videothoracoscopic/open approach, resection type, operative time...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29218659/single-site-robotic-assisted-laparoscopic-cholecystectomy-in-children-and-adolescents-a-report-of-20-cases
#10
Peter Mattei
BACKGROUND: Single-site laparoscopy is increasingly popular for straightforward operations like appendectomy. Due to limited triangulation and maneuverability, single-site cholecystectomy is riskier and more difficult. Robotics offer to make it easier and safer. METHODS: Twenty children and adolescents underwent robotic-assisted single-site cholecystectomy at a large academic children's hospital. Patients were not randomized; patients were offered the option of robotic-assisted single-site (SSR) or standard four-incision laparoscopic (LAP) cholecystectomy...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29211190/incidence-and-risk-factors-for-surgical-site-infection-in-general-surgeries
#11
Rafael Lima Rodrigues de Carvalho, Camila Cláudia Campos, Lúcia Maciel de Castro Franco, Adelaide De Mattia Rocha, Flávia Falci Ercole
OBJECTIVE: to estimate the incidence of surgical site infection in general surgeries at a large Brazilian hospital while identifying risk factors and prevalent microorganisms. METHOD: non-concurrent cohort study with 16,882 information of patients undergoing general surgery from 2008 to 2011. Data were analyzed by descriptive, bivariate and multivariate analysis. RESULTS: the incidence of surgical site infection was 3.4%. The risk factors associated with surgical site infection were: length of preoperative hospital stay more than 24 hours; duration of surgery in hours; wound class clean-contaminated, contaminated and dirty/infected; and ASA index classified into ASA II, III and IV/V...
December 4, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29210513/the-efficacy-of-a-novel-budesonide-chitosan-gel-on-wound-healing-following-endoscopic-sinus-surgery
#12
Thanh Ha, Rowan Valentine, Stephen Moratti, Lyall Hanton, Simon Robinson, Peter-John Wormald
BACKGROUND: Adhesion formation and ostial stenosis are common causes of surgical failure after endoscopic sinus surgery (ESS). Postoperative topical steroid application has been shown to improve wound healing. Chitosan-dextran gel (CD gel) is an effective hemostatic nasal dressing. This study aims to determine the effect of the addition of budesonide to CD gel on postoperative ostial stenosis and adhesion formation following ESS. METHODS: This prospective, blinded, randomized controlled trial was conducted between October 2012 and April 2015...
December 6, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29209669/comparison-of-alveolar-ridge-splitting-and-autogenous-onlay-bone-grafting-to-enable-implant-placement-in-patients-with-atrophic-jaw-bones
#13
Gokhan Gurler, Cagri Delilbasi, Hasan Garip, Sukran Tufekcioglu
To compare alveolar ridge splitting (ARS) and autogenous onlay bone grafting (AOBG) in atrophic jaw bones.  Methods: Forty patients were included in this retrospective, parallel-group study conducted at the Istanbul Medipol University School of Dentistry, Istanbul, Turkey, between 2012-2015. The initial bone thickness was measured by cone beam computed tomography (CBCT). Patients were allocated into ARS (n=17) and AOGB (n=23) groups on the basis of ridge thickness and shape. Follow-up CBCT measurements to assess horizontal bone were repeated 4 to 6 months post augmentation...
December 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/29208881/clinicopathological-assessment-of-colorectal-carcinoma-in-mymensingh-medical-college-hospital-bangladesh
#14
M M Mahamud, F Wahed, J Ferdous, M K Khan
Colorectal carcinoma (CRC) is the third most commonly diagnosed cancer and the third leading cause of cancer death in both men and women in the US. It is mainly a disease of the developed countries with a western culture, yet the disease is not uncommon in developing countries. There is substantial geographical variation in the incidence and demographic characteristics of the disease. Variations are also observed in the risk factors, mode of presentation, sub site distribution and stage of the disease at presentation...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29207978/potential-therapeutic-effects-of-n-butylidenephthalide-from-radix-angelica-sinensis-danggui-in-human-bladder-cancer-cells
#15
Sheng-Chun Chiu, Tsung-Lang Chiu, Sung-Ying Huang, Shu-Fang Chang, Shee-Ping Chen, Cheng-Yoong Pang, Teng-Fu Hsieh
BACKGROUND: N-butylidenephthalide (BP) isolated from Radix Angelica Sinensis (Danggui) exhibits anti-tumorigenic effect in various cancer cells both in vivo and in vitro. The effect of BP in bladder cancer treatment is still unclear and worth for further investigate. METHODS: Changes of patients with bladder cancer after Angelica Sinensis exposure were evaluated by analysis of Taiwan's National Health Insurance Research Database (NHIRD) database. The anti-proliferative effect of BP on human bladder cancer cells was investigated and their cell cycle profiles after BP treatment were determined by flow cytometry...
December 6, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29207758/mycobacterium-fortuitum-infection-at-umbilical-hernioplasty-site
#16
Bharti Chogtu, Daliparty Vasudev Malik, Rahul Magazine, Vishnu Prasad Shenoy
Non Tuberculous Mycobacteria (NTM) are a group of rapidly growing mycobacteria and are generally considered to be of low virulence. Of late, there has been an increase in incidence of infections due to these organisms. Among them, Mycobacterium fortuitum, M. chelonae and M. abscessus are the common species which have been identified. Though they are occasionally implicated in pulmonary infections, NTM are very commonly associated with cutaneous infections, especially surgical site infections. Identification of NTM infection at such sites should be suspected when there is delayed healing of the wound...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29207079/molecular-basis-of-coronary-artery-dilation-and-aneurysms-in-patients-with-kawasaki-disease-based-on-differential-protein-expression
#17
Wanting Liu, Chaowu Liu, Li Zhang, Xiaofei Xie, Xiaoqiong Gu, Chuanlan Sang, Mingguo Xu, Weijun Xu, Hongling Jia
Kawasaki disease (KD) is an acquired cardiac disease with a high incidence that affects children. KD has various complications, including coronary artery dilation (CAD) and coronary artery aneurysms (CAA). The identification of differentially expressed proteins and the underlying mechanisms may be the key to understanding differences between these KD complications. In the present study, isobaric tags for relative and absolute quantitation were used to identify variations in serum proteins between KD patients with CAD and CAA...
November 20, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29202338/cranial-trauma-in-handgun-executions-experimental-data-using-polyurethane-proxies
#18
Seth C Taylor, Elena F Kranioti
Gun violence is a global phenomenon with regional variation in frequency and severity. Handguns are often used in violent deaths such as suicides and homicides. Hence, ballistic trauma is a critical subject of forensic investigations. Trauma patterns are fundamental evidence for the reconstruction of the incident and for the determination of the manner of death. This study investigated the differences in trauma patterns with a series of experiments using six different calibers (.22 LR, .38 Special, .380 ACP, 9×19mm, ...
November 27, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29197316/developing-a-mass-casualty-surge-capacity-protocol-for-emergency-medical-services-to-use-for-patient-distribution
#19
Samuel E Shartar, Brooks L Moore, Lori M Wood
OBJECTIVES: Metropolitan areas must be prepared to manage large numbers of casualties related to a major incident. Most US cities do not have adequate trauma center capacity to manage large-scale mass casualty incidents (MCIs). Creating surge capacity requires the distribution of casualties to hospitals that are not designated as trauma centers. Our objectives were to extrapolate MCI response research into operational objectives for MCI distribution plan development; formulate a patient distribution model based on research, hospital capacities, and resource availability; and design and disseminate a casualty distribution tool for use by emergency medical services (EMS) personnel to distribute patients to the appropriate level of care...
December 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29195906/patterns-and-predictors-of-emergency-department-visits-among-older-patients-after-breast-cancer-surgery-a-population-based-cohort-study
#20
Tracy Westley, Ania Syrowatka, David Henault, Young-Soo Rho, Francois Khazoom, Sue-Ling Chang, Robyn Tamblyn, Nancy Mayo, Ari N Meguerditchian
OBJECTIVES: To characterize rates, reasons for, and associated predictors for emergency department (ED) visits after breast cancer (BC) surgery. METHODS: All women over 65 years undergoing curative surgery for non-metastatic incident BC (1998-2012) were identified using Quebec's universal healthcare administrative databases. Reasons for ED visits within 45days of operation were reported. Associated factors were estimated using Cox regression. RESULTS: Of 24,463 patients, 12...
November 28, 2017: Journal of Geriatric Oncology
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