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https://www.readbyqxmd.com/read/29228443/postoperative-deep-wound-dehiscence-of-thoracotomy-with-isolation-of-corynebacterium-tuberculostearicum-surgical-site-infection-or-colonization
#1
A Tampakis, E C Tampaki, K Kontzoglou, E Patsouris, G Kouraklis, D Lardinois
OBJECTIVE: Infections with Corynebacterium tuberculostearicum are very rare as in most of the cases its isolation is associated with tissue colonization rather than infection. CASE REPORT: An 80-year old female patient was sent to the consultation hour of thoracic surgery for evaluation of a symptomatic persistent unilateral pleural effusion of her right lung. The differential diagnosis included either the presence of a chronic pleural empyema or the presence of malignancy...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29227854/surgical-intervention-in-a-complicated-persistent-chyle-leak
#2
Bradley Curtis Tenny, Jeko Madjarov, Travis Shipe
INTRODUCTION: Chyle leak following cervical surgery has a reported incidence of around 2% annually, and the injury primarily favors a left sided involvement. Our patient presented with a right sided neck persistent chyle leak status post cervical neck dissection and radiation therapy. Infection complicated the patient's clinical course, and he inevitably required a right sided VATS thoracic duct ligation. PRESENTATION OF CASE: The patient was a 53-year-old African American male, with a past medical history of T1N0 right tonsil carcinoma status post chemo-radiation in 2016...
November 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29227180/removal-of-the-cecum-affects-intestinal-fermentation-enteric-bacterial-community-structure-and-acute-colitis-in-mice
#3
Kirsty Brown, D Wade Abbott, Richard R E Uwiera, G Douglas Inglis
The murine cecum is a major site of fermentation of dietary materials, and production of short chain fatty acids (SCFAs). To examine the role that the cecum plays in acute bacterial infection in mice, the cecum was surgically removed, and changes in bacterial communities and production of SCFAs were analyzed relative to surgical sham animals. To incite bacterial colitis, mice were orally challenged with Citrobacter rodentium. The impact of butyrate administered directly into the colon was also examined. Concentrations of SCFAs in feces were substantially lower in mice with an excised cecum...
December 11, 2017: Gut Microbes
https://www.readbyqxmd.com/read/29225958/overcoming-challenges-in-implementing-the-who-surgical-safety-checklist-lessons-learnt-from-using-a-checklist-training-course-to-facilitate-rapid-scale-up-in-madagascar
#4
REVIEW
Kristin L Close, Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Emily Bruno, Alison Herbert, Vanessa Andean, James Callahan, Hery H Andriamanjato, Michelle C White
The WHO Surgical Safety Checklist was launched in 2009, and appropriate use reduces mortality, surgical site infections and complications after surgery by up to 50%. Implementation across low-income and middle-income countries has been slow; published evidence is restricted to reports from a few single institutions, and significant challenges to successful implementation have been identified and presented. The Mercy Ships Medical Capacity Building team developed a multidisciplinary 3-day Surgical Safety Checklist training programme designed for rapid wide-scale implementation in all regional referral hospitals in Madagascar...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225618/influence-of-enhanced-recovery-pathway-on-surgical-site-infection-after-colonic-surgery
#5
Caroline Gronnier, Fabian Grass, Christiane Petignat, Basile Pache, Dieter Hahnloser, Giorgio Zanetti, Nicolas Demartines, Martin Hübner
Background: The present study aimed to evaluate a potential effect of ERAS on surgical site infections (SSI). Methods: Colonic surgical patients operated between May 2011 and September 2015 constituted the cohort for this retrospective analysis. Over 100 items related to demographics, surgical details, compliance, and outcome were retrieved from a prospectively maintained database. SSI were traced by an independent National surveillance program. Risk factors for SSI were identified by univariate and multinomial logistic regression...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29225064/intracranial-high-%C3%AE-connectivity-distinguishes-wakefulness-from-sleep
#6
Ezequiel Mikulan, Eugenia Hesse, Lucas Sedeño, Tristán Bekinschtein, Mariano Sigman, María Del Carmen García, Walter Silva, Carlos Ciraolo, Adolfo M García, Agustín Ibáñez
Neural synchrony in the γ-band is considered a fundamental process in cortical computation and communication and it has also been proposed as a crucial correlate of consciousness. However, the latter claim remains inconclusive, mainly due to methodological limitations, such as the spectral constraints of scalp-level electroencephalographic recordings or volume-conduction confounds. Here, we circumvented these caveats by comparing γ-band connectivity between two global states of consciousness via intracranial electroencephalography (iEEG), which provides the most reliable measurements of high-frequency activity in the human brain...
December 7, 2017: NeuroImage
https://www.readbyqxmd.com/read/29224905/the-mechanics-of-corneal-deformation-and-rupture-for-penetrating-injury-in-the-human-eye
#7
Andrew Rau, Scott T Lovald, Steven Nissman, John McNulty, Jorge A Ochoa, Michael Baldwinson
Penetrating eye injuries are surgical emergencies with guarded visual prognosis. The purpose of the current study was to determine the force required to rupture the cornea with a penetrating object, and to study how this force is affected by the object geometry. Thirty-six human cadaveric eyes from donors of various ages were characterized for diameter, axial length, and pre-test intraocular pressure. In order to investigate the effects of specimen storage time on the tissue response, half of the specimens were tested within two weeks of donor expiration, and half of the specimens were stored at -4°C for 12-18 months...
December 2, 2017: Injury
https://www.readbyqxmd.com/read/29224818/reconstruction-after-salvage-laryngectomy
#8
David H Yeh, Axel Sahovaler, Kevin Fung
Both early and advanced stage laryngeal cancers are treated with organ-preserving strategies including radiation alone or concurrent chemoradiotherapy. While organ-preserving modalities have proven effective in eradicating cancer while also preserving laryngeal function, there remains a proportion of cases where residual or recurrent cancer prevails, or conversely, where radiotherapy renders a larynx dysfunctional. In these circumstances, salvage total laryngectomy is often the surgical treatment. The effects of radiotherapy to the neck, amplified by chemotherapy, can create an inhospitable surgical environment, making the salvage laryngectomy an operation fraught with the potential for major complications such as the dreaded pharyngocutaneous fistula...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29224816/hypermethylated-znf582-and-pax1-genes-in-oral-scrapings-collected-from-cancer-adjacent-normal-oral-mucosal-sites-are-associated-with-aggressive-progression-and-poor-prognosis-of-oral-cancer
#9
Shih-Jung Cheng, Chi-Feng Chang, Hui-Hsin Ko, Yi-Ching Liu, Hsin-Hui Peng, Huei-Jen Wang, Hsiao-Shan Lin, Chun-Pin Chiang
OBJECTIVE: This study assessed whether hypermethylated ZNF582 and PAX1 genes in oral scrapings are correlated with the progression and prognosis of oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Methylation levels of ZNF582 and PAX1 genes in oral scrapings, collected from the cancer and adjacent normal oral mucosal sites of 80 OSCC patients before surgical cancer excision, were quantified using real-time methylation-specific PCR after bisulfite conversion...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29224706/prophylactic-placement-of-permanent-synthetic-mesh-at-the-time-of-ostomy-closure-prevents-formation-of-incisional-hernias
#10
Jeremy A Warren, Lucas R Beffa, Alfredo M Carbonell, Jennifer Cull, Brent Sinopoli, Joseph A Ewing, Cedrek McFadden, Jay Crockett, William S Cobb
BACKGROUND: Reversal of an enterostomy results in a high rate of incisional hernia at the ostomy site. Prophylactic mesh reinforcement of the fascial defect is typically not considered due to the contaminated nature of the case. We present the outcomes of a series of prophylactic mesh reinforcements with retromuscular, large-pore polypropylene at the time of enterostomy reversal. METHODS: Retrospective review of all ostomy reversals was performed. All cases with placement of synthetic mesh reinforcement were identified from a prospectively maintained, hernia database...
December 7, 2017: Surgery
https://www.readbyqxmd.com/read/29224652/primary-percutaneous-coronary-intervention-at-centers-with-and-without-on-site-surgical-support-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2
#11
Majed Afana, Hitinder S Gurm, Milan Seth, Kathleen M Frazier, Sheryl Fielding, Gerald C Koenig
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is being increasingly performed nationally at sites without on-site cardiac surgery; however, recent guidelines only provide a Class IIa recommendation for this practice. The state of Michigan has permitted PPCI without on-site surgery under a closely monitored system that mandates auditing of all procedures and quarterly feedback on quality and outcomes. This study sought to compare outcomes of patients undergoing PPCI at centers with and without on-site surgery in the state of Michigan...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29224568/internal-herniation-through-lesser-omentum-hiatus-and-gastrocolic-ligament%C3%A2-with-malrotation-a-case-report
#12
Ang Li, Renwang Hu, Dong Zhou, Senmao Li, Dan Huang, Xin Wei, Zhixin Cao
BACKGROUND: Internal herniation through lesser omentum hiatus and gastrocolic ligament with malrotation is extremely rare. This type of internal hernia has rarely been described before. Preoperative diagnosis is difficult and prone to misdiagnosis. CASE PRESENTATION: A 38-year-old Chinese woman was an emergency admission to our hospital with a sudden onset of acute epigastralgia for the past 14 hours. We made a presumptive diagnosis of gastrointestinal perforation and septic shock...
December 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29224263/-strategies-for-the-prevention-and-control-of-bleeding-due-to-vascular-injury-in-thoracoscopic-lung-surgery
#13
J D Mei, Q Pu, L Ma, C W Liu, L X Liu
The technique of thoracoscopic lung surgery has gradually matured. Nowadays, thoracoscope is recommended as the most preferred approach for surgical treatment of early stage non-small cell lung cancer in different guidelines. However, there are still some cases of accidential major bleeding due to vascular injury during thoracoscopic lung surgery. The wall of the hilum vessels is relatively thin. These vessels often involve a great portion of the cardiac output blood flow. Once the injury happened, the emergent condition may be life-threatening due to massive blood loss...
December 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29224055/peri-operative-antibiotic-treatment-of-bacteriuria-reduces-early-deep-surgical-site-infections-in-geriatric-patients-with-proximal-femur-fracture
#14
Ronny Langenhan, Stefanie Bushuven, Niklas Reimers, Axel Probst
PURPOSE: The aim of this study was to conduct a re-evaluation of current strategies for peri-operative prophylaxis of infections in orthopaedic surgery of geriatric patients (≥65 years) with proximal femoral fractures (PFF). METHODS: Between 01/2010 and 08/2014 all post-operative infections after stabilization of PFF of 1,089 geriatric patients were recorded retrospectively. All patients pre-operatively received a single dose of 1.5 g cefuroxime (group 1). These were compared to prospectively determined post-operative rates of surgical site infection (SSI) of 441 geriatric patients, which were operated on between 09/2014 and 03/2017 due to PFF...
December 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29223633/effectiveness-of-irrigation-with-chlorhexidine-after-removal-of-mandibular-third-molars-a-randomised-controlled-trial
#15
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/29223632/comparative-morbidity-of-cubital-tunnel-surgeries-a-prospective-cohort-study
#16
Robert Staples, Dan London, Agnes Z Dardas, Charles A Goldfarb, Ryan P Calfee
PURPOSE: Randomized controlled trials have not identified a superior surgical approach to cubital tunnel syndrome surgery. This study evaluates the early morbidity of open in situ decompression and transposition. METHODS: This prospective cohort study enrolled 125 adult patients indicated for cubital tunnel surgery at a tertiary institution. Exclusion criteria included preoperative use of narcotics and concurrent elbow procedures. In situ decompressions (n = 47) and ulnar nerve transpositions (n = 78) were performed...
December 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29223423/the-requirement-of-sutures-to-close-intercostal-drains-site-wounds-in-thoracic-surgery
#17
Jeremy L C Smelt, Natalie Simon, Lukacs Veres, Karen Harrison-Phipps, Andrea Bille
BACKGROUND: Chest drains are used routinely in thoracic surgery. Often a pursestring or mattress suture is used to facilitate closure of the defect on removal of the drain. This stitch can cause an unsightly scar, increase drain removal pain, and necessitate that the patient attend a community health care center to have this removed. The objective of this study was to assess whether this stitch is necessary in modern thoracic surgical practice. METHODS: Data from a single surgeon's practice were collected over an 18-month period...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29223228/endophthalmitis-after-cataract-surgery-effect-of-behind-the-lens-washout
#18
Tetsuro Oshika, Yuichi Ohashi
PURPOSE: To analyze the outcomes of cataract surgery with emphasis on the relationship between surgery-related factors and the incidence of postoperative infectious endophthalmitis. SETTING: Ninety-three surgical sites in Japan. DESIGN: Prospective case series. METHODS: Eyes that were scheduled to have cataract surgery from January 20 to September 30, 2014, were included. Phacoemulsification and implantation of a single-piece hydrophobic acrylic foldable intraocular lens (IOL) were performed...
November 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29221750/secondary-surgical-site-infection-after-coronary-artery-bypass-grafting-a-multi-institutional-prospective-cohort-study
#19
Brian C Gulack, Katherine A Kirkwood, Wei Shi, Peter K Smith, John H Alexander, Sandra G Burks, Annetine C Gelijns, Vinod H Thourani, Daniel Bell, Ann Greenberg, Seth D Goldfarb, Mary Lou Mayer, Michael E Bowdish
OBJECTIVE: To analyze patient risk factors and processes of care associated with secondary surgical-site infection (SSI) after coronary artery bypass grafting (CABG). METHODS: Data were collected prospectively between February and October 2010 for consenting adult patients undergoing CABG with saphenous vein graft (SVG) conduits. Patients who developed a deep or superficial SSI of the leg or groin within 65 days of CABG were compared with those who did not develop a secondary SSI...
December 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29221343/adult-onset-langerhans-cell-histiocytosis-of-the-sternum
#20
Yi-Jhih Huang, Kuan-Hsun Lin, Tai-Kuang Chao, Tsai-Wang Huang, Hsu-Kai Huang
Langerhans cell histiocytosis (LCH) is a rare disease with uncertain etiology that is more prevalent in children. LCH typically invades skeletal systems, but in rare cases, it has been reported in the ribs or sternum. Optimal treatment choices for single-site, skeletal LCH are still undefined. We report a case of adult-onset LCH of the sternum. The range of surrounding soft tissue invasion was confirmed by three-dimensional fusion and reconstruction of chest computed tomography and magnetic resonance images...
September 2017: Journal of Thoracic Disease
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