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Intestinal trauma

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https://www.readbyqxmd.com/read/28434082/senior-general-surgery-residents-can-be-trained-to-perform-focused-assessment-with-sonography-for-trauma-patients-accurately
#1
Sheng-Der Hsu, Cheng-Jueng Chen, De-Chuan Chan, Jyh-Cherng Yu
PURPOSES: Researchers studying trauma have found that physicians are able to perform a focused assessment with sonography for trauma (FAST) with minimal training and achieve ideal accuracy. However, there are currently no consensus or standard guidelines regarding the performance of this assessment. The aim of our study was to clarify the value of FAST performed by well-qualified senior general surgery residents in cases of suspected blunt abdominal trauma, which presents an important diagnostic problem in emergency departments...
April 22, 2017: Surgery Today
https://www.readbyqxmd.com/read/28421780/intestinal-dysfunction-in-the-critical-trauma-patients-an-early-and-frequent-event
#2
Beatriz Pinto Costa, Paulo Martins, Carla Verissimo, Marta Simões, Marisa Tomé, Manuela Grazina, Jorge Pimentel, Francisco Castro-Sousa
BACKGROUND: Small-bowel dysfunction exerts a relevant prognostic impact in the critically ill patients. Citrullinemia has been used in the evaluation of the intestinal function and it is considered an objective parameter of the functional enterocyte mass. Present study proposes to determine the intestinal dysfunction prevalence and the citrullinemia kinetic profile in severe trauma patients and to investigate its correlation with severity indicators and clinical outcome. METHODS: A prospective study including 23 critical trauma patients was performed...
March 30, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28374712/-external-pancreatic-fistulas-management
#3
E V Stepan, A S Ermolov, M L Rogal', Yu S Teterin
The main principles of treatment of external postoperative pancreatic fistulas are viewed in the article. Pancreatic trauma was the reason of pancreatic fistula in 38.7% of the cases, operations because of acute pancreatitis - in 25.8%, and pancreatic pseudocyst drainage - in 35.5%. 93 patients recovered after the treatment. Complex conservative treatment of EPF allowed to close fistulas in 74.2% of the patients with normal patency of the main pancreatic duct (MPD). The usage of octreotide 600-900 mcg daily for at least 5 days to decrease pancreatic secretion was an important part of the conservative treatment...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28366562/traumatic-colorectal-injuries-in-children-the-national-trauma-database-experience
#4
Pamela M Choi, Michael Wallendorf, Martin S Keller, Adam M Vogel
PURPOSE: We sought to utilize a nationwide database to characterize colorectal injuries in pediatric trauma. METHODS: The National Trauma Database (NTDB) was queried for all patients (age≤14years) with colorectal injuries from 2013 to 2014. We stratified patients by demographics and measured outcomes. We analyzed groups based on mechanism, colon vs rectal injury, as well as colostomy creation. Statistical analysis was conducted using t-test and ANOVA for continuous variables as well as chi-square for continuous variables...
March 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28362133/intestinal-epithelial-stem-cells-distinct-behavior-after-surgical-injury-and-teduglutide-administration
#5
Beatriz P Costa, Ana C Gonçalves, Ana M Abrantes, Raquel Alves, Paulo Matafome, Raquel Seiça, Ana B Sarmento-Ribeiro, M Filomena Botelho, Francisco Castro-Sousa
BACKGROUND: Previous studies suggest that intestinal epithelial stem cells (IESC), critical drivers of homeostasis and regeneration, include two subpopulations: crypt-based columnar and "position +4" stem cells, identified by Lgr5 and Bmi1 biomarkers, respectively. Teduglutide is an enterotrophic counterpart of glucagon-like peptide 2. This study aimed to investigate the response of putative IESC to surgical injury and teduglutide administration on an animal model of intestinal resection and anastomosis...
March 31, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28358728/estradiol-modulates-local-gut-injury-induced-by-intestinal-ischemia-reperfusion-in-male-rats
#6
Fernanda Yamamoto Ricardo-da-Silva, Evelyn Thaís Fantozzi, Sara Rodrigues-Garbin, Ricardo Martins Oliveira-Filho, Bernardo Boris Vargaftig, Ana Cristina Breithaupt-Faloppa, Wothan Tavares de Lima
Intestinal ischemia and reperfusion (I/R) triggers a systemic inflammatory response characterized by leukocyte mobilization from the bone marrow, release of cytokines to the circulation, and increased microvascular permeability, leading to high mortality. Females have shown attenuated inflammatory response to trauma when compared to males, indicating a role for female sex hormones in this process. Here we have evaluated the effect of estradiol on the local gut injury induced by I/R in male rats. I/R was induced by the clamping of the superior mesenteric artery for 45 min, followed by 2 h of reperfusion...
March 29, 2017: Shock
https://www.readbyqxmd.com/read/28342135/pacap-protects-against-ethanol-and-nicotine-toxicity-in-sh-sy5y-cells-implications-for-drinking-smoking-co-morbidity
#7
Sridharan Manavalan, Bruk Getachew, Kebreten F Manaye, Syed J Khundmiri, Antonei B Csoka, Raechel McKinley, Andrea Tamas, Dora Reglodi, Yousef Tizabi
The detrimental effects of heavy drinking and smoking are multiplied when the two are combined. Treatment modalities for each and especially for the combination are very limited. Although in low concentration, alcohol and nicotine, each may have beneficial effects including neuroprotection, their combination, instead of providing additive protection, may actually lead to toxicity in cell cultures. Pituitary adenylate cyclase-activating polypeptide (PACAP) is an endogenous 38 amino-acid peptide with demonstrated protection against neuronal injury, trauma as well as various endogenous and exogenous toxic agents...
March 24, 2017: Neurotoxicity Research
https://www.readbyqxmd.com/read/28272208/early-diagnosis-of-hollow-viscus-injury-using-intestinal-fatty-acid-binding-protein-in-blunt-trauma-patients
#8
Shokei Matsumoto, Kazuhiko Sekine, Hiroyuki Funaoka, Tomohiro Funabiki, Masayuki Shimizu, Kei Hayashida, Mitsuhide Kitano
A delay in diagnosing hollow viscus injury (HVI) causes an increase in mortality and morbidity. HVI remains a challenge to diagnose, and there is no specific diagnostic biomarker for HVI. We evaluated the utility of intestinal fatty acid-binding protein (I-FABP) in diagnosing HVI in blunt trauma patients. Within a 5-year period, 93 consecutive patients with clinically suspected HVI at our trauma center were prospectively enrolled. The diagnostic performance of I-FABP for HVI was compared with that of other various parameters (physical, laboratory, and radiographic findings)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28269737/the-autodigestion-hypothesis-proteolytic-receptor-cleavage-in-rheological-and-cardiovascular-cell-dysfunction1
#9
Geert W Schmid-Schönbein
Transformation of circulating leukocytes from a dormant into an activated state with changing rheological properties leads to a major shift of their behavior in the microcirculation. Low levels of pseudopod formation or expression of adhesion molecules facilitate relatively free passage through microvessels while activated leukocytes with pseudopods and enhanced levels of adhesion membrane proteins become trapped in microvessels, attach to the endothelium and migrate into the tissue. The transformation of leukocytes into an activated state is seen in many diseases...
2016: Biorheology
https://www.readbyqxmd.com/read/28261776/a-rare-cause-of-ileus-late-jejunal-stricture-following-blunt-abdominal-trauma
#10
Ulaş Aday, Ebubekir Gündeş, Kamuran Cumhur Değer, Hüseyin Çiyiltepe, Şükran Kayıpmaz, Mustafa Duman
Small intestinal stricture forming in the late phase following nonpenetrating abdominal trauma is rare cause of ileus. It has often been suggested that it is result of localized feeding deficiency on the intestinal wall related to minor trauma in the mesentery. Laparoscopy has been increasingly used for diagnosis and treatment. Diagnosis should be supported by pathological analyses in case of intestinal stenosis related to blunt abdominal traumas.
January 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28242029/tranexamic-acid-and-the-gut-barrier-protection-by-inhibition-of-trypsin-uptake-and-activation-of-downstream-intestinal-proteases
#11
Mark E Diebel, Lawrence N Diebel, David M Liberati
OBJECTIVE: Intraluminal pancreatic trypsin and other digestive enzymes injure the gut barrier following trauma-hemorrhagic shock (T/HS). Intestinal proteases (sheddases) exert important effects on normal gut function but may cause barrier disruption due to exaggerated production following T/HS. We hypothesized that the protective mechanism of TXA on the gut barrier following T/HS includes inhibition of these "downstream" proteases. This was studied in vitro. METHODS: Trypsin, matrix metalloproteinase (MMP-9) and ADAM-17 activity were measured in intestinal epithelial cells (IEC) exposed to HR + trypsin...
March 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28207376/hookworm-infection-in-south-american-fur-seal-arctocephalus-australis-pups
#12
M Seguel, F Muñoz, M J Navarrete, E Paredes, E Howerth, N Gottdenker
Tissues of South American fur seal pups naturally infected with hookworms ( Uncinaria sp) were examined. Hookworm infection was found in nearly all pups examined (132/140, 94%), and hookworm enteritis with secondary bacteremia was considered the cause of death in 46 (35%) pups. Common findings in these pups included severe hemorrhagic enteritis and numerous (mean intensity = 761.8) hookworms in the jejunum. Hookworms were recovered from the abdominal cavity in 12 of 55 pups (22%) examined through peritoneal wash; these pups had an average of 1343...
March 2017: Veterinary Pathology
https://www.readbyqxmd.com/read/28167239/6-gingerol-protects-intestinal-barrier-from-ischemia-reperfusion-induced-damage-via-inhibition-of-p38-mapk-to-nf-%C3%AE%C2%BAb-signalling
#13
Yanli Li, Bin Xu, Ming Xu, Dapeng Chen, Yongjian Xiong, Mengqiao Lian, Yuchao Sun, Zeyao Tang, Li Wang, Chunling Jiang, Yuan Lin
Intestinal ischemia reperfusion (I/R) injury caused by severe trauma, intestinal obstruction, and operation is one of the tough challenges in clinic. 6-Gingerol (6G), a main active ingredient of ginger, is found to have anti-microbial, anti-inflammatory, anti-oxidative, and anti-cancer activities. The present study was designed to characterize the potential protective effects of 6G on rat intestinal I/R injury and reveal the correlated mechanisms. Rat intestinal I/R model was established with clamping the superior mesenteric artery (SMA) and 6G was intragastrically administered for three consecutive days before I/R injury...
May 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28151898/how-much-does-decompressive-laparotomy-reduce-the-mortality-rate-in-primary-abdominal-compartment-syndrome-a-single-center-prospective-study-on-66-patients
#14
Mircea Muresan, Simona Muresan, Klara Brinzaniuc, Septimiu Voidazan, Daniela Sala, Ovidiu Jimborean, Al Husseim Hussam, Tivadar Bara, Gabriel Popescu, Cristian Borz, Radu Neagoe
Contribution of decompressive laparotomy within the framework of the complex therapeutic algorithm of abdominal compartment syndrome (ACS) is cited with an extremely heterogeneous percentage in terms of survival. The purpose of this study was to present new data regarding contribution of each therapeutic step toward decreasing the mortality of this syndrome.This is a longitudinal prospective study including 134 patients with risk factors for ACS. The intra-abdominal pressure was measured every hour indirectly based on transvesical approach and the appearance of organ dysfunction...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28133149/-a-case-of-mesenteric-fibromatosis-after-robot-assisted-total-gastrectomy-for-gastric-cancer
#15
Makoto Nakai, Toshiyuki Tazawa, Naoki Wajima, Takahiro Muroya, Katsuya Mikami, Kenichi Hakamada
The patient underwent robot-assisted total gastrectomy for an early gastric cancer. Thirty-four months later, he was admitted to another hospital because of abdominal discomfort. Computed tomography scans showed a giant solid mass approximately 13 cm in diameter in the lower abdomen. We performed a resection of the tumor; operative findings showed a giant solid tumor, without adhesion, in the mesentery of the jejunum. The tumor did not involve other parts of the small intestine. The resected tumor had a smooth surface with an elastic hard consistency...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133146/-damage-control-surgery-for-perforation-of-colon-cancer
#16
Takeshi Ebihara, Motohiko Yamada, Katsushu Simizu, Koji Amano, Masahiro Kawada, Genta Sawada, Yusuke Tsunetoshi, Ken Nakata, Akihiro Usui, Masaki Tujie, Yutaka Kimura, Satoru Munakata, Yasuki Nakata, Junya Fujita
Perforation due to colon cancer maycause peritonitis and septic shock. In these cases, we maynot be able to rescue the patients in spite of emergencysurgical intervention; in these conditions, owing to limitations of operation time, it is difficult for us to assess the state or extent of the disease and to perform an ideal oncological surgerywith dissection of lymph nodes. To overcome these limitations, we introduce the concept of "damage control surgery" developed in the trauma region to treat perforations of colon cancer...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28125558/o-010-microbial-metabolites-establish-a-gradient-of-protons-which-mediate-interkingdom-host-microbiome-cross-talk-and-maintain-intestinal-homeostasis-via-two-proton-sensing-gprs
#17
Ashfaqul Alam, Huixia Wu, Jason Matthews, Bejan Saeedi, Rheinallt Jones, Andrew Neish
BACKGROUND: The mammalian intestine houses a complex microbial community, which fundamentally influences the development and activation of the immune system, and is integral to the repair of damaged intestinal mucosa. Intestinal damage is observed in inflammatory bowel disease (IBD), enteric infections, as well as following surgical trauma, and environmental insults. Tissue restitution is a complex but coordinated cellular process to repair gut mucosa, which involves both cellular proliferation and migration...
February 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28121679/effects-of-prostaglandin-e1-on-patients-undergoing-major-gastrointestinal-surgery
#18
Fabao Hao, Hongjie Guo, Jia Zhong, Qiankun Geng, Yang Yang, Bailin Chen, Chunbao Guo
OBJECTIVE: The aim of this study was to investigate the clinical effects of prostaglandin E1 (PGE1) in patients who underwent surgery for gastrointestinal (GI) trauma, perforation, or obstruction. BACKGROUND: PGE1 is thought to enhance intestinal blood supply and reduce GI complications during the postoperative period. METHODS: The medical records of 889 patients undergoing major GI surgery were reviewed retrospectively. Propensity score matching was performed to adjust for any baseline differences...
January 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28118112/development-of-a-novel-murine-model-of-combined-radiation-and-peripheral-tissue-trauma-injuries
#19
Vlado Antonic, Isabel L Jackson, Gurung Ganga, Terez Shea-Donohue, Zeljko Vujaskovic
Detonation of a 10-kiloton nuclear bomb in an urban setting would result in >1 million casualties, the majority of which would present with combined injuries. Combined injuries, such as peripheral tissue trauma and radiation exposure, trigger inflammatory events that lead to multiple organ dysfunction (MOD) and death, with gastrointestinal (GI) and pulmonary involvement playing crucial roles. The objective of this study was to develop an animal model of combined injuries, peripheral tissue trauma (TBX animal model) combined with total body irradiation with 5% bone marrow shielding (TBI/BM5) to investigate if peripheral tissue trauma contributes to reduced survival...
February 2017: Radiation Research
https://www.readbyqxmd.com/read/28100944/ostomy-in-nontraumatic-conditions-our-experience-and-review-of-the-literature
#20
Kenan Büyükaşık, Bünyamin Gürbulak, Emre Özoran, Yiğit Düzköylü, Esin Kabul Gürbulak, Aziz Arı, Hasan Bektaş
A number of nontraumatic acute abdomen can result in peritonitis leading to sepsis. In emergent conditions, various procedures like segmentary colectomy and/or subtotal colectomy with anastomosis, Hartmann's procedure, transverse colectomy, and/or expandable metallic stent (SEMS) placement can be performed, considering the status of the patient and the facilitaties of the institution. In our study, we examined the cases diagnosed as acute abdomen without the history of trauma, which had lead to a procedure requiring colostomy...
December 2016: Indian Journal of Surgery
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