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https://www.readbyqxmd.com/read/28226350/-value-of-endoscopy-application-in-the-management-of-complications-after-radical-gastrectomy-for-gastric-cancer
#1
Yiqun Zhang, Pinghong Zhou
Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28225198/adjunctive-steroid-therapy-versus-antibiotics-alone-for-acute-endophthalmitis-after-intraocular-procedure
#2
REVIEW
Carole H Kim, Monica F Chen, Anne L Coleman
BACKGROUND: Endophthalmitis refers to severe infection within the eye that involves the aqueous humor or vitreous humor, or both, and threatens vision. Most cases of endophthalmitis are exogenous (i.e. due to inoculation of organisms from an outside source), and most exogenous endophthalmitis is acute and occurs after an intraocular procedure. The mainstay of treatment is emergent administration of broad-spectrum intravitreous antibiotics. Due to their anti-inflammatory effects, steroids in conjunction with antibiotics have been proposed to be beneficial in endophthalmitis management...
February 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28225051/low-muscle-mass-at-initiation-of-anti-tnf-therapy-for-inflammatory-bowel-disease-is-associated-with-early-treatment-failure-a-retrospective-analysis
#3
D Q Holt, P Varma, B J G Strauss, A S Rajadurai, G T Moore
BACKGROUND/OBJECTIVES: Delayed treatment failure occurs in a significant proportion of inflammatory bowel disease (IBD) patients treated with tumor necrosis factor-alpha (TNF) antagonists. Identification of predictors of loss of response (LOR) may help to optimize therapy. We sought to determine whether body composition parameters at the commencement of anti-TNF therapy were associated with earlier treatment failure. SUBJECTS/METHODS: A retrospective cohort study was performed on 68 patients who had undergone cross-sectional abdominal imaging coincident with the commencement of anti-TNF drugs...
February 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28224953/perceived-learning-needs-of-patients-with-abdominal-aortic-aneurysm
#4
Olga Nilsson, Rebecka Hultgren, Anna Letterstål
BACKGROUND: Patients undergoing surgical treatment of abdominal aortic aneurysm (AAA) should receive adequate information about the disease, treatment options, and self-care. Patients' learning needs should be acknowledged. The aim was to describe the perceived learning needs in patients with AAA. A secondary aim was to explore their experience of methods for patient education. METHODS: Three focus group interviews were conducted with 14 patients treated with open or endovascular repair of AAA...
March 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28224207/-differentiated-application-of-recommended-guideline-techniques-for-treatment-of-inguinal-hernia
#5
H Niebuhr, M Pawlak, F Köckerling
The new worldwide guidelines of all international hernia societies only recommend the mesh-based methods TEP, TAPP and Lichtenstein. The best mesh-free technique, the Shouldice operation, should only be used if the patient has declined the use of a mesh or no mesh is available. The systematic use of the Shouldice technique for smaller inguinal hernias and younger men should be confined to study settings. A tailored approach should be taken for mesh-based procedures to minimize the risk to patients. Due to lower pain rates the laparoendoscopic techniques TEP and TAPP are the methods of choice for primary male unilateral inguinal hernia...
February 21, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28223728/levothyroxine-therapy-and-impaired-clearance-are-the-strongest-contributors-to-small-intestinal-bacterial-overgrowth-results-of-a-retrospective-cohort-study
#6
Thorsten Brechmann, Andre Sperlbaum, Wolff Schmiegel
AIM: To identify a set of contributors, and weight and rank them on a pathophysiological basis. METHODS: Patients who have undergone a lactulose or glucose hydrogen breath test to rule out small intestinal bacterial overgrowth (SIBO) for various clinical symptoms, including diarrhoea, weight loss, abdominal pain, cramping or bloating, were seen as eligible for inclusion in a retrospective single-centre study. Clinical data such as co-morbidities, medication, laboratory parameters and other possible risk factors have been identified from the electronic data system...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#7
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28222678/tracheal-extubation-in-deeply-anesthetized-pediatric-patients-after-tonsillectomy-a-comparison-of-high-concentration-sevoflurane-alone-and-low-concentration-sevoflurane-in-combination-with-dexmedetomidine-pre-medication
#8
Meiqin Di, Yuan Han, Zhuqing Yang, Huacheng Liu, Xuefei Ye, Hongyan Lai, Jun Li, Wangning ShangGuan, Qingquan Lian
BACKGROUND: Dexmedetomidine can facilitate a smooth extubation process and reduce the requirement of sevoflurane and emergence agitation when administrated perioperatively. We aimed to observe the extubation process and the recovery characteristics in pediatric patients undergoing tonsillectomy while anesthetized with either high-concentration sevoflurane alone or low-concentration sevoflurane combined with pre-medication of single dose of intravenous dexmedetomidine. METHODS: Seventy-five patients (ASA I or II, aged 3-7 years) undergoing tonsillectomy were randomized into three equal groups: to receive intravenous saline (Group D0), dexmedetomidine 1 μg/kg (Group D1), or dexmedetomidine 2 μg/kg (Group D2) approximately 10 min before anesthesia...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28222277/antibiotic-prophylaxis-in-blepharoplasty-review-of-the-current-literature
#9
REVIEW
Elie M Ferneini, Steven Halepas, Steven I Aronin
The purpose of this study was to provide an evidence-based overview of antibiotic prophylaxis in blepharoplasty. We performed a literature search that evaluated the risk of infection associated with blepharoplasty, as well as the risks and benefits of antibiotic prophylaxis. The overall infection rate associated with eyelid surgery is extremely low. However, the use of antibiotic prophylaxis has increased over the past 25 years in esthetic facial procedures. There is no standard of care for or against antibiotic prophylaxis, and routine practices vary widely...
February 1, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28221665/totally-percutaneous-versus-surgical-cut-down-femoral-artery-access-for-elective-bifurcated-abdominal-endovascular-aneurysm-repair
#10
REVIEW
Madelaine Gimzewska, Alexander Ir Jackson, Su Ern Yeoh, Mike Clarke
BACKGROUND: Abdominal aortic aneurysms (AAAs) are a vascular condition with significant risk attached, particularly if they rupture. It is, therefore, critical to identify and repair these as an elective procedure before they rupture and require emergency surgery. Repair has traditionally been an open surgical technique that required a large incision across the abdomen. Endovascular abdominal aortic aneurysm repairs (EVARs) are now a common alternative. In this procedure, the common femoral artery is exposed via a cut-down approach and a graft introduced to the aneurysm in this way...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28221179/natural-orifice-transluminal-endoscopic-surgery-notes-in-gynecology
#11
Karl Jallad, Mark D Walters
Natural Orifice Transluminal Endoscopic Surgery (NOTES) is an emerging field in minimally invasive surgery. NOTES can be performed via a variety of approaches, including through the stomach, esophagus, bladder, and rectum, but the majority of cases have been performed transvaginally. Potential advantages of natural orifice surgery in gynecology include the lack of abdominal incisions, less operative pain, shorter hospital stay, improved visibility, and the possibility to circumvent extensive lysis of adhesion to reach the pelvic cavity...
February 17, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28220804/impact-of-symptomatic-skeletal-events-on-health-care-resource-utilization-and-quality-of-life-among-patients-with-castration-resistant-prostate-cancer-and-bone-metastases
#12
R McKay, B Haider, M S Duh, A Valderrama, M Nakabayashi, M Fiorillo, L Ristovska, L Wen, P Kantoff
BACKGROUND: Data regarding the impact of symptomatic skeletal events (SSEs) on health economics and patient-reported outcomes in men with castration-resistant prostate cancer (CRPC) and bone metastases from a clinical setting are lacking. Hence, this study aimed to quantify the effects of SSEs on health-care resource utilization (HRU), health-related quality of life (HRQoL) and pain in men with CRPC metastasized to bone. METHODS: This cohort study included men with CRPC and bone metastasis treated at a tertiary center during December 1996-July 2015...
February 21, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28220232/targeted-temperature-management-after-intraoperative-cardiac-arrest-a-multicenter-retrospective-study
#13
Anne-Laure Constant, Nicolas Mongardon, Quentin Morelot, Nicolas Pichon, David Grimaldi, Lauriane Bordenave, Alexis Soummer, Bertrand Sauneuf, Sybille Merceron, Sylvie Ricome, Benoit Misset, Cedric Bruel, David Schnell, Julie Boisramé-Helms, Etienne Dubuisson, Jennifer Brunet, Sigismond Lasocki, Pierrick Cronier, Belaid Bouhemad, Serge Carreira, Emmanuelle Begot, Benoit Vandenbunder, Gilles Dhonneur, Philippe Jullien, Matthieu Resche-Rigon, Jean-Pierre Bedos, Claire Montlahuc, Stephane Legriel
PURPOSE: Few outcome data are available about temperature management after intraoperative cardiac arrest (IOCA). We describe targeted temperature management (TTM) (32-34 °C) modalities, adverse events, and association with 1-year functional outcome in patients with IOCA. METHODS: Patients admitted to 11 ICUs after IOCA in 2008-2013 were studied retrospectively. The main outcome measure was 1-year functional outcome. RESULTS: Of the 101 patients [35 women and 66 men; median age, 62 years (interquartile range, 42-72)], 68 (67...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28220199/-novel-pharmaceutical-treatment-approaches-for-gastric-cancer
#14
F Lordick
This review article delineates novel approaches for the pharmaceutical treatment of gastric cancer. A newly developed molecular classification of gastric cancer based on histology, genetic, epigenetic and proteomic characteristics has evolved. It provides a road map for development of new drugs and combinations as well as for patient stratification in clinical research and it is expected to be introduced into clinical practice in the near future. Anti-HER2 targeted treatment is a validated strategy for treatment of metastatic gastric cancer and is now also being studied in the perioperative setting to increase response rates and ultimately survival in patients undergoing curative surgery; however, the resistance mechanisms of HER2-targeted treatment are poorly understood and optimal patient selection remains challenging...
February 20, 2017: Der Pathologe
https://www.readbyqxmd.com/read/28219624/the-effects-of-body-mass-index-on-complications-and-mortality-after-emergency-abdominal-operations-the-obesity-paradox
#15
Elizabeth R Benjamin, Evren Dilektasli, Tobias Haltmeier, Elizabeth Beale, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Recent literature suggests that obesity is protective in critically illness. This study addresses the effect of BMI on outcomes after emergency abdominal surgery (EAS). METHODS: Retrospective, ACS-NSQIP analysis. All patients that underwent EAS were included. The study population was divided into five groups based on BMI; regression models were used to evaluate the role of obesity in morbidity and mortality. RESULTS: 101,078 patients underwent EAS; morbidity and mortality were 19...
February 13, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28218883/case-239-cerebrotendinous-xanthomatosis
#16
Amy C Gerrish, Suchi Gaba
History A 63-year-old man with learning difficulties presented to the Accident and Emergency Department with right ankle pain after an inversion injury and underwent plain radiography. The patient had developed normally until his teenage years, at which point he experienced cognitive regression. He experienced swallowing difficulties, tinnitus, and fecal incontinence, and he had undergone cataract surgery at the age of 20 years. He also had a small nodule on the volar surface of his right ring finger. Magnetic resonance (MR) imaging of the brain and the right ankle had been performed 3 years previously...
March 2017: Radiology
https://www.readbyqxmd.com/read/28218203/cystic-dystrophy-of-the-duodenal-wall-a-rare-but-need-to-know-disease
#17
Lydia Plana Campos, Carlos Alventosa Mateu, Javier Sempere García-Argüelles, Ana Belén Durá Ayet, Inma Bort Pérez, Patricia Suárez Callol
Cystic dystrophy of the duodenal wall (CDDW) is a serious but uncommon complication of heterotopic pancreatic tissue characterized by increased duodenal wall thickness associated with intraparietal cystic lesions. It is mainly observed in middle-aged male patients with alcoholic chronic pancreatitis. Clinical symptoms are usually nonspecific and it is important to take them into account in patients with the abovementioned history. Imaging techniques have been useful for diagnosis, especially endoscopic ultrasound (EUS), to visualize cystic lesions in the wall...
January 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28218155/perceptions-of-nonsurgical-permanent-contraception-among-potential-users-providers-and-influencers-in-wardha-district-and-new-delhi-india-exploratory-research
#18
Jennifer C Aengst, Elizabeth K Harrington, Pramod Bahulekar, Poonam Shivkumar, Jeffrey T Jensen, B S Garg
BACKGROUND: New permanent contraceptive methods are in development, including nonsurgical permanent contraception (NSPC). OBJECTIVE: In the present study, perceptions of NSPC in India among married women, married men, mothers-in-law, providers, and health advocates in Eastern Maharashtra (Wardha district) and New Delhi were examined. METHODS: We conducted semi-structured interviews with 40 married women and 20 mothers-in-law; surveys with 150 married men; and focus group discussions with obstetrics/gynecology providers and advocates...
January 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28217701/gut-microbiota-and-oxalate-homeostasis
#19
Marguerite Hatch
This perspective focuses on how the gut microbiota can impact urinary oxalate excretion in the context of hyperoxaluria, a major risk factor in kidney stone disease. In the genetic disease of Primary Hyperoxaluria Type 1 (PH1), an increased endogenous production of oxalate, due to a deficiency of the liver enzyme alanine-glyoxylate aminotransferase (AGT), results in hyperoxaluria and oxalate kidney stones. The constant elevation in urinary oxalate in PH1 patients ultimately leads to tissue deposition of oxalate, renal failure and death and the only known cure for PH1 is a liver or liver-kidney transplant...
January 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28217260/robotic-liver-surgery-is-the-optimal-approach-as-bridge-to-transplantation
#20
Paolo Magistri, Giuseppe Tarantino, Roberto Ballarin, Andrea Coratti, Fabrizio Di Benedetto
The role of minimally invasive liver surgery as a bridge to transplantation is very promising but still underestimated. However, it should be noted that surgical approach for hepatocellular carcinomas (HCC) is not merely a technical or technological issue. Nowadays, the epidemiology of HCC is evolving due to the increasing role of non-alcoholic fatty-liver-disease, and the emerging concerns on direct-acting antivirals against hepatitis C virus in terms of HCC incidence. Therefore, a fully multidisciplinary study of the cirrhotic patient is currently more important than ever before, and the management of those patients should be reserved to tertiary referral hepatobiliary centers...
February 8, 2017: World Journal of Hepatology
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