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https://www.readbyqxmd.com/read/28110453/update-on-the-diagnosis-and-treatment-of-cholangiocarcinoma
#1
REVIEW
Bryan Doherty, Vinod E Nambudiri, William C Palmer
PURPOSE OF REVIEW: Cholangiocarcinoma is a rare biliary adenocarcinoma associated with poor outcomes. Cholangiocarcinoma is subdivided into extrahepatic and intrahepatic variants. Intrahepatic cholangiocarcinoma is then further differentiated into (1) peripheral mass-forming tumors and (2) central periductal infiltrating tumors. We aimed to review the currently known risk factors, diagnostic tools, and treatment options, as well as highlight the need for further clinical trials and research to improve overall survival rates...
January 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28110370/multidetector-ct-findings-of-histopathologically-proven-peritoneal-tuberculous-cold-abscesses
#2
Jae-Joon Chung, Jeong Min Choi, Eun-Suk Cho, Joo Hee Kim, Jeong-Sik Yu
PURPOSE: To evaluate the characteristic multidetector CT findings of peritoneal tuberculous (TB) cold abscesses. PATIENTS AND METHODS: The morphological characteristics of 48 peritoneal TB cold abscesses in 29 patients (male:female = 13:16; age range 16-75 years) were retrospectively evaluated. TB infection was histologically proven by acid fast bacilli (AFB) smear or culture, TB-polymerase chain reaction (PCR), or histopathological specimen diagnosis. RESULTS: Seventeen abscesses (35...
January 21, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28109798/adverse-events-associated-with-surgical-antibiotic-prophylaxis-for-outpatient-circumcisions-at-us-children-s-hospitals
#3
Katherine H Chan, Benjamin M Whittam, Elizabeth A S Moser, Mark P Cain, William E Bennett
INTRODUCTION: Doctors often use surgical antibiotic prophylaxis (SAP) despite limited evidence to support its efficacy. We sought to determine the association between SAP in children undergoing circumcision and the rate of perioperative adverse events. MATERIAL AND METHODS: We performed a retrospective study of males >30 days old and <18 years old who underwent circumcision from 2004 to 2014 using the Pediatric Health Information System database. We excluded inpatients and those with any concomitant procedures...
November 22, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28109672/optimizing-follow-up-after-anatomic-total-shoulder-arthroplasty
#4
Bradley Schoch, Jean David Werthel, Cathy D Schleck, William S Harmsen, John Sperling, Joaquín Sánchez-Sotelo, Robert H Cofield
BACKGROUND: With increases in both total shoulder arthroplasty (TSA) volumes and patient life expectancies, the number of patients requiring follow-up after shoulder arthroplasty continues to grow exponentially. The purpose of this study is to establish a data-based follow-up schedule minimizing unnecessary patient and health care system costs without sacrificing patient care. METHODS: Between January 1975 and January 2013, 2786 consecutive anatomic TSAs were performed at our institution...
January 19, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28109628/preoperative-bathing-of-the-surgical-site-with-chlorhexidine-for-infection-prevention-systematic-review-with-meta-analysis
#5
Lúcia Maciel de Castro Franco, Gláucia Fernandes Cota, Tatiana Saraiva Pinto, Flávia Falci Ercole
BACKGROUND: Preoperative bathing with 4% chlorhexidine is recommended as a measure to prevent surgical site infection (SSI) despite uncertainty regarding the effectiveness of the intervention. This review aimed to assess the effect of bathing with 4% chlorhexidine on the prevention of SSIs in clean surgeries compared with bathing with placebo solution or soap. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews and the Cochrane manual were followed...
January 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28109620/effect-of-pre-operative-octenidine-nasal-ointment-and%C3%A2-showering-on-surgical-site-infections-in-patients-undergoing-cardiac-surgery
#6
M Reiser, A Scherag, C Forstner, F M Brunkhorst, S Harbarth, T Doenst, M W Pletz, S Hagel
OBJECTIVE: To evaluate the effect of pre-operative octenidine (OCT) decolonization on surgical site infection (SSI) rates. DESIGN: Before-and-after cohort study. PATIENTS: Patients undergoing an elective isolated coronary artery bypass graft (CABG) procedure: control group (1(st) January to 31(st) December 2013), N=475; intervention group (1(st) January to 31(st) December 2014), N=428. INTERVENTIONS: The intervention consisted of nasal application of OCT ointment three times daily, beginning on the day before surgery, and showering the night before and on the day of surgery with OCT soap...
November 18, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28109479/therapeutic-use-of-the-hpv-vaccine-in-recurrent-respiratory-papillomatosis-a-case-report
#7
Christopher Sullivan, Stuart Curtis, Jason Mouzakes
Recurrent Respiratory Papillomatosis (RRP) is a condition characterized by recurring squamous papillomas in the aerodigestive tract due to Human Papilloma Virus (HPV) infection. Treatment includes surgical debridement of the lesions often with adjuvant therapy. A newer adjuvant agent being tested is the HPV vaccine. The case report includes a child with RRP who underwent 10 surgeries in a year with an average inter-surgical interval (ISI) of 46 days. The patient then received the scheduled regimen of 3 doses of 9 valent HPV vaccine...
February 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28109195/fungal-periprosthetic-joint-infection-following-total-elbow-arthroplasty-a-case-report-and-review-of-the-literature
#8
Cory A Kwong, Shannon K T Puloski, Kevin A Hildebrand
BACKGROUND: With improving surgical techniques for total elbow arthroplasty clinical outcomes have improved and its utilization continues to increase. Despite these advances, complication rates remain as high as 24%. Of these complications periprosthetic joint infection is one of the most common and morbid. The rheumatoid elbow remains a leading indication for total elbow arthroplasty. Patients with this condition frequently require immunosuppressive therapy, which places them at higher risk of both typical and atypical infections...
January 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28109160/antibiotics-for-infection-prevention-after-excision-of-the-cervical-transformation-zone
#9
REVIEW
Chumnan Kietpeerakool, Bandit Chumworathayi, Jadsada Thinkhamrop, Butsakorn Ussahgij, Pisake Lumbiganon
BACKGROUND: Excision of the transformation zone of the cervix is the most commonly used approach to treat cervical precancerous lesions (cervical intraepithelial neoplasia (CIN)) to reduce the risk of developing cervical cancer. As the excision of the transformation zone leaves a raw area on the cervix, there is a risk of infection following the procedure. The incidence of infection after cold knife conization (CKC) is 36%, whereas the incidence for large loop excision of the transformation zone (LLETZ, also known as loop electrical excision procedure (LEEP)) is much lower (0...
January 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28108822/the-feasibility-of-local-anesthesia-for-the-surgical-treatment-of-umbilical-hernia-a-systematic-review-of-the-literature
#10
REVIEW
A P Jairam, R Kaufmann, F Muysoms, J Jeekel, J F Lange
BACKGROUND: Yearly approximately 4500 umbilical hernias are repaired in The Netherlands, mostly under general anesthesia. The use of local anesthesia has shown several advantages in groin hernia surgery. Local anesthesia might be useful in the treatment of umbilical hernia as well. However, convincing evidence is lacking. We have conducted a systematic review on safety, feasibility, and advantages of local anesthesia for umbilical hernia repair. METHODS: A systematic review was conducted according to the PRISMA guidelines...
January 20, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28107859/dengue-fever-may-mislead-the-surgeons-when-it-presents-as-an-acute-abdomen
#11
Bingumal Jayasundara, Lalith Perera, Ajith de Silva
OBJECTIVE: To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF (Dengue fever)/DHF (Dengue hemorrhagic fever). METHODS: Clinical data of all cases of apparent acute abdomen (AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed. Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered...
January 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28107302/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#12
(no author information available yet)
No abstract text is available yet for this article.
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#13
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107224/abdominal-sepsis
#14
Quirine J J Boldingh, Fleur E E de Vries, Marja A Boermeester
PURPOSE OF REVIEW: To summarize the recent evidence on the treatment of abdominal sepsis with a specific emphasis on the surgical treatment. RECENT FINDINGS: A multitude of surgical approaches towards abdominal sepsis are practised. Recent evidence shows that immediate closure of the abdomen has a better outcome. A short course of antibiotics has a similar effect as a long course of antibiotics in patients with intra-abdominal infection without severe sepsis. SUMMARY: Management of abdominal sepsis requires a multidisciplinary approach...
January 19, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#15
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28106966/pericardial-fat-flap-surgical-technique-for-infection-control-after-graft-replacement
#16
Yoshitsugu Nakamura, Yohei Kawatani, Yujiro Ito, Takaki Hori
Surgical treatment of mycotic aneurysm of the thoracic aorta is challenging because contamination from surrounding tissues may occur even after complete debridement with a prosthetic graft replacement of the aneurysm. This study describes the simple but very useful technique of using a pericardial fat flap to protect the prosthetic graft from reinfection.
January 18, 2017: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/28106675/treatment-of-slipped-capital-femoral-epiphysis-with-the-modified-dunn-procedure-a-multicenter-study
#17
Masquijo J Javier, Allende Victoria, D'Elia Martín, Miranda Gabriela, Fernández Claudio A
INTRODUCTION: Treatment of moderate to severe slipped capital femoral epiphysis (SCFE) is controversial. Over the last years, 3 institutions in Argentina adopted the modified Dunn procedure for capital realignment in selected cases of SCFE. Our aim in this study was to evaluate the clinical outcome and the rate of complications of patients who had undergone surgical hip dislocation and capital realignment. METHODS: A multicenter retrospective cohort study of patients who received the modified Dunn procedure from January 2009 to 2013 was performed...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28106651/evaluating-the-impact-of-intraoperative-surgical-team-handoffs-on-patient-outcomes
#18
Lauren E Giugale, Sarah Sears, Erin S Lavelle, Charelle M Carter-Brooks, Michael Bonidie, Jonathan P Shepherd
OBJECTIVE: The aim of the study was to assess the impact of intraoperative personnel handoffs on clinical outcomes in patients undergoing minimally invasive sacrocolpopexy (SCP). METHODS: We retrospectively reviewed SCPs performed at an academic center between 2009 and 2014. We analyzed the number of staff handoffs, defined as any instance a scrub technician (tech) or circulating nurse handed off responsibility for a break or shift change. Outcomes included operative (OR) time and composite variables for major complications (conversion to an open procedure, bladder injury, bowel injury, blood transfusion, infection, ileus, bowel obstruction, readmission, or mesh complication) and prolapse recurrence (prolapse at or beyond the hymen or retreatment)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106608/a-perioperative-systems-design-to-improve-intraoperative-glucose-monitoring-is-associated-with-a-reduction-in-surgical-site-infections-in-a-diabetic-patient-population
#19
Jesse M Ehrenfeld, Jonathan P Wanderer, Maxim Terekhov, Brian S Rothman, Warren S Sandberg
BACKGROUND: Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve intraoperative glucose monitoring. METHODS: With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the authors created an automatic system to identify diabetic patients, detect insulin administration, check for recent glucose measurement, and remind clinicians to check intraoperative glucose...
January 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28106513/long-term-follow-up-of-superior-gluteal-artery-perforator-flap-closure-of-large-myelomeningoceles
#20
Brett A Whittemore, Dale M Swift, Bradley E Weprin, Frederick J Duffy
OBJECTIVE Large myelomeningocele defects and poor surrounding tissue quality make some defects particularly difficult to close primarily. This paper describes the superior gluteal artery perforator (SGAP) flap technique for defect closure and long-term clinical outcomes. METHODS The technique for closing a myelomeningocele with an SGAP flap is described. A retrospective chart review was performed on a cohort of 11 patients who underwent closure in this manner. RESULTS Between 1999 and 2015, 271 myelomeningoceles were closed, 11 of which were SGAP flap closures...
January 20, 2017: Journal of Neurosurgery. Pediatrics
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