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Damage control surgery

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https://www.readbyqxmd.com/read/28630035/the-effects-of-preoperative-volume-replacement-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-surgery-protocol-for-a-randomized-controlled-trial-verdict-trial
#1
Madeleine Clout, Tracy Harris, Chris Rogers, Lucy Culliford, Jodi Taylor, Gianni Angelini, Pradeep Narayan, Barnaby Reeves, James Hillier, Kate Ashton, Kunal Sarkar, Raimondo Ascione
BACKGROUND: Diabetes mellitus is a major risk factor for prolonged hospital stays, renal failure, and mortality in patients having coronary artery bypass grafting (CABG). Complications pose a serious threat to patients and prolong intensive care and hospital stays. Low glomerular filtration rate (GFR) due to existing renal impairment or volume depletion may exacerbate acute renal impairment/failure in these patients. Preoperative volume replacement therapy (VRT) is reported to increase the GFR and we hypothesize that VRT will reduce renal impairment and related complications in diabetic patients...
June 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28628601/the-damage-control-surgery-in-austere-environments-research-group-dcsaerg-a-dynamic-program-to-facilitate-real-time-telementoring-telediagnosis-to-address-exsanguination-in-extreme-and-austere-environments
#2
Andrew W Kirkpatrick, Jessica L McKee, Paul B McBeth, Chad G Ball, Anthony LaPorta, Timothy Broderick, Tim Leslie, David King, Heather E Wright Beatty, Jocelyn Keillor, Homer Tien
Hemorrhage is the most preventable cause of posttraumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or resuscitative surgery in austere environments. Revolutions in technology for remote mentoring of ultrasound and surgery may enhance capabilities to utilize the skill sets of non-physicians. Thus, our research collaborative explored remote mentoring to empower non-physicians to address junctional and torso hemorrhage control in austere environments...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28627355/-recent-advances-in-the-pathogenesis-and-treatment-of-hypoproteinemia-after-surgical-stress
#3
Siyuan Jiang, Jin Zhang
After major operation, a series of complicated pathological and physiological changes will occur during the trauma and stress state. The protein synthesis is affected, which results in negative nitrogen balance. In addition, the release of inflammatory factors can damage the capillary endothelial cells and increase the permeability of micrangium, induce vascular colloidal albumin leakage to the extravascular tissue, decrease plasma albumin, make wound edema, eventually lead to postoperative hypoproteinemia...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625659/abnormal-semantic-knowledge-in-a-case-of-developmental-amnesia
#4
Anna Blumenthal, Devin Duke, Ben Bowles, Asaf Gilboa, R Shayna Rosenbaum, Stefan Köhler, Ken McRae
An important theory holds that semantic knowledge can develop independently of episodic memory. One strong source of evidence supporting this independence comes from the observation that individuals with early hippocampal damage leading to developmental amnesia generally perform normally on standard tests of semantic memory, despite their profound impairment in episodic memory. However, one aspect of semantic memory that has not been explored is conceptual structure. We built on the theoretically important distinction between intrinsic features of object concepts (e...
June 15, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/28625441/the-protective-effects-of-dexmedetomidine-on-ischemic-brain-injury-a-meta-analysis
#5
REVIEW
Lianxiang Jiang, Meizhu Hu, Yan Lu, Ya Cao, Yan Chang, Zeping Dai
BACKGROUND: Intracranial lesions, trauma or surgery-related damage activate immune inflammation and neuroendocrine responses, causing ischemic brain injury. Studies have shown that inflammatory cascade mediated by neuroendocrine hormones and proinflammatory mediators is implicated in the pathophysiology of ischemic brain injury. Alpha2-adrenoceptor agonists, dexmedetomidine, is widely used as neuroprotectants in anesthesia practice. However, it is still lack of a comprehensive meta-analysis to evaluate the neuroprotection of dexmedetomidine against ischemic brain injury via suppressing these two physiological responses...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28620644/topical-application-of-mesenchymal-stromal-cells-ameliorated-liver-parenchyma-damage-after-ischemia-reperfusion-injury-in-an-animal-model
#6
Ping Kuen Lam, Charing Ching Ning Chong, Anthony Wing Ip Lo, Anthony Wing Hung Chan, Cindy See Wai Tong, Don Wai Ching Chin, Kenneth Hoi Kin Wong, Richard Kwong Wai Choy, Andrew Kai-Yip Fung, Yi Xiang Wang, Ka Fai To, Paul Bo San Lai
BACKGROUND: Ischemia-reperfusion injury (IRI) is commonly encountered after liver surgery. This study evaluated the hepatoprotective effects of topically applied adipose-derived mesenchymal stromal cells (ADMSCs) on hepatic IRI in a rat model. METHODS: ADMSCs from transgenic green fluorescent protein Sprague-Dawley rats were topically applied to the liver surface of Sprague-Dawley rats after hepatic IRI and fixed in position by fibrin glue (group A, n = 24). An equivalent amount of ADMSCs were administered through the portal (group B, n = 24) or tail vein (group C, n = 24)...
June 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28619043/effect-of-transcutaneous-electrical-stimulation-treatment-on-lower-urinary-tract-symptoms-after-class-iii-radical-hysterectomy-in-cervical-cancer-patients-study-protocol-for-a-multicentre-randomized-controlled-trial
#7
Xiu-Li Sun, Hai-Bo Wang, Zhi-Qi Wang, Ting-Ting Cao, Xin Yang, Jing-Song Han, Yang-Feng Wu, Kathleen H Reilly, Jian-Liu Wang
BACKGROUND: Class III radical hysterectomy (RH III)_plus pelvic lymphadenectomy is the standard surgery for early stage cervical cancer (CC) patients, the 5 year survival rate is about 90%, but pelvic floor disorders especially bladder dysfunction are common due to damaged vessels and nerve fibers following surgery. Transcutaneous electrical stimulation (TENS) treatment has been used to treat bladder disorders for many years, but its effect on cervical cancer patients, the best treatment time point and stimulated protocol, had never been assessed...
June 15, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28616778/auditory-brainstem-responses-after-electrolytic-lesions-in-bilateral-subdivisions-of-the-medial-geniculate-body-of-tree-shrews
#8
Meichan Zhu, Heng Li, Bibek Gyanwali, Guangyao He, Chenglin Qi, Xuemin Yang, Zhenhua Li, Zhenxing Yao, Zhi Wang, Anzhou Tang
This study aimed to establish a tree shrew model of bilateral electrolytic lesions in the medial geniculate body (MGB) to determine the advantages of using a tree shrew model and to assess the pattern of sound processing in tree shrews after bilateral electrolytic damage in different parts of the MGB. The auditory brainstem responses (ABRs) of a normal control group (n = 30) and an electrical damage group (n = 30) were tested at 0 h, 24 h, 48 h, 72 h, 7 days, 15 days, and 30 days after surgery. (1) The bilateral ablations group exhibited a significant increase in the ABR threshold of the electrolytic damage group between pre- and post-operation...
June 14, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28614785/drag-reducing-polymers-decrease-hepatic-injury-and-metastases-after-liver-ischemia-reperfusion
#9
Samer Tohme, Marina V Kameneva, Hamza O Yazdani, Vikas Sud, Julie Goswami, Patricia Loughran, Hai Huang, Richard L Simmons, Allan Tsung
INTRODUCTION: Surgery, a crucial therapeutic modality in the treatment of solid tumors, can induce sterile inflammatory processes which can result in metastatic progression. Liver ischemia and reperfusion (I/R) injury, an inevitable consequence of hepatic resection of metastases, has been shown to foster hepatic capture of circulating cancer cells and accelerate metastatic growth. Efforts to reduce these negative consequences have not been thoroughly investigated. Drag reducing polymers (DRPs) are blood-soluble macromolecules that can, in nanomolar concentrations, increase tissue perfusion, decrease vascular resistance and decrease near-wall microvascular concentration of neutrophils and platelets thereby possibly reducing the inflammatory microenvironment...
May 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/28614043/antibiotics-vs-appendectomy-for-acute-uncomplicated-appendicitis-in-adults-review-of-the-evidence-and-future-directions
#10
Jared M Huston, Lillian S Kao, Phillip K Chang, James M Sanders, Sara Buckman, Charles A Adams, Christine S Cocanour, Sarah E Parli, Julia Grabowski, Jose Diaz, Jeffrey M Tessier, Therese M Duane
BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency in the United States, with a lifetime risk of 7%-8%. The treatment paradigm for complicated appendicitis has evolved over the past decade, and many cases now are managed by broad-spectrum antibiotics. We determined the role of non-operative and operative management in adult patients with uncomplicated appendicitis. METHODS: Several meta-analyses have attempted to clarify the debate. Arguably the most influential is the Appendicitis Acuta (APPAC) Trial...
June 14, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28612105/-polytrauma-and-concomitant-traumatic-brain-injury-the-role-of-the-trauma-surgeon
#11
REVIEW
A Antoni, T Heinz, J Leitgeb
BACKGROUND: Concomitant traumatic brain injury (TBI) increases mortality and reduces quality of life of polytrauma patients. These facts demand effective treatment strategies while the growing specialization of medicine is questioning the role of the trauma surgeon in the management of these patients. OBJECTIVES: Which factors influence outcome of polytrauma with concomitant TBI? Who should be responsible for the management of these patients and what is the limit of management? MATERIALS AND METHODS: A literature search using Medline via PubMed was performed with Medical Subject Headings and text word search...
June 13, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28608271/repeated-subretinal-surgery-and-removal-of-subretinal-decalin-is-well-tolerated-evidence-from-a-porcine-model
#12
Nina Buus Sørensen, Kristian Klemp, Troels Wesenberg Kjær, Steffen Heegaard, Morten la Cour, Jens Folke Kiilgaard
PURPOSE: Subretinal perfluorocarbon liquid (PFCL) is a serious complication that can occur after retinal detachment repair. It is possible to remove the PFCL surgically, but retinal damage related to the procedure is unknown. Also, increasing interest in subretinal treatment makes it relevant to examine the functional and morphological consequences of repeated subretinal manipulation. We hypothesized that PFCL in a porcine model can be injected in the subretinal space and removed with minimal effect on retinal structure and function...
June 12, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28598277/surgical-strategy-to-avoid-ischemic-complications-of-the-pyramidal-tract-in-resective-epilepsy-surgery-of-the-insula-technical-case-report
#13
Naoki Ikegaya, Akio Takahashi, Takanobu Kaido, Yuu Kaneko, Masaki Iwasaki, Nobutaka Kawahara, Taisuke Otsuki
Surgical treatment of the insula is notorious for its high probability of motor complications, particularly when resecting the superoposterior part. Ischemic damage to the pyramidal tract in the corona radiata has been regarded as the cause of these complications, resulting from occlusion of the perforating arteries to the pyramidal tract through the insular cortex. The authors describe a strategy in which a small piece of gray matter is spared at the bottom of the periinsular sulcus, where the perforating arteries pass en route to the pyramidal tract, in order to avoid these complications...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28593415/the-effects-of-laparoscopic-graspers-with-enhanced-haptic-feedback-on-applied-forces-a-randomized-comparison-with-conventional-graspers
#14
Chantal C J Alleblas, Michel P H Vleugels, Sjors F P J Coppus, Theodoor E Nieboer
BACKGROUND: Haptic feedback, which enables surgeons to perceive information on interaction forces between instrument and tissue, is deficient in laparoscopic surgery. This information, however, is essential for accurate tissue manipulation and recognition of tissue consistencies. To this end, a laparoscopic grasper with enhanced haptic feedback has been developed: the force reflecting operation instrument (FROI). This study tested the effects of enhanced haptic feedback on force control, tissue consistency interpretation, and the associated surgeons' level of confidence through a randomized controlled crossover experiment...
June 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28590354/optimal-timing-for-repair-of-peripheral-nerve-injuries
#15
Eugene Wang, Kenji Inaba, Saskya Byerly, Diandra Escamilla, Jayun Cho, Joseph Carey, Milan Stevanovic, Alidad Ghiassi, Demetrios Demetriades
BACKGROUND: Data regarding outcomes after peripheral nerve injuries is limited, and the optimal management strategy for an acute injury is unclear. The aim of this study was to examine timing of repair and specific factors that impact motor-sensory outcomes after peripheral nerve injury. METHODS: This was a single center, retrospective study. Patients with traumatic peripheral nerve injury 01/2010 - 06/2015 were included. Patients who died, required amputation, suffered brachial plexus injury, or had missing motor-sensory exams were excluded...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28589185/damage-control-laparoscopic-partial-cholecystectomy-with-an-endoscopic-linear-stapler
#16
Beyza Özçınar, Ecem Memişoğlu, Ali Fuat Kaan Gök, Orhan Ağcaoğlu, Fatih Yanar, Mehmet İlhan, Hakan Teoman Yanar, Kayıhan Günay
OBJECTIVE: Several damage-control procedures have been described in the literature in case of severe Calot's triangle inflammation and fibrosis. In this report, we describe patients who underwent laparoscopic partial cholecystectomy using an endoscopic linear stapler. MATERIALS AND METHODS: Five patients with acute cholecystitis underwent laparoscopic partial cholecystectomy in our clinic between January - December 2011. All patients had severe fibrosis and inflammation of Calot's triangle...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28585119/the-effectiveness-of-hybrid-treatment-for-sever-multiple-trauma-a-case-of-multiple-trauma-for-damage-control-laparotomy-and-thoracic-endovascular-repair
#17
Naofumi Bunya, Keisuke Harada, Yosuke Kuroda, Tsubasa Toyohara, Takashi Toyohara, Narumi Kubota, Ryuichiro Kakizaki, Hideto Irifune, Shuji Uemura, Eichi Narimatsu
BACKGROUND: Time is a crucial factor for the successful early management of the multi-trauma patient. Hybrid operating theaters, which support the integration of surgical treatment and interventional radiology, provide opportunities to reduce the time-to-surgery for life threatening conditions. CASE PRESENTATION: We describe the early successful treatment of a 54-year-old male who sustained multiple injuries when he was hit by a 1000 kg bale of wheat that fell from a height...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28583542/splenectomy-for-severe-intestinal-bleeding-caused-by-portal-hypertensive-enteropathy-after-pediatric-living-donor-liver-transplantation-a-report-of-three-cases
#18
K Tokodai, N Kawagishi, S Miyagi, C Nakanishi, Y Hara, W Nakanishi, T Kamei, N Ohuchi
BACKGROUND: The incidence of portal vein thrombosis after pediatric living-donor liver transplantation (LDLT) is reported to be higher than that after deceased-donor or adult liver transplantation. Portal vein thrombosis can cause portal hypertension and related complications, including portal hypertensive gastropathy or portal hypertensive enteropathy (PHE). PHE, in particular, can lead to severe intestinal bleeding, which is extremely difficult to treat. However, the pathogenesis of and appropriate treatment for PHE are not clearly defined, especially after pediatric LDLT...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28580446/protective-effects-of-melatonin-on-testis-histology-following-acute-torsion-detorsion-in-rats
#19
Mehri Mirhoseini, Fereshteh Talebpour Amiri, Abbas Ali Karimpour Malekshah, Zahra Rezanejad Gatabi, Elmira Ghaffari
BACKGROUND: Testicular damage due to spermatic cord torsion may lead to infertility. It is probably because of changes in oxidative stress factors such as malondialdehyde. OBJECTIVE: To investigate the protective effect of melatonin (MLT), as an antioxidant, on testicular damage induced by acute unilateral spermatic cord torsion and detorsion (T/D) in rats. MATERIALS AND METHODS: In this experimental study, 48 adult male Wistar rats were randomly divided into three groups (8 rats/group): sham group underwent right scrotal surgery only...
March 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/28565865/alterations-of-caspr2-and-nav1-6-on-myelinated-axon-damage-in-a-rat-model-of-chronic-cerebral-hypoperfusion
#20
Weihua Liang, Weiwei Zhang, Shifu Zhao, Hua Liang, Jinli Zhang, Luyan Wang
Myelinated axons require the correct localization of key proteins that are essential for nerve conduction and cognitive function. Little is known regarding the altered expression of contactin-associated protein 2 (Caspr2) at the juxtaparanodal regions and Nav1.6 at the node of Ranvier in response to chronic cerebral hypoperfusion (CCH). The aim of the present study was to examine the alterations in the key protein of myelinated axons and the potential mechanisms that may follow CCH. We established a rat model of CCH by controllable partial narrowing of bilateral common carotid arteries...
May 2017: Experimental and Therapeutic Medicine
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