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https://www.readbyqxmd.com/read/29783184/postoperative-outcomes-in-patients-with-a-do-not-resuscitate-dnr-order-undergoing-elective-procedures
#1
Ethan Y Brovman, Elisa C Walsh, Brittany N Burton, Christine E Kuo, Charlotta Lindvall, Rodney A Gabriel, Richard D Urman
STUDY OBJECTIVE: Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. DESIGN: Retrospective cohort study. SETTING: A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit...
May 18, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29783002/a-stepwise-approach-to-laparoscopic-enucleation-and-excision-of-retroperitoneal-cysts
#2
Haider Jan, Tina Kapoor, Vishalli Ghai
STUDY OBJECTIVE: Technical video demonstrating a step by step approach to laparoscopic enucleation and excision of retroperitoneal cysts. DESIGN: Technical video (Canadian Task Force classification III). SETTING: Benign Gynecology Department at a University Hospital. INTERVENTION: Laparoscopic enucleation and excision of retroperitoneal cysts. CONCLUSION: Retroperitoneal cysts are rare lesions associated with numerous complications including compression on neighbouring organs, infection, rupture and malignant transformation...
May 18, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29782983/an-in-vivo-biocompatibility-study-of-surgical-meshes-made-from-bacterial-cellulose-modified-with-chitosan
#3
Joanna Piasecka-Zelga, Piotr Zelga, Joanna Szulc, Justyna Wietecha, Danuta Ciechańska
Bacterial cellulose modified with chitosan (MBC) is an innovative biomaterial used in regenerative medicine which may potentially improve treatment outcomes mesh for hernia repair surgery by facilitating better absorption in native tissue with less risk of mesh-related infections. The aim of the present study was to evaluate the biocompatibility of mesh based on MBC, and determine whether immunological reactions occur due to hypersensitivity to the implants. Forty five Imp:WIST rats were randomly assigned to be implanted with one of three mesh types: simple polypropylene mesh (n = 15), mesh modified by bacterial cellulose only (n = 15) and MBC mesh (n = 15) and evaluated after one and three months following intramuscular implantation...
May 18, 2018: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29782913/statewide-collaborative-to-reduce-surgical-site-infection-results-of-the-hawaii-surgical-unit-based-safety-program
#4
Della M Lin, Kathryn A Carson, Lisa H Lubomski, Elizabeth C Wick, Julius Cuong Pham
BACKGROUND: Surgical Site Infections (SSI) after colorectal surgery are common, lead to patient harm, and are costly to the healthcare system. This study's purpose was to evaluate the effectiveness of the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Surgery in Hawaii. STUDY DESIGN: This pre-post cohort study involved 100% of 15 hospitals in Hawaii from January 2013-June 2015. The intervention was a statewide implementation of the Comprehensive-Unit-based-Safety-Program (CUSP) and individualized bundles of interventions to reduce SSI...
May 3, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29782609/low-cost-customized-cranioplasty-using-a-3d-digital-printing-model-a-case-report
#5
Abel De La Peña, Javier De La Peña-Brambila, Juan Pérez-De La Torre, Miguel Ochoa, Guillermo J Gallardo
Background: Cranial defects usually occur after trauma, neurosurgical procedures like decompressive craniotomy, tumour resections, infection and congenital defects. The purpose of cranial vault repair is to protect the underlying brain tissue, to reduce any localized pain and patient anxiety, and improve cranial aesthetics. Cranioplasty is a frequent neurosurgical procedure achieved with the aid of cranial prosthesis made from materials such as: titanium, autologous bone, ceramics and polymers...
2018: 3D Print Med
https://www.readbyqxmd.com/read/29782303/clindamycin-induced-maculopapular-exanthema-with-preferential-involvement-of-striae-distensae-a-koebner-phenomenon
#6
Benigno Monteagudo, Miguel Cabanillas, Pilar Iriarte, Aquilina Ramírez-Santos, Elvira León-Muinos, Daniel González-Vilas, Óscar Suárez-Amor
Clindamycin is a lincomycin-derived antibiotic useful for the treatment of anaerobic and Gram-positive aerobic bacterial infections. Cutaneous adverse reactions are usually maculopapular exanthemas, although hypersensitivity syndrome, acute generalized exanthematous pustulosis, and Stevens-Johnson syndrome have also been reported (1). We report the case of a patient with a maculopapular rash triggered by clindamycin who developed cutaneous lesions on striae distensae (SD). A 47-year-old woman was referred to our clinic for pruritic cutaneous lesions which had started 6 days earlier...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29782301/lymphangioma-circumscriptum-post-radiotherapy-for-penile-cancer-treated-with-co%C3%A2-laser
#7
Dietmar Schulz, Andreas Lein, Ancuta Proca Nicula, Katrin Schierle, Caius Solovan
Lymphangioma circumscriptum (LC) is a rare, benign condition, predominantly characterized by the malformation of lymphatic skin vessels. Its onset may be congenital or due to secondary causes such as radiotherapy, infections, or surgical procedures. We present the case of a 55-year-old patient with a pathologic history of squamous cell carcinoma of the penis followed by radical penectomy. Due to metastasis to the locoregional lymph nodes, the entire affected area was subsequently treated with radiation therapy, receiving a total dose of 55...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29782264/-the-case-of-successful-surgical-treatment-of-a-patient-with-thoracic-endograft-infection-in-5-years-after-thoracic-endovascular-aortic-repair
#8
V A Popov, A N Korostelev, E S Malyshenko, A S Revishvili
We present here a case of successful staged treatment of a patient with para-aortic abscess that arose 5 years after thoracic endovascular aortic repair because of thoracic aortic aneurysm. After stabilization of the patient's condition by intensive antibiotic therapy we performed left-subclavian extra-thoracic debranching as the first stage of the surgical treatment. In 2 weeks via median sternotomy and on-pump we removed the infected endograft and performed extraanatomical ascending-to-descending aortic bypass with good postoperative result...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29782018/novel-method-of-plasmid-dna-delivery-to-mouse-bladder-urothelium-by-electroporation
#9
Chuan Yu, Ofir Stefanson, Yueli Liu, Zhu A Wang
Genetically engineered mouse models (GEMMs) are extremely valuable in revealing novel biological insights into the initiation and progression mechanisms of human diseases such as cancer. Transgenic and conditional knockout mice have been frequently used for gene overexpression or ablation in specific tissues or cell types in vivo. However, generating germline mouse models can be time-consuming and costly. Recent advancements in gene editing technologies and the feasibility of delivering DNA plasmids by viral infection have enabled rapid generation of non-germline autochthonous mouse cancer models for several organs...
May 3, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29781928/interface-fungal-keratitis-after-descemet-stripping-automated-endothelial-keratoplasty-a-review-of-the-literature-with-a-focus-on-outcomes
#10
Elizabeth McElnea, Billy Power, Conor Murphy
PURPOSE: To examine the management and associated outcomes of reported cases of interface fungal infection after Descemet stripping automated endothelial keratoplasty (EK). METHODS: A literature review identified reports of interface fungal infection after Descemet stripping automated EK. Data retrieved from the same included patient demographics, surgical procedure undertaken, donor rim culture result, clinical course, and outcome. A review of the relevant literature was also conducted...
May 16, 2018: Cornea
https://www.readbyqxmd.com/read/29781854/salvage-of-threatened-cardiovascular-implantable-electronic-devices-case-series-and-review-of-literature
#11
Andrew M Simpson, W Tyler Rockwell, Roger A Freedman, W Bradford Rockwell
BACKGROUND: The treatment of infected or exposed cardiac pacing and defibrillator devices is controversial. The conservative and widely accepted management calls for removal of the device and leads with immediate or delayed replacement of new components in a new site. Lead extraction carries a 2% major complication risk. In this article, we describe our experience with device salvage techniques and review the current literature. METHODS: This is a retrospective case series of consecutive patients with infected, exposed, or at-risk implanted cardiac devices that were treated with aggressive surgical debridement, local pocket irrigation, and revision...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781853/the-use-of-pedicled-perforator-flaps-in-chest-reconstruction-a-systematic-review-of-outcomes-and-reliability
#12
Anne-Sophie Florczak, Benoit Chaput, Christian Herlin, Pascal Rousseau, Eric Watier, Nicolas Bertheuil
BACKGROUND: In recent years, pedicled perforator flaps have revolutionized plastic surgery by reducing donor site morbidity and ensuring larger and deeper reconstructions with local pedicled cutaneous flaps. The aim of the study was to make a systematic review of perforator pedicled propeller flaps (PPPFs) in chest reconstruction. METHODS: Pubmed and Cochrane databases were searched from 1989 to October 2016 for articles describing the use of PPPFs in chest reconstruction...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781818/lower-extremity-megaprostheses-in-orthopaedic-oncology
#13
Santiago A Lozano Calderón, Joseph Kuechle, Kevin A Raskin, Francis J Hornicek
The megaprosthesis is designed to reproduce the form and function of a removed or lost large segment of bone and accompanying soft tissues. Slow but substantial improvements in the design and surgical implementation of these devices have advanced the capacity to restore patients' functional abilities. The essential challenges include identifying the ideal materials, bonding these materials to bone and soft tissues, reproducing functional anatomy, and adapting to the growing skeleton. Failure of these devices can result from soft-tissue insufficiency, aseptic loosening, structural failures, infection, and tumor recurrence...
May 17, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29781787/evaluating-the-duration-of-prophylactic-post-operative-antibiotic-agents-after-open-reduction-internal-fixation-for-closed-fractures
#14
Brett D Crist, Lasun O Oladeji, Gregory J Della Rocca, David A Volgas, James P Stannard, David D Greenberg
BACKGROUND: The importance of timely pre-operative antibiotic agents for effective surgical prophylaxis has been established but the optimal duration of antimicrobial coverage post-operatively has not yet been defined clearly. The purpose of this study was to determine if prophylactic post- operative cefazolin for 23 hours decreases the risk of surgical site infection (SSI) after open reduction internal fixation (ORIF) of closed extremity fractures. PATIENTS AND METHODS: After Institutional Reviews Board approval, patients undergoing ORIF of closed extremity fractures who had a planned post-operative stay of at least 23 hours were randomly assigned to either receive 23 hours of cefazolin or a placebo...
May 21, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29781101/feline-ureteral-obstructions-part-2-surgical-management
#15
REVIEW
D L Clarke
Feline obstructive ureteral disease will likely remain a common and frustrating cause of critical illness in cats for the foreseeable future. Since many cats are uraemic and cardiovascularly unstable secondary to obstructive nephropathy, prompt recognition using clinical intuition, blood work and diagnostic imaging is essential to make a timely diagnosis and decision about timing for intervention, if indicated. Multiple surgical and interventional procedures exist for the management of feline ureteral obstructions but there is no ideal technique and all currently available procedures carry risk of infection, re-obstruction, urine leakage and the need for additional procedures in the future...
May 20, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29780900/prophylactic-antibiotics-at-the-time-of-elective-cholecystectomy-are-effective-in-reducing-the-post-operative-infective-complications-a-systematic-review-and-meta-analysis
#16
Muhammad S Sajid, Joanna Bovis, Saad Rehman, Krishna K Singh
Background: The objective of this article is to evaluate the role of prophylactic antibiotics in preventing the infective complications in patients undergoing elective laparoscopic cholecystectomy (ELC). Methods: A systematic review of the literature on the published randomized, controlled reporting the role of prophylactic antibiotics in preventing the infective complications in patients undergoing ELC was undertaken using the principles of meta-analysis. Results: Twenty-five RCTs on 6,138 patients evaluating the infective complications in patients undergoing ELC were systematically analysed...
2018: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29780895/salvage-procedure-using-a-chimney-endograft-for-early-cerebral-ischaemia-after-hybrid-aortic-arch-repair-of-a-primary-aorto-bronchial-fistula
#17
M Cappelle, V Coppin, H Thieren, G Maleux, I Fourneau
Introduction: Hybrid aortic arch repair for the treatment of aorto-bronchial fistulas has been suggested as a safe alternative to open repair. However, surgical morbidity and mortality are still significant and re-intervention is sometimes inevitable. Report: Successful rescue by a hybrid approach is reported in a 76 year old woman who was transferred from another centre with recurrent episodes of left hemiplegia shortly after debranching of the supra-aortic vessels and thoracic aortic stent grafting for an aorto-bronchial fistula associated with a true aneurysm at the level of origin of the left subclavian artery...
2018: EJVES Short Reports
https://www.readbyqxmd.com/read/29780755/ovarian-teratoma-associated-anti-n-methyl-d-aspartate-receptor-encephalitis-a-difficult-diagnosis-with-a-favorable-prognosis
#18
Ananya Datta Mitra, Alaa Afify
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a recently described auto-immune and paraneoplastic encephalitis with prominent neuropsychiatric manifestations affecting young adults with ovarian teratoma. The availability of a novel assay to measure these antibodies might suggest an etiology for this potentially life-threatening disease, which if early recognized can be treated promptly with surgery with chances of a good clinical outcome. Reported prognostic indicators for a good outcome depend on the presence of a tumor, prompt treatment and no admission to an intensive care unit...
April 2018: Autopsy & case reports
https://www.readbyqxmd.com/read/29780599/perioperative-blood-transfusion-is-associated-with-post-operative-infectious-complications-in-patients-with-crohn-s-disease
#19
Nan Lan, Luca Stocchi, Yi Li, Bo Shen
Background: We have previously demonstrated that blood transfusion (BT) was associated with post-operative complications in patients undergoing surgery for Crohn's disease (CD), based on our institutional data registry. The aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Methods: All CD patients undergoing surgery between 2005 and 2013 were identified from NSQIP...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29780575/community-acquired-infection-to-raoultella-ornithinolytica-presenting-as-appendicitis-and-shock-in-a-healthy-individual
#20
Roy Hajjar, Frank Schwenter, Shih-Hann Su, Marie-Christine Gasse, Herawaty Sebajang
Raoultella ornithinolytica and Raoultella planticola are histamine-producing bacteria that are usually found in fish and water. They are associated with scombroid syndrome that presents with vomiting and flushing. A wide range of infections with these germs is reported, but mainly in fragile hospitalized patients with multiple comorbidities. We report the case of a 54-year-old healthy patient who presented with 24-hours abdominal pain, vomiting, flushing and shock. The abdominal examination showed guarding in the right lower quadrant (RLQ), and the abdominal CT scan images showed a thickened terminal ileum and a distended appendix...
May 2018: Journal of Surgical Case Reports
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