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https://www.readbyqxmd.com/read/28304317/early-onset-necrotizing-enterocolitis-nec-in-premature-twins
#1
B Afzal, V Elberson, C McLaughlin, V Hs Kumar
Twin infants born at 34 week gestation had frank blood in stools on day three of life on mixed feeds of formula and maternal breast milk. Sepsis work up was negative in these relatively well appearing infants with pneumatosis in the colon on abdominal x-ray. Blood in stools recurred on reintroduction of breast milk in Twin A. Both infants recovered from episodes of bloody stools on amino-acid based formula and were thriving at discharge. Early necrotizing enterocolitis in both twins is rare and has not been reported...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28289755/-necrotizing-fasciitis-of-the-upper-and-lower-extremities
#2
M Kückelhaus, T Hirsch, M Lehnhardt, A Daigeler
Necrotizing fasciitis is a potentially fatal soft tissue infection that may affect the upper and lower extremities, scrotum, perineum and abdominal wall. Typically, the infection demonstrates rapid spreading along the fascial planes leading to sepsis with mortality rates of 15-46%. Without adequate treatment, the mortality rate increases to close to 100%. There are four groups of pathogens that can lead to necrotizing fasciitis, namely beta-hemolytic group A streptococci, mixed infections with obligate and facultative anaerobes, clostridium species and fungal infections...
March 13, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28286376/high-mobility-group-box-1-protein-and-outcomes-in-critically-ill-surgical-patients-requiring-open-abdominal-management
#3
Michelle S Malig, Craig N Jenne, Chad G Ball, Derek J Roberts, Zhengwen Xiao, Andrew W Kirkpatrick
Background. Previous studies assessing various cytokines in the critically ill/injured have been uninformative in terms of translating to clinical care management. Animal abdominal sepsis work suggests that enhanced intraperitoneal (IP) clearance of Damage-Associated Molecular Patterns (DAMPs) improves outcome. Thus measuring the responses of DAMPs offers alternate potential insights and a representative DAMP, High Mobility Group Box-1 protein (HMGB-1), was considered. While IP biomediators are being recognized in critical illness/trauma, HMGB-1 behaviour has not been examined in open abdomen (OA) management...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28282605/variations-of-renal-tissue-oxygenation-during-abdominal-compartment-syndrome-and-sepsis
#4
Stavros Kalfadis, Vaia Nalbanti, Orestis Ioannidis, George Porfiriou, Dimitrios Botsios, Konstantinos Tsalis
PURPOSE: This experimental study was designed to evaluate the renal tissue oxygenation under the coexistence of abdominal compartment syndrome and sepsis. MATERIAL AND METHODS: Fourteen non-breed dogs were divided into two groups: the control group (8) and the study group (6). Sepsis was established with intravenous endotoxin infusion at 100μg/kg for over 30min. Insufflation of CO2 in the peritoneal cavity was used for the increase in intra-abdominal pressure (IAP)...
March 7, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28279777/sutureless-vs-sutured-gastroschisis-closure-a-prospective-randomized-controlled-trial
#5
Matias Bruzoni, Joshua D Jaramillo, Jonathan L Dunlap, Claire Abrajano, Shobha W Stack, Susan R Hintz, Tina Hernandez-Boussard, Sanjeev Dutta
BACKGROUND: Sutureless gastroschisis repair involves covering the abdominal wall defect with the umbilical cord or a synthetic dressing to allow closure by secondary intention. No randomized studies have described the outcomes of this technique. Our objective was to prospectively compare short-term outcomes of sutureless versus sutured closure in a randomized fashion. STUDY DESIGN: We recruited patients who presented with gastroschisis between 2009 and 2014 and were randomized into either sutureless or sutured treatment groups...
March 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28279749/how-to-diagnose-an-acutely-inflamed-appendix-a-systematic-review-of-the-latest-evidence
#6
REVIEW
S A Kabir, S I Kabir, R Sun, Sadaf Jafferbhoy, Ahmed Karim
Acute appendicitis is the most common condition that presents with an acute abdomen needing emergency surgery. Despite this common presentation, correctly diagnosing appendicitis remains a challenge as clinical signs or positive blood results can be absent in 55% of the patients. The reported proportion of missed diagnoses of appendicitis ranges between 20% and 40%. A delay or mis-diagnosis of appendicitis can result in severe complications such as perforation, abscess formation, sepsis, and intra-abdominal adhesions...
March 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28277439/role-of-laparoscopy-in-patients-with-abdominal-trauma-at-level-i-trauma-center
#7
Purushottam Parajuli, Subodh Kumar, Amit Gupta, Virinder Kumar Bansal, Sushma Sagar, Biplab Mishra, Maneesh Singhal, Atin Kumar, Shivanand Gamangatti, Babita Gupta, Chhavi Sawhney, Mahesh C Misra
INTRODUCTION: Abdominal trauma is one of the preventable causes of death in polytrauma patients. Decision and timing of laparotomy is a major challenge. Rate of nontherapeutic laparotomy is still high. Laparoscopy can avoid nontherapeutic laparotomy and also provide a reliable and accurate diagnosis of injury. MATERIALS AND METHODS: This ambispective observational study was conducted in the division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, All India Institute Medical Sciences, New Delhi...
March 8, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28266902/soluble-triggering-receptor-expressed-on-myeloid-cells-1-as-a-novel-marker-for-abdominal-sepsis
#8
Xiaofei Song, Yucheng Song, Xuedong Zhang, Huanzhou Xue
BACKGROUND: The aim of the study was to investigate the concentration and diagnostic significance of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in acute abdominal conditions. METHODS: Plasma specimens were obtained from 68 patients with abdominal sepsis, 60 patients with systemic inflammatory response syndrome (SIRS), and 60 healthy individuals. The sepsis group was divided into the survival and death groups according to the 28-d outcome...
March 7, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28266289/non-complicated-acute-appendicitis-in-adults-treated-successfully-by-conservative-treatment-without-recurrences
#9
Anestis Charalampopoulos, Ioannis Dimopoulos, Nikolaos Koliakos, Konstantinos Kopanakis, Theodoros Liakakos And
Backround: Surgical treatment of appendicitis remains the standard treatment, but many cases respond conservatively. Our purpose was the clarification of the clinical, laboratory and imaging characteristics of uncomplicated cases undergoing successful conservative treatment without recurrence. Methods: 105 adult patients (66 female, 39 male) with non-complicated acute appendicitis. Symptom duration, clinical abdominal examination, body temperature, inflammatory markers, imaging studies results and in-hospital treatment were recorded...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28260769/morbidity-and-mortality-after-pancreatoduodenectomy-a-five-year-experience-in-bangabandhu-sheikh-mujib-medical-university
#10
B C Das, A S Khan, N E Elahi, M S Uddin, B C Debnath, Z R Khan
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28258192/atg7-deficiency-intensifies-inflammasome-activation-and-pyroptosis-in-pseudomonas-sepsis
#11
Qinqin Pu, Changpei Gan, Rongpeng Li, Yi Li, Shirui Tan, Xuefeng Li, Yuquan Wei, Lefu Lan, Xin Deng, Haihua Liang, Feng Ma, Min Wu
Sepsis is a severe and complicated syndrome that is characterized by dysregulation of host inflammatory responses and organ failure, with high morbidity and mortality. The literature implies that autophagy is a crucial regulator of inflammation in sepsis. In this article, we report that autophagy-related protein 7 (Atg7) is involved in inflammasome activation in Pseudomonas aeruginosa abdominal infection. Following i.p. challenge with P. aeruginosa, atg7(fl/fl) mice showed impaired pathogen clearance, decreased survival, and widespread dissemination of bacteria into the blood and lung tissue compared with wild-type mice...
March 3, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28255613/intensive-care-medicine-research-agenda-on-invasive-fungal-infection-in-critically-ill-patients
#12
REVIEW
Matteo Bassetti, Jose Garnacho-Montero, Thierry Calandra, Bartjan Kullberg, George Dimopoulos, Elie Azoulay, Arunaloke Chakrabarti, Daniel Kett, Cristobal Leon, Luis Ostrosky-Zeichner, Maurizio Sanguinetti, Jean-Francois Timsit, Malcom D Richardson, Andrew Shorr, Oliver A Cornely
PURPOSE: To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting. METHODS: A systematic review of the medical literature taking account of national and international guidelines and expert opinion...
March 2, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28254728/serum-oxygen-radical-activity-and-total-antioxidation-capacity-are-related-with-severities-of-surgical-patient-with-sepsis-prospective-pilot-study
#13
Ji Young Jang, Seung Hwan Lee, Hongjin Shim, Jae Gil Lee
PURPOSE: The purpose of this pilot study was to evaluate the correlation between clinical severity and serum oxygen radical activity (ORA) and total antioxidation capacity (TAC) in critically ill surgical patients with sepsis. MATERIALS AND METHODS: The prospective observational study was performed in surgical intensive care unit (SICU) patients with intra-abdominal sepsis. Serum ORA and TAC levels were measured using a spectrophotometry-based antioxidant assay machine...
February 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28247301/il-6-rs1800795-polymorphism-is-associated-with-septic-shock-related-death-in-patients-who-underwent-major-surgery-a-preliminary-retrospective-study
#14
Maria Angeles Jiménez-Sousa, Luz Maria Medrano, Pilar Liu, Amanda Fernández-Rodríguez, Raquel Almansa, Esther Gomez-Sanchez, Alicia Ortega, María Heredia-Rodríguez, Estefanía Gómez-Pesquera, Eduardo Tamayo, Salvador Resino
BACKGROUND: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection, being the primary cause of death from infection, especially if not recognized and treated promptly. The aim of this study was to analyze whether IL-6 rs1800795 polymorphism is associated with septic shock-related death in European white patients who underwent major surgery. METHODS: We performed a retrospective study on 202 septic shock patients who underwent major cardiac or abdominal surgery...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28242983/dumbbell-gallbladder-cholecystitis-on-tc-99m-diisopropyliminodiacetic-acid-hepatobiliary-imaging
#15
Asif Ali Fakhri, Paul David Rodrigue, Aun Hussain, Abbas Taiyebi
We present a case of a 79-year-old immunocompromised female admitted for abdominal pain and sepsis, who had an abdominal computed tomography (CT) showing distal gallbladder fundus wall thickening, pericholecystic edema, and a right posteroinferior hepatic abscess. Subsequent hepatobiliary scintigraphy with Tc-99m diisopropyliminodiacetic acid showed gallbladder filling of the proximal gallbladder fundus, yet no radiotracer filling of the distal gallbladder fundus. Further correlation with the initial CT showed a partial gallbladder stricture and a resultant altered morphology resembling a dumbbell-shaped gallbladder...
January 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/28240465/comparing-laparoscopic-appendectomy-to-open-appendectomy-in-managing-generalised-purulent-peritonitis-from-complicated-appendicitis-the-uncharted-path
#16
B Ndofor, S Mokotedi, M Koto
BACKGROUND: The objective of the study was to compare the outcomes of patients with generalised purulent peritonitis from complicated appendicitis diagnosed intraoperatively who were managed laparoscopically to those managed via the open approach in a single institution. METHOD: Data were collected from all cases admitted at Sebokeng Hospital, Johannesburg, over the past two years (2008 and 2009) with an intraoperative diagnosis of generalised purulent peritonitis from complicated appendicitis...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28226029/predictive-value-of-c-reactive-protein-in-critically-ill-patients-after-abdominal-surgery
#17
Frédéric Sapin, Patrick Biston, Michael Piagnerelli
OBJECTIVES: The development of sepsis after abdominal surgery is associated with high morbidity and mortality. Due to inflammation, it may be difficult to diagnose infection when it occurs, but measurement of C-reactive protein could facilitate this diagnosis. In the present study, we evaluated the predictive value and time course of C-reactive protein in relation to outcome in patients admitted to the intensive care unit (ICU) after abdominal surgery. METHODS: We included patients admitted to the ICU after abdominal surgery over a period of two years...
January 1, 2017: Clinics
https://www.readbyqxmd.com/read/28225739/damage-control-laparotomy-utilization-rates-are-highly-variable-among-level-i-trauma-centers-pragmatic-randomized-optimal-platelet-and-plasma-ratios-findings
#18
Justin Jeremiah Joseph Watson, Jamison Nielsen, Kyle Hart, Priya Srikanth, John D Yonge, Christopher R Connelly, Phillip M Kemp Bohan, Hillary Sosnovske, Barbara C Tilley, Gerald van Belle, Bryan A Cotton, Terence S OʼKeeffe, Eileen M Bulger, Karen J Brasel, John B Holcomb, Martin A Schreiber
BACKGROUND: Damage control laparotomy (DCL) is intended to limit deleterious effects from trauma-induced coagulopathy. DCL has been associated with mortality reduction, but may increase complications including sepsis, abscess, respiratory failure, hernia, and gastrointestinal fistula. We hypothesized that (1) DCL incidence would vary between institutions; (2) mortality rates would vary with DCL rates; (3) standard DCL criteria of pH, international normalized ratio, temperature and major intra-abdominal vascular injury would not adequately capture all patients...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#19
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28220740/the-spectrum-and-outcome-of-surgical-sepsis-in-pietermaritzburg-south-africa
#20
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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