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Surgical culture

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https://www.readbyqxmd.com/read/28742690/do-surgeons-react-a-retrospective-analysis-of-surgeons-response-to-harassment-of-a-colleague-during-simulated-operating-theatre-scenarios
#1
Hannah Gostlow, Camila Vega Vega, Nicholas Marlow, Wendy Babidge, Guy Maddern
OBJECTIVE: To assess and report on surgeons' ability to identify and manage incidences of harassment. BACKGROUND: The Royal Australasian College of Surgeons is committed to driving out discrimination, bullying, harassment, and sexual harassment from surgical training and practice, through changing the culture of the workplace. To eradicate these behaviors, it is first critical to understand how the current workforce responds to these actions. METHODS: A retrospective analysis of video data of an operating theatre simulation was conducted to identify how surgeons, from a range of experience levels, react to instances of harassment...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28740847/fournier-s-gangrene-lessons-learned-from-multimodal-and-multidisciplinary-management-of-perineal-necrotizing-fasciitis
#2
Orestis Ioannidis, Loukiani Kitsikosta, Dimitris Tatsis, Ioannis Skandalos, Aggeliki Cheva, Aikaterini Gkioti, Ioannis Varnalidis, Savvas Symeonidis, Natalia Antigoni Savvala, Styliani Parpoudi, George K Paraskevas, Manousos George Pramateftakis, Efstathios Kotidis, Ioannis Mantzoros, Konstantinos George Tsalis
BACKGROUND: Fournier's gangrene (FG) is a rapidly evolving necrotizing fasciitis of the perineum and the genital area, the scrotum as it most commonly affects man in the vast majority of cases. It is polymicrobial in origin, due to the synergistic action of anaerobes and aerobes and has a very high mortality. There are many predisposing factors including diabetes mellitus, alcoholism, immunosuppression, renal, and hepatic disease. The prognosis of the disease depends on a lot of factors including but not limited to patient age, disease extent, and comorbidities...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28740662/treatment-for-sternoclavicular-joint-infections-a-multi-institutional-study
#3
Allen Murga, Hannah Copeland, Rachel Hargrove, Jason M Wallen, Salman Zaheer
BACKGROUND: Sternoclavicular joint (SCJ) infections are rare and difficult to manage. Surgery is necessary for treatment. METHODS: A retrospective chart review of the university hospital and Veterans Administration (VA) hospitals of all patients treated for SCJ infections since 2001 was conducted. Fifteen [15] patients were identified and evaluated for the types of infections, risk factors, treatments and survival. RESULTS: All 15 patients were symptomatic including: pain [13], erythema [9], purulent drainage [3], fever greater than 38...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28739122/idiopathic-granulomatous-mastitis-a-diagnostic-and-therapeutic-challenge
#4
C M Freeman, B T Xia, G C Wilson, J D Lewis, S Khan, S J Lee, E E Lower, M J Edwards, E A Shaughnessy
BACKGROUND: Idiopathic granulomatous mastitis is a rare benign breast disease of women of reproductive age. It usually presents as a painful mass. Since the etiology is unclear, directed diagnosis and management is lacking. METHODS: This is a retrospective chart review of 14 patients, over twelve years (2004-2016), identified through query of pathology findings. RESULTS: Two asymptomatic patients were diagnosed after oncologic breast resection following neoadjuvant chemotherapy...
July 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28736974/topical-sevoflurane-for-chronic-venous-ulcers-infected-by-multi-drug-resistant-organisms
#5
Adrián Imbernón-Moya, Francisco Javier Ortiz-de Frutos, Mónica Sanjuan-Alvarez, Isabel Portero-Sanchez, Raúl Merinero-Palomares, Victoria Alcazar
Several anaesthetic drugs have demonstrated antibacterial properties in vitro. Anaesthetics can primarily affect the cell wall of both susceptible and multi-resistant bacteria. They may also have a synergistic effect with conventional antibiotics through an unknown mechanism. We present three cases of a chronic venous ulcer infected by multi-resistant bacteria refractory to conventional systemic antibiotics, including Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). Treatment with topical sevoflurane was performed for 1 month without systemic antibiotics...
July 23, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28736852/successful-medical-treatment-of-an-aspergillus-terreus-mycetoma-of-the-nostril-lip-in-a-16-year-old-fjord-pony-gelding-with-pituitary-pars-intermedia-dysfunction
#6
Pia K Randleff-Rasmussen, Marion Mosca, Frédéric Knoerr, Didier Pin, Isabelle Desjardins
BACKGROUND: Mycetoma is a chronic, proliferative lesion of cutaneous/subcutaneous tissue characterized by draining tracts and granules in the discharge caused by actinomycetes (actinomycetoma) or filamentous fungi (eumycotic mycetoma). OBJECTIVES: This case report describes the unusual finding of a cutaneous mycetoma of the lateral wing of the right nostril in a gelding. ANIMAL: A 16-year-old Fjord gelding with suspected pituitary pars intermedia dysfunction (PPID) was presented for evaluation of a nonpainful, firm and raised mass involving the lateral wing of the right nostril and the lip...
July 23, 2017: Veterinary Dermatology
https://www.readbyqxmd.com/read/28736162/-skin-engineering-for-severe-burns
#7
J-J Lataillade, B Magne, E Bey, T Leclerc, M Trouillas
Severe burned patients need definitive and efficient wound coverage. Outcome of massive burns has been improved by using cultured epithelial autografts (CEA). Despite fragility, percentages of success take, cost of treatment and long-term tendency to contracture, this surgical technique has been developed in few burn centres. First improvements were to combine CEA and dermis-like substitute. Cultured skin substitutes provide earlier skin closure and satisfying functional result. These methods have been used successfully in massive burns...
July 20, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28736122/treatment-of-tibial-nonunion-with-posterolateral-bone-grafting
#8
Michael J Foster, Robert V O'Toole, Theodore T Manson
OBJECTIVES: Posterolateral bone grafting to treat nonunions of the distal two-thirds of the tibia avoids the often traumatized and more tenuous anterior soft-tissue envelope. Few modern reports of its effectiveness are available. We assessed whether posterolateral bone grafting leads to high union and low complication rates. METHODS: We conducted a retrospective review at a Level I trauma center. Our study group was 59 patients with distal two-thirds tibial fractures treated with posterolateral bone grafting...
May 3, 2017: Injury
https://www.readbyqxmd.com/read/28735135/endoscope-assisted-abscess-drainage-secondary-to-endoscope-assisted-tlif-1-year-follow-up
#9
Karthik Madhavan, Steven Shelby Burks, Lee Onn Chieng, Anand Veeravagu, Michael Y Wang
INTRODUCTION: Endoscopic discectomy and fusions have been gaining popularity in the recent past and are noted to be safe for its application in elderly population. It involves ultra-small incision for discectomy followed by placement of percutaneous screws in awake patients. Treatment of advanced spinal pathology using endoscope-assisted techniques are challenging. Although not common with endoscopic approach, post-operative infection can be problematic as there are no established guidelines on its management...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28730548/orthopedic-infections-caused-by-obligatory-anaerobic-gram-negative-rods-report-of-two-cases
#10
Marta Kierzkowska, Piotr Pedzisz, Ireneusz Babiak, Jakub Janowicz, Mateusz Kulig, Anna Majewska, Anna Sawicka-Grzelak, Grazyna Mlynarczyk
Anaerobic bone and joint infections are uncommon, although the number of anaerobic infections is presumably underestimated because of difficulties with isolation and identification of obligate anaerobes. This study describes two cases of complicated Bacteroides fragilis peri-implant infection of the lumbar spine, infection of the hip and osteomyelitis. Bacteria were identified with the use of a mass spectrometer, VITEK MS system. Drug susceptibility was performed with the use of E-test. The EUCAST breakpoints were used for interpretation with B...
July 20, 2017: Medical Microbiology and Immunology
https://www.readbyqxmd.com/read/28730531/comparing-different-tissue-engineered-repair-materials-for-the-treatment-of-pelvic-organ-prolapse-and-urinary-incontinence-which-material-is-better
#11
Xiaojuan Wang, Yisong Chen, Zhongyong Fan, Keqin Hua
INTRODUCTION AND HYPOTHESIS: Synthetic non-absorbable meshes are widely used to augment surgical repair of pelvic organ prolapse (POP) and stress urinary incontinence (SUI), but these meshes are associated with serious complications. This study compares the attachment and extracellular matrix (ECM) production of adipose-derived stem cells (ADSCs) on different biodegradable nanomaterials to develop tissue engineered repair materials. METHODS: Rat ADSCs were isolated and cultured on electrospun poly-L-lactic acid (PLA) and electrospun poly(L-lactide)-trimethylene carbonate-gycolide (PLTG) terpolymers for 1 and 2 weeks...
July 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28729187/poor-employment-conditions-adversely-affect-mental-health-outcomes-among-surgical-trainees
#12
Jasmina Kevric, Nathan Papa, Marlon Perera, Prem Rashid, Sumeet Toshniwal
BACKGROUND: Poor mental health in junior clinicians is prevalent and may lead to poor productivity and significant medical errors. We aimed to provide contemporary data on the mental health of surgical trainees and identify risk factors relating to poorer mental health outcomes. METHODS: A detailed questionnaire was developed comprising questions based on the 36-item short-form health survey (SF-36) and Physical Activity Questionnaire. Each of the questionnaires has proven validity and reliability in the clinical context...
July 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28729062/pharmacological-activation-of-ampk-inhibits-incision-evoked-mechanical-hypersensitivity-and-the-development-of-hyperalgesic-priming-in-mice
#13
Michael D Burton, Dipti V Tillu, Khadijah Mazhar, Galo L Mejia, Marina N Asiedu, Kufreobong Inyang, Travis Hughes, Bo Lian, Gregory Dussor, Theodore J Price
New therapeutics to manage post-surgical pain are needed to mitigate the liabilities of opioid and other analgesics. Our previous work shows that key modulators of excitability in peripheral nociceptors, such as extracellular signal-regulated kinases (ERK) are inhibited by activation of adenosine monophosphate activated protein kinase (AMPK). We hypothesized that AMPK activation would attenuate acute incision-evoked mechanical hypersensitivity and the development of hyperalgesic priming caused by surgery in mice...
July 17, 2017: Neuroscience
https://www.readbyqxmd.com/read/28727229/volatile-organic-compound-detection-as-a-potential-means-of-diagnosing-cutaneous-wound-infections
#14
Mohammed Ashrafi, Matt Bates, Mohamed Baguneid, Teresa Alonso-Rasgado, Riina Rautemaa-Richardson, Ardeshir Bayat
Chronic cutaneous wound infections and surgical site infections (SSIs) present a huge burden on the healthcare system and can lead to increased morbidity and mortality. Current diagnostic methods of identifying and confirming infection involve culture-based and molecular methods. Both techniques are time consuming and delays commonly lead to un-targeted empirical treatment. An ideal diagnostic method would be non-invasive and highly sensitive and detect pathogenic organisms with a high degree of accuracy in order to allow targeted treatment...
July 20, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28719425/organizational-contributors-to-the-variation-in-red-blood-cell-transfusion-practices-in-cardiac-surgery-survey-results-from-the-state-of-michigan
#15
Anton Camaj, Darin B Zahuranec, Gaetano Paone, Barbara R Benedetti, Warren D Behr, Marc A Zimmerman, Min Zhang, Robert S Kramer, Jason Penn, Patricia F Theurer, Theron A Paugh, Milo Engoren, Alphonse DeLucia, Richard L Prager, Donald S Likosky
BACKGROUND: While large volumes of red blood cell transfusions are given to preserve life for cardiac surgical patients, indications for lower volume transfusions (1-2 units) are less well understood. We evaluated the relationship between center-level organizational blood management practices and center-level variability in low volume transfusion rates. METHODS: All 33 nonfederal, Michigan cardiac surgical programs were surveyed about their blood management practices for isolated, nonemergent coronary bypass procedures, including: (1) presence and structure of a patient blood management program, (2) policies and procedures, and (3) audit and feedback practices...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719311/infective-endocarditis-in-french-west-indies-a-13-year-observational-study
#16
Elisabeth Fernandes, Claude Olive, Jocelyn Inamo, François Roques, André Cabié, Patrick Hochedez
We conducted an observational study to describe the characteristics of infective endocarditis (IE) in French West Indies (FWI) and to identify variables associated with in-hospital case fatality. The records of the patients admitted for IE to the University Hospital of Martinique between 2000 and 2012 were collected using an electronic case report form. Only Duke-Li definite cases were considered for this analysis. Variables associated with in-hospital mortality were tested using univariate logistic regression analysis...
July 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28718012/implant-decontamination-with-phosphoric-acid-during-surgical-peri-implantitis-treatment-a-rct
#17
Diederik F M Hentenaar, Yvonne C M De Waal, Hans Strooker, Henny J A Meijer, Arie-Jan Van Winkelhoff, Gerry M Raghoebar
BACKGROUND: Peri-implantitis is known as an infectious disease that affects the peri-implant soft and hard tissue. Today, scientific literature provides very little evidence for an effective intervention protocol for treatment of peri-implantitis. The aim of the present randomized controlled trial is to evaluate the microbiological and clinical effectiveness of phosphoric acid as a decontaminating agent of the implant surface during surgical peri-implantitis treatment. METHODS: Peri-implantitis lesions were treated with resective surgical treatment aimed at peri-implant granulation tissue removal, bone recontouring, and pocket elimination...
December 2017: International Journal of Implant Dentistry
https://www.readbyqxmd.com/read/28717843/septic-arthritis-associated-with-systemic-sepsis
#18
Sung-Weon Jung, Dong-Hee Kim, Sung-Jin Shin, Byoung-Youl Kang, Yil-Ju Eho, Seong-Wook Yang
PURPOSE: Septic arthritis presents with good joint function, but sometimes leads to poor outcomes. Concurrent systemic sepsis has been regarded as the poor outcome, and the exact cause remains unclear. This paper was performed to identify factors associated with concurrent systemic sepsis and to research results to predict poor outcomes in patients with septic arthritis. METHODS: Laboratory and medical data were reviewed for 137 adults with acute septic arthritis who underwent open or arthroscopic surgical debridement at our institution between January 2005 and December 2014...
July 17, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28715515/surgical-suture-releasing-macrophage-targeted-drug-loaded-nanoparticles-for-an-enhanced-anti-inflammatory-effect
#19
Hansol Kim, Byung Hwi Kim, Beom Kang Huh, Yeon Chun Yoo, Chan Yeong Heo, Young Bin Choy, Ji-Ho Park
A surgical suture is a medical device to close the wound site of skin and organs but excessive inflammation surrounding the suture can disrupt the wound healing process. Although post-operative prescription of anti-inflammatory drugs is used to manage the inflammation, the need for local drug delivery systems has been rising because of low bioavailability and fast clearance of drugs. In this work, we proposed a new strategy for a local anti-inflammatory device by incorporating macrophage-targeted anti-inflammatory nanoparticles into the suture...
July 17, 2017: Biomaterials Science
https://www.readbyqxmd.com/read/28713978/bone-marrow-mesenchymal-stem-cell%C3%A2-derived-extracellular-vesicles-improve-the-survival-of-transplanted-fat-grafts
#20
He Huang, Shaoqing Feng, Wenjie Zhang, Wei Li, Peng Xu, Xiangsheng Wang, Ai Ai
Autologous fat grafting is a promising surgical technique for soft tissue augmentation, reconstruction and rejuvenation. However, it is limited by the low survival rate of the transplanted fat, due to the slow revascularization of such grafts. Previous studies have demonstrated that bone marrow mesenchymal stem cell‑derived extracellular vesicles (BMSC‑EVs) are proangiogenic. The present study aimed to investigate whether BMSC‑EVs could improve the survival of transplanted fat grafts. Extracellular vesicles were isolated from the supernatant of cultured rat bone marrow mesenchymal stem cells, and characterized by flow cytometry and scanning electron microscopy...
September 2017: Molecular Medicine Reports
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