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Antoine Guérin, Gaspard Kerner, Nico Marr, Janet G Markle, Florence Fenollar, Natalie Wong, Sabri Boughorbel, Danielle T Avery, Cindy S Ma, Salim Bougarn, Matthieu Bouaziz, Vivien Beziat, Erika Della Mina, Carmen Oleaga-Quintas, Tomi Lazarovt, Lisa Worley, Tina Nguyen, Etienne Patin, Caroline Deswarte, Rubén Martinez-Barricarte, Soraya Boucherit, Xavier Ayral, Sophie Edouard, Stéphanie Boisson-Dupuis, Vimel Rattina, Benedetta Bigio, Guillaume Vogt, Frédéric Geissmann, Lluis Quintana-Murci, Damien Chaussabel, Stuart G Tangye, Didier Raoult, Laurent Abel, Jacinta Bustamante, Jean-Laurent Casanova
Most humans are exposed to Tropheryma whipplei (Tw). Whipple's disease (WD) strikes only a small minority of individuals infected with Tw (<0.01%), whereas asymptomatic chronic carriage is more common (<25%). We studied a multiplex kindred, containing four WD patients and five healthy Tw chronic carriers. We hypothesized that WD displays autosomal dominant (AD) inheritance, with age-dependent incomplete penetrance. We identified a single very rare non-synonymous mutation in the four patients: the private R98W variant of IRF4, a transcription factor involved in immunity...
March 14, 2018: ELife
Ga Jin Han, Suk Kim, Nam Kyung Lee, Chang Won Kim, Hyeong Il Seo, Hyun Sung Kim, Tae Un Kim
Objective: Postpancreatectomy hemorrhage (PPH) is an uncommon but serious complication of Whipple surgery. To evaluate the radiologic features associated with late PPH at the first postoperative follow up CT, before bleeding. Materials and Methods: To evaluate the radiological features associated with late PPH at the first follow-up CT, two radiologists retrospectively reviewed the initial postoperative follow-up CT images of 151 patients, who had undergone Whipple surgery...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Enio Campos Amico, Ítalo Medeiros de Azevedo, Marcos Vinicius de Lira Fernandes, Mariane Albuquerque Reis, Samir Assi João
BACKGROUND: The value of drain amylase on the first postoperative day after pancreatic resections has been described as an efficient predictor of pancreatic fistula. In spite of this, the cut-off point below which the drains can be removed early remains controversial. AIM: Validate the use of the amylase on the 1st postoperative day in the correlation with pancreatic fistula and define the value at which early drain removal is safe. METHOD: Were included patients undergoing Whipple surgery in the period of 2007 to 2016...
March 1, 2018: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Ana Lopes, Ana Filipa Santos, Maria Joana Alvarenga, Alberto Mello E Silva
Whipple's disease is a chronic, rare, multisystemic, infectious entity, described for the first time in 1907. Its aetiological agent is the Gram-negative rod, Tropheryma whipplei, which was isolated for the first time in 2001 from a cardiac valve of a patient with endocarditis. We present the case of a 71-year-old man, who came into the emergency room complaining of anorexia, weakness, abdominal pain and diarrhoea with haematochezia and presented disseminated palpable purpuric lesions, predominantly in the lower limbs...
March 5, 2018: BMJ Case Reports
Muhammad Bilal, Hina Tariq, Nadira Mamoon
BACKGROUND: Margin assessment is done in Whipple procedures which are usually performed to resect tumours of head of pancreas and ampullary/periampullary region. Aims and objective of the study are to determine the concordance between frozen sections (FS) and permanent sections (PS) of surgical margins in Whipple resections. METHODS: It is a retrospective study, from January 2008 to January 2015 (07 years). It includes the specimen with malignancy in final report and for which FS of pancreatic and/or CBD margin(s) were requested...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Tanya L Hoskin, Mary O Whipple, Sanjeev Nanda, Ann Vincent
BACKGROUND: Using self-report questionnaires of key fibromyalgia symptom domains (pain, fatigue, sleep disturbance, function, stiffness, dyscognition, depression, and anxiety), we previously identified four unique symptom clusters. The purpose of this study was to examine the stability of fibromyalgia symptom clusters between baseline and 2-year follow-up. METHODS: Women with a diagnosis of fibromyalgia completed the Brief Pain Inventory, Profile of Mood States, Medical Outcomes Study Sleep measure, Multidimensional Fatigue Inventory, Multiple Ability Self-Report Questionnaire, Revised Fibromyalgia Impact Questionnaire, and the 36-Item Short Form Survey Instrument at baseline...
February 27, 2018: Arthritis Research & Therapy
Chen-Chiang Lin, Kang-Ping Lin, Chuan-Ching Huang, Wen-Chuan Chen, Hung-Wen Wei, Cheng-Lun Tsai, Kun-Jhih Lin
Headless compression screws (HCSs) are commonly used to fixate small bones and articular fractures. Understanding the biomechanical efficacy of different HCS designs can help surgeons make proper interfragmentary compression when a specific implant is chosen. HCSs with three different central shaft designs (unthreaded, fully threaded, and partially threaded) were studied: the Herbert-Whipple, Mini-Acutrak 2, and headless reduction (HLR). Polyurethane foam blocks were machined with a simulated fracture gap of 0...
January 2018: Journal of Orthopaedic Surgery
K Homsy, J-L Paquay, H Farghadani
INTRODUCTION: Pancreatic cancer is a rare disease with a high mortality rate, for which complete surgical resection, when possible, is the preferred therapeutic. Pancreaticoduodenectomy represents the surgical technique of choice. Abdominal surgeons can be faced with the challenge of patients with a history of coronary artery bypass graft in which the right gastro-epiploic artery is used. CASE REPORT: We report the case of a patient with an adenocarcinoma of the pancreatic head, stage IIA, having previously undergone a triple coronary artery bypass, one of which being a right gastro-epiploic graft...
February 20, 2018: Acta Chirurgica Belgica
William W Tseng, Denice D Tsao-Wei, Dario Callegaro, Giovanni Grignani, Lorenzo D'Ambrosio, Sylvie Bonvalot, Cecilia G Ethun, Kenneth Cardona, John T Mullen, Robert J Canter, John E Mullinax, Ricardo J Gonzalez, Frits van Coevorden, Markus Albertsmeier, Kiran K Dhanireddy, Salvatore L Renne, Alessandro Gronchi
BACKGROUND: In retroperitoneal sarcoma (RPS), the optimal extent of resection must balance adequate disease control with potential for morbidity. We sought to study the frequency and outcomes after a Whipple procedure or pancreaticoduodenectomy (PD) in patients undergoing resection for primary RPS. METHODS: Participating referral centers within the Trans-Atlantic Retroperitoneal Sarcoma Working Group provided retrospective data from January 2007 to December 2016 for patients with primary RPS who underwent PD along with the total number of consecutive resections done during the same time period...
February 5, 2018: European Journal of Surgical Oncology
Dereck L Salisbury, Mary O Whipple, Marsha Burt, Rebecca J L Brown, Alan Hirsch, Christopher Foley, Diane Treat-Jacobson
The purpose of this study was to implement and evaluate quality outcomes including referral, enrollment, and completion rates of a new peripheral artery disease (PAD)-specific supervised exercise therapy (SET) program within a preexisting clinical exercise wellness program and to evaluate the clinical effectiveness and patient-centered outcomes derived from 12 weeks of PAD-specific SET. Recruited participants completed an individualized, minimally supervised, PAD-specific SET program based on the AHA-ACC guidelines...
March 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
Bassan J Allan, Stephanie M Novak, Melissa E Hogg, Herbert J Zeh
Indications for resection of pancreatic cancers have evolved to include selected patients with involvement of peri-pancreatic vascular structures. Open Whipple procedures have been the standard approach for patients requiring reconstruction of the portal vein (PV) or superior mesenteric vein (SMV). Recently, high-volume centers are performing minimally invasive Whipple procedures with portovenous resections. Our institution has performed seventy robotic Whipple procedures with concomitant vascular resections...
2018: Journal of Visualized Surgery
Cyriac A Philips, Philip Augustine, Lijesh Kumar, George Joseph, Pushpa Mahadevan
To present and discuss a novel association between branch duct-type intraductal papillary mucinous neoplasm and paraneoplastic parapsoriasis. We present the case of a middle-aged male presenting with skin lesions that were suggestive of parapsoriasis, resistant to treatment, and in whom a diagnosis of branch-type intraductal papillary mucinous neoplasm of the pancreas was eventually made. A curative Whipple's surgery led to complete resolution of the skin lesions within 3 weeks. Paraneoplastic parapsoriasis in association with intraductal papillary mucinous pancreatic neoplasm has never been reported before...
January 2018: Indian Dermatology Online Journal
Sherko Abdullah Molah Karim, Karzan Seerwan Abdulla, Qalandar Hussein Abdulkarim, Fattah Hama Rahim
BACKGROUND: Pancreaticoduodenectomy (PD) is one of the most difficult and complex surgery that carries a high rate of major complications, including delayed gastric emptying (DGE), pancreatic fistula, bleeding, intra-abdominal collection, and pulmonary complications. In this study, we have tried to demonstrate the outcomes, and rates of complications from patients who had undergone this procedure by our surgical team. MATERIALS AND METHODS: This retrospective study has been constructed on 98 patients who underwent pancreaticoduodenectomy from May 2010 to November 2017 in three different hospitals of the Sulaimanyah governorate in the Kurdistan region of Iraq by the same surgical team...
February 10, 2018: International Journal of Surgery
Alexander R Brinker, Jane L Liao, Kent R Kraus, Jocelyn Young, Morgan Sandelski, Carter Mikesell, Daniel Robinson, Michael Adjei, Shatoria D Lunsford, James Fischer, Melissa A Kacena, Elizabeth C Whipple, Randall T Loder
STUDY DESIGN: A bibliometric analysis. OBJECTIVE: The aim of this article was to study bibliometric changes over the last 30 years of Spine. These trends are important regarding academic publication productivity. SUMMARY OF BACKGROUND DATA: Inflation in authorship number and other bibliometric variables has been described in the scientific literature. The issue of author gender is taking on increasing importance, as efforts are being made to close the gender gap...
February 12, 2018: Spine
Hiroaki Saito, Junji Shiode, Shogen Ohya, Atsushi Yao, Shunsuke Saito, Masakuni Fujii, Mamoru Itoh, Shuhei Ishiyama, Akiko Fujiwara, Junichiro Nasu, Masao Yoshioka, Kazuhide Yamamoto
A 72-year-old man presented with anorexia and 15-kg weight loss over 3 years. Endoscopy revealed yellow, shaggy mucosa alternating with erythematous, eroded mucosa in the duodenum. Biopsy specimens showed massive infiltration of periodic acid-Schiff-positive macrophages in the lamina propria, consistent with Whipple's disease. The patient was treated with intravenous ceftriaxone for four weeks, followed by oral trimethoprim-sulfamethoxazole. His condition improved, and he gradually gained weight. Although the endoscopic findings improved with continuous trimethoprim-sulfamethoxazole administration, macrophage infiltration of the duodenal mucosa persisted...
February 9, 2018: Internal Medicine
Kathleen Doyle Lyons, Robin M Newman, Peter A Kaufman, Martha L Bruce, Diane M Stearns, Frederick Lansigan, Mary Chamberlin, Stephen J Bartels, Jessica Whipple, Mark T Hegel
OBJECTIVE: In this pilot study of a home-based occupational therapy intervention intended to reduce disability and improve quality of life, our objective was to identify rates of goal attainment and patterns of goal adjustment of participants. METHOD: Thirty older adults with cancer were randomized to the intervention arm, and 24 participants identified goals and completed the six-session intervention. An exploratory content analysis of qualitative and quantitative session data was performed...
March 2018: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
Mitra Menon, Justin C Bagley, Christopher J Friedline, Amy V Whipple, Anna W Schoettle, Alejandro Leal-Saenz, Christian Wehenkel, Francisco Molina-Freaner, Lluvia Flores-Renteria, M Socorro Gonzalez-Elizondo, Richard A Sniezko, Samuel A Cushman, Kristen M Waring, Andrew J Eckert
Interactions between extrinsic factors, such as disruptive selection, and intrinsic factors, such as genetic incompatibilities among loci, often contribute towards the maintenance of species boundaries. The relative roles of these factors in the establishment of reproductive isolation can be examined using species pairs characterized by gene flow throughout their divergence history. We investigated the process of speciation and the maintenance of species boundaries between Pinus strobiformis and P. flexilis...
February 7, 2018: Molecular Ecology
Ryan Gupta, Geoffrey C Darby, David K Imagawa
Surgical site infections (SSIs) occur at an average rate of 21.1 per cent after Whipple procedures per NSQIP data. In the setting of adherence to standard National Surgery Quality Improvement Program (NSQIP) Hepatopancreatobiliary recommendations including wound protector use and glove change before closing, this study seeks to evaluate the efficacy of using negative pressure wound treatment (NPWT) over closed incision sites after a Whipple procedure to prevent SSI formation. We retrospectively examined consecutive patients from January 2014 to July 2016 who met criteria of completing Whipple procedures with full primary incision closure performed by a single surgeon at a single institution...
October 1, 2017: American Surgeon
Adrienne Nguyen, Aram Demirjian, Maki Yamamoto, Kathryn Hollenbach, David K Imagawa
Because the islets of Langerhans are more prevalent in the body and tail of the pancreas, distal pancreatectomy (DP) is believed to increase the likelihood of developing new onset diabetes mellitus (NODM). To determine whether the development of postoperative diabetes was more prevalent in patients undergoing DP or Whipple procedure, 472 patients undergoing either a DP (n = 122) or Whipple (n = 350), regardless of underlying pathology, were analyzed at one month postoperatively. Insulin or oral hypoglycemic requirements were assessed and patients were stratified into preoperative diabetic status: NODM or preexisting diabetes...
October 1, 2017: American Surgeon
Raffaele Dalla Valle, Matteo Rossini, Laura Lamecchi, Maurizio Iaria
Pancreatic fistula (PF) remains the Achilles' heel of pancreaticoduodenectomy (PD). Pancreaticogastrostomy (PG) appears to be associated with a lower risk of postoperative leak according to recent evidence. We started to fashion PG, especially in soft pancreas, modifying the original technique described by Bassi. At our institution, 105 PD procedures were carried out from January 2011 to December 2016; pancreatic-enteric continuity was restored by PG in 35 cases. Superior mesenteric/portal vein resection/reconstruction was necessary in three patients...
January 31, 2018: Updates in Surgery
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