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Arnab Majumder, Heidi J Miller, Parita Patel, Yuhsin V Wu, Heidi L Elliott, Yuri W Novitsky
BACKGROUND: Despite patient risk factors such as diabetes and obesity, contamination during surgery remains a significant cause of infections and subsequent wound morbidity. Pressurized pulse lavage (PPL) has been utilized as a method to reduce bacterial bioburden with promising results in many fields. Although existing methods of lavage have been utilized during abdominal operations, no studies have examined the use of PPL during complex hernia repair. METHODS: Patients undergoing abdominal wall reconstruction (AWR) in clean-contaminated or contaminated fields with antibiotic PPL, from January 2012 to May 2013, were prospectively evaluated...
October 31, 2016: Surgical Endoscopy
Y-Q He, X-Q Lang, L Lin, L Ji, X-Y Yuan, Q Chen, Y-M Ran, H-S Chen, L Li, J-M Wang, Z-G Wang, H Gregersen, D-W Zou, H-P Liang, M Yang
BACKGROUND: Patients with posttraumatic stress disorder (PTSD) often share co-morbidity with chronic pain conditions. Recent studies suggest a role of P2X3 receptors and ATP signaling in pain conditions. However, the underlying mechanisms of visceral hyperalgesia following exposure to PTSD-like stress conditions remain unclarified. METHODS: The behavior and hormones relevant for PTSD were studied. Visceromotor responses (VMR) and the abdominal withdrawal reflexes (AWR) to colorectal distention (CRD) were recorded to determine P2X3-receptor-mediated alteration of hyperalgesia following single-prolonged stress (SPS) exposure...
October 25, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Jad Chamieh, Wen Hui Tan, Ricardo Ramirez, Eden Nohra, Chukwuma Apakama, William Symons
BACKGROUND: Synthetic meshes have been used with varying rates of success in a contaminated setting, although their use is not widely accepted because of concerns for infection. A biologic mesh (BM) is assumed to be more resistant to infection than a synthetic mesh; however, sparse clinical data support this theory. The hypothesis for this study: Uncoated polypropylene synthetic mesh (USM) can be used to obtain a durable repair in the setting of a contaminated abdominal wall reconstruction (AWR) in a single-stage procedure with comparable infectious outcomes to a biologic mesh repair...
October 18, 2016: Surgical Infections
Ji-Meng Zhao, Liu Chen, Ci-Li Zhou, Yin Shi, Yu-Wei Li, Hai-Xia Shang, Lu-Yi Wu, Chun-Hui Bao, Chuan-Zi Dou, Huan-Gan Wu
Aim. To compare whether there is different effect between electroacupuncture (EA) and moxibustion (Mox) on visceral hypersensitivity (their analgesic effects) in constipation-predominant irritable bowel syndrome (C-IBS). Methods. EA at 1 mA and 3 mA and Mox at 43°C and 46°C were applied to the Shangjuxu (ST37, bilateral) acupoint in rats with C-IBS and normal rats. An abdominal withdrawal reflex (AWR) score was used to assess visceral hypersensitivity. Toluidine blue staining was used to assess mast cell (MC) activity in colon of rats...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Karl Claxton, Stephen Palmer, Louise Longworth, Laura Bojke, Susan Griffin, Marta Soares, Eldon Spackman, Claire Rothery
BACKGROUND: The value of evidence about the performance of a technology and the value of access to a technology are central to policy decisions regarding coverage with, without, or only in research and managed entry (or risk-sharing) agreements. OBJECTIVES: We aim to outline the key principles of what assessments are needed to inform "only in research" (OIR) or "approval with research" (AWR) recommendations, in addition to approval or rejection. METHODS: We developed a comprehensive algorithm to inform the sequence of assessments and judgments that lead to different types of guidance: OIR, AWR, Approve, or Reject...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Salvatore Giordano, Patrick B Garvey, Donald P Baumann, Jun Liu, Charles E Butler
BACKGROUND: Prior abdominal wall radiotherapy (XRT) adversely affects wound healing, but data are limited on how prior XRT may affect abdominal wall reconstruction (AWR) outcomes. The purpose of this study was to determine whether prior abdominal wall radiotherapy is associated with a higher incidence of complications following AWR for a hernia or oncologic resection defect. METHODS: We performed a retrospective study of consecutive patients who underwent complex AWR using acellular dermal matrix (ADM) at a single center...
September 30, 2016: Annals of Surgical Oncology
Zhi Wei Tay, Patrick W Goodwill, Daniel W Hensley, Laura A Taylor, Bo Zheng, Steven M Conolly
Magnetic Particle Imaging (MPI) is a promising new tracer modality with zero attenuation deep in tissue, high contrast and sensitivity, and an excellent safety profile. However, the spatial resolution of MPI is limited to around 1 mm currently and urgently needs to be improved for clinical applications such as angiography and brain perfusion. Although MPI resolution is highly dependent on tracer characteristics and the drive waveforms, optimization is limited to a small subset of possible excitation strategies by current MPI hardware that only does sinusoidal drive waveforms at very few frequencies...
September 30, 2016: Scientific Reports
Simon G Royce, Anna M Tominaga, Matthew Shen, Krupesh P Patel, Brooke M Huuskes, Rebecca Lim, Sharon D Ricardo, Chrishan S Samuel
Current asthma therapies primarily target airway inflammation (AI) and suppress episodes of airway hyperresponsiveness (AHR) but fail to treat airway remodelling (AWR), which can develop independently of AI and contribute to irreversible airway obstruction. This study compared the anti-remodelling and therapeutic efficacy of human bone marrow-derived mesenchymal stem cells (MSCs) to that of human amnion epithelial stem cells (AECs) in the setting of chronic allergic airways disease (AAD), in the absence or presence of an anti-fibrotic (serelaxin; RLX)...
September 19, 2016: Clinical Science (1979-)
Kristian Kiim Jensen, Tina Lee Brøndum, Bo Belhage, Margaret Hensler, Regnar Bøge Arnesen, Henrik Kehlet, Lars Nannestad Jørgensen
INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair are lacking, perhaps due to a fear of impaired wound healing. We hypothesised that patients undergoing AWR would benefit from preoperative glucocorticoids and aimed at examining this in a randomised controlled trial...
August 2016: Danish Medical Journal
Erin H Baker, Darren Lepere, Megan P Lundgren, Patrick J Greaney, David A Ehrlich, Steven E Copit, Allison L Murphree, Anthony J Canfield, Glenn Parker, David A Iannitti
BACKGROUND: Non-crosslinked porcine acellular dermal grafts (NCPADG) are currently the mainstay biomaterial for abdominal wall reconstruction (AWR) in complex hernia patients. We report early clinical outcomes using a novel rifampin/minocycline-coated NCPADG for AWR. STUDY DESIGN: A multi-institutional retrospective review was performed of patients who underwent ventral hernia repair using XenMatrix AB Surgical Graft (CR Bard, Inc [Davol]). Patient demographics, hernia and procedure characteristics, and surgical site occurrences/postoperative complications were reviewed up to 6 months after AWR...
October 2016: Journal of the American College of Surgeons
X-P Zhou, J Sha, L Huang, T-N Li, R-R Zhang, M-D Tang, L Lin, X-L Li
BACKGROUND: Nesfatin-1, a recently identified satiety molecule derived from nucleobindin 2 (NUCB2), is associated with visceral hypersensitivity in rats and is expressed in the amygdala. We tested the hypothesis that nesfatin-1 expression in the amygdala is involved in the pathogenesis of irritable bowel syndrome (IBS) visceral hypersensitivity. METHODS: An animal model of IBS-like visceral hypersensitivity was established using maternal separation (MS) during postnatal days 2-16...
October 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Debo Qi, Shuqin Wu, Yuhua Zhang, Weimin Li
AIMS: To investigate the efficacy of electroacupuncture (EA) alleviation of acute visceral hyperalgesia, the frequency dependence of this efficacy, and the difference in endogenous opioid pathways as underlying mechanism explaining the frequency dependence. MAIN METHODS: A visceral hyperalgesia model was established by colorectal instillation of 2% acetic acid (AA) in adult rats. EA treatment at 2Hz, 100Hz, 2/100Hz and sham EA were performed at two bilateral acupoints, ST-36 and ST-37, in the hind-limbs...
September 1, 2016: Life Sciences
Qing Qing Qi, Fei Xue Chen, Dong Yan Zhao, Li Xiang Li, Peng Wang, Yan Qing Li, Xiu Li Zuo
OBJECTIVE: The aim of this study was to investigate whether colonic mucosal N-methyl-D-aspartate receptor (NMDAR) participates in visceral hypersensitivity in irritable bowel syndrome (IBS). METHODS: C57BL/6 mice were administered intrarectally with trinitrobenzenesulfonic acid (TNBS) for the establishment of an IBS-like visceral hypersensitivity model. Those received an equivalent volume of 50% ethanol were regarded as the controls. Abdominal withdrawal reflex (AWR) scores in response to colorectal distention (CRD) were used to assess visceral sensitivity...
July 2016: Journal of Digestive Diseases
Mojtaba Fayezizadeh, Arnab Majumder, Igor Belyansky, Yuri W Novitsky
BACKGROUND: Optimal mesh reinforcement and operative technique for major abdominal wall reconstructions (AWR) remain debatable. Posterior component separation via transversus abdominis release (TAR) allows for wide sublay mesh reinforcement with durable reconstruction, and has been gaining popularity in recent years. Although biologic mesh has been associated with mixed results, outcomes of AWR with bioprosthetics have not been well elucidated to date. We evaluated our outcomes of TAR reconstructions with retromuscular porcine biologic mesh reinforcement...
September 2016: Journal of the American College of Surgeons
Jorge Daes, Rodolfo J Dennis
BACKGROUND: Proper defect closure during abdominal wall reconstruction (AWR) is a key to improving cosmetic and functional results, and reducing morbidity. We have completed the initial prospective evaluation of a technique we previously described and published: endoscopic subcutaneous anterior component separation (ACS) as an adjunct to mainly laparoscopic AWR. We now present the long-term clinical and imaging follow-up results. STUDY DESIGN: Data were prospectively collected over a 3-year period (2012-2015) on patients who underwent AWR with endoscopic ACS...
June 22, 2016: Surgical Endoscopy
Kristian K Jensen, Kanzah Munim, Michael Kjaer, Lars N Jorgensen
OBJECTIVE: The aim of the study was to examine abdominal wall function in patients undergoing abdominal wall reconstruction (AWR) for incisional hernia. BACKGROUND: The literature on abdominal wall function in patients with incisional hernia is sparse. It has been suggested that AWR leads to improvement in function, but it is unknown whether this is specific to the abdominal wall or due to an improvement in overall physical fitness. METHODS: We performed a prospective case-control study of 18 consecutive patients with large incisional hernia undergoing AWR with linea alba restoration...
June 8, 2016: Annals of Surgery
Nian-Zhao Zhang, Lin Ma, Chen Jun, Yan-Xia Guo, Hui-Qing Yuan
OBJECTIVE: To establish the detrusor overactivity (DO) model induced by visceral hypersensitivity (VH) and investigate the relationship between mast cell (MC) infiltration and DO. MATERIALS AND METHODS: Sixty rats are divided into 4 groups randomly: Group 1:Baseline group; Group 2: DO group; Group 3: CON group; Group 4: VH group. The colorectal distension (CRD) and abdominal withdral reflex (AWR) scores are performed to evaluate VH. The cystometric investigation and histological test of MC infiltration are assessed...
March 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Hongping Liu, Yuhua Zhang, Debo Qi, Weimin Li
The involvement of spinal NR2B, a N-methyl-D-aspartate (NMDA) receptor subunit, in the therapeutic effect of electro-acupuncture (EA) on chronic visceral hyperalgesia was investigated. Chronic visceral hyperalgesia was induced using an irritable bowel syndrome (IBS) model in rats. Graded colorectal distention (CRD) stimuli at strengths of 20, 40, 60 and 80 mmHg were applied, and behavioral tests were performed to measure the abdominal withdrawal reflex (AWR) in response to the CRD stimuli and assess the severity of the visceral hyperalgesia...
May 25, 2016: Journal of Physiological Sciences: JPS
Monique M J Walenkamp, Abdelali Bentohami, Annelie Slaar, M S H Suzan Beerekamp, Mario Maas, L C Cara Jager, Nico L Sosef, Romuald van Velde, Jan M Ultee, Ewout W Steyerberg, J C Carel Goslings, Niels W L Schep
BACKGROUND: Although only 39% of patients with wrist trauma have sustained a fracture, the majority of patients is routinely referred for radiography. The purpose of this study was to derive and externally validate a clinical decision rule that selects patients with acute wrist trauma in the Emergency Department (ED) for radiography. METHOD: This multicenter prospective study consisted of three components: (1) derivation of a clinical prediction model for detecting wrist fractures in patients following wrist trauma; (2) external validation of this model; and (3) design of a clinical decision rule...
2016: Nederlands Tijdschrift Voor Geneeskunde
Mojtaba Fayezizadeh, Arnab Majumder, Ruel Neupane, Heidi L Elliott, Yuri W Novitsky
BACKGROUND: Transversus abdominis plane block (TAPb) is an analgesic adjunct used for abdominal surgical procedures. Liposomal bupivacaine (LB) demonstrates prolonged analgesic effects, up to 72 hours. We evaluated the analgesic efficacy of TAPb using LB for patients undergoing open abdominal wall reconstruction (AWR). METHODS: Fifty patients undergoing AWR with TAPb using LB (TAP-group) were compared with a matched historical cohort undergoing AWR without TAPb (control group)...
September 2016: American Journal of Surgery
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