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https://www.readbyqxmd.com/read/28506674/removal-of-an-infected-hip-arthroplasty-is-a-high-risk-surgery-putting-morbidity-into-context-with-other-major-nonorthopedic-operations
#1
James A Browne, Jourdan M Cancienne, Wendy M Novicoff, Brian C Werner
BACKGROUND: Two-stage revision remains the most common approach to periprosthetic joint infection of total hip arthroplasty (THA) in the United States. The postoperative risks associated with removal of an infected prosthesis and placement of a spacer have not been thoroughly studied. METHODS: Patients who underwent THA implant removal and spacer placement for infection were identified in a large administrative database. Morbidity and mortality rates were assessed for the 90-day postoperative period and readmission rates were assessed at 30 days postoperatively...
April 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28502319/an-unusual-case-of-a-young-patient-with-whipple-s-disease-involving-the-central-nervous-system
#2
Margaret E Flanagan, Nicole Andeen, Joshua Lieberman, Joseph Freeburg, John R Williams, Daniel R Hoogestraat, Andrew Bryan, Daniel E Sabath
No abstract text is available yet for this article.
May 15, 2017: Clinical Neuropathology
https://www.readbyqxmd.com/read/28502028/hypoglycemia-following-bariatric-surgery-our-31-year-experience
#3
Alex D Michaels, J Hunter Mehaffey, W Brenton French, Bruce D Schirmer, Jennifer L Kirby, Peter T Hallowell
PURPOSE: The purposes of this study are to identify the cumulative incidence of post-bariatric surgery hypoglycemia (PBSH), describe its symptomatology, and characterize treatment patterns at a large academic institution. MATERIALS AND METHODS: All patients who underwent bariatric surgery at a single institution from 1985 to 2015 were identified using a clinical database, administrative billing data identified patients who were treated for hypoglycemia, and chart reviews were performed to make a diagnosis of PBSH based on Whipple's triad...
May 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28501471/comparison-of-endoscopic-ultrasound-guided-fine-needle-aspiration-and-pet-ct-in-preoperative-diagnosis-of-pancreatic-adenocarcinoma
#4
Jin-Ping Lai, Yong Yue, Wei Zhang, Yihua Zhou, David Frishberg, Laith H Jamil, James M Mirocha, Maha Guindi, Bonnie Balzer, Shikha Bose, Dengfeng Cao, Simon Lo, Xuemo Fan, Joanne K Rutgers
BACKGROUND: Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) is the procedure of choice to investigate and sample pancreatic masses for the preoperative diagnosis of pancreatic ductal adenocarcinoma (PDAC). The role of (18)fluoro-deoxyglucose positron emission tomography/computed tomography (PET/CT) in PDAC is debated. This study evaluates the role of EUS-FNA as compared to PET/CT in the preoperative evaluation of PDAC. METHODS: Preoperative evaluation by PET/CT and EUS-FNA was performed on 25 patients with pancreatic solid lesions, who underwent a subsequent Whipple procedure or partial pancreatic resection...
April 13, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28497727/using-white-tailed-deer-odocoileus-virginianus-in-infectious-disease-research
#5
Mitchell Palmer, Rebecca J Cox, W Ray Waters, Tyler C Thacker, Diana L Whipple
Between 1940 and 2004, more than 335 emerging infectious disease events were reported in the scientific literature. Themajority (60%) of these events involved zoonoses, most of which (72%) were of wildlife origin or had an epidemiologically important wildlife host. Because this trend of increasing emerging diseases likely will continue, understanding the pathogenesis, transmission, and diagnosis of these diseases in the relevant wildlife host is paramount. Achieving this goal often requires using wild animals as research subjects, which are vastly different from the traditional livestock or laboratory animals used by most universities and institutions...
May 11, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28486387/minimally-invasive-versus-open-pancreaticoduodenectomy-a-propensity-matched-study-from-a-national-cohort-of-patients
#6
Ibrahim Nassour, Sam C Wang, Alana Christie, Mathew M Augustine, Matthew R Porembka, Adam C Yopp, Michael A Choti, John C Mansour, Xian-Jin Xie, Patricio M Polanco, Rebecca M Minter
OBJECTIVE: To compare the perioperative outcomes of minimally invasive pancreaticoduodenectomy (MIPD) in comparison with open pancreaticoduodenectomy (OPD) in a national cohort of patients. BACKGROUND: Limited well-controlled studies exist comparing perioperative outcomes between MIPD and OPD. METHODS: Patients who underwent MIPD and OPD were abstracted from the 2014 to 2015 pancreas-targeted American College of Surgeons National Surgical Quality Improvement Program...
May 8, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28484677/iatrogenic-non-reconstructable-duodenal-injury-presenting-without-peritonitis-an-indication-of-pancreatoduodenectomy-in-the-presence-of-safe-hands-a-case-report
#7
Humaid Ahmad, Jahanzaib Haider, Sheeraz S Siddiqui, Sumbul Naz, Shams Nadeem Alam
Iatrogenic duodenal injuries are rare complications of upper gastrointestinal endoscopic procedures, gallbladder, and right kidney operations. Management includes diverse options depending on a number of factors that include the size of the injury, timing of presentation, degree of peritoneal contamination, and presence of peritonitis and/or sepsis, etc. While most duodenal injuries are small, large complex non-reconstructable injuries may occasionally occur, requiring complex surgical procedures rather than primary repair which if done in the latter cases, may lead to further morbidity and mortality...
April 6, 2017: Curēus
https://www.readbyqxmd.com/read/28464571/-expert-consensus-of-laparoscopic-pancreaticoduodenectomy-postscript-of-operation-process-and-main-steps
#8
(no author information available yet)
Laparoscopic pancreaticoduodenectomy (LPD) is a minimally invasive approach for Whipple by total or assistant laparoscopic techniques. The results of feasibility, safety, short and long outcomes have slowly been gaining acceptance over the past decade. Aim to further adapt to the development trend, improve the safety and oncologic outcomes, promote the standardized development of LPD in China, four pancreas surgery groups in China wrote this LPD consensus. The consensus includes seven sections: operator request, indications and contraindications, preoperative preparation and anesthesia, equipment and instruments, positioning of patient and trocars, abdominal pressure, indications of conversion to laparotomy, postoperative observation and treatment...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28462447/predictive-power-of-the-nsqip-risk-calculator-for-early-post-operative-outcomes-after-whipple-experience-from-a-regional-center-in-northern-ontario
#9
Henry Y Jiang, Erica L Kohtakangas, Kengo Asai, Jeffrey B Shum
BACKGROUND: NSQIP Risk Calculator was developed to allow surgeons to inform their patients about their individual risks for surgery. Its ability to predict complication rates and length of stay (LOS) has made it an appealing tool for both patients and surgeons. However, the NSQIP Risk Calculator has been criticized for its generality and lack of detail towards surgical subspecialties, including the hepatopancreaticobiliary (HPB) surgery. We wish to determine whether the NSQIP Risk Calculator is predictive of post-operative complications and LOS with respect to Whipple's resections for our patient population...
May 2, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28459079/pancreatic-fungal-ball-presenting-as-pseudomass
#10
Naomi Chou, Rebecca Burbridge, Sarah Karram
Fungal infections of the pancreas have been shown to occur most commonly in the setting of necrotizing pancreatitis, pancreatic cysts, or pancreatic abscesses. Pancreatic fungal infections are rare without these predisposing factors, and may present similarly to pancreatic neoplasm. We report the case of a 48-year-old man who presented with epigastric abdominal pain, nausea, vomiting, and weight loss, with a potential mass in the head of the pancreas. The mass was resected via the Whipple procedure and was found to be a fungal collection with inflammatory cells and no malignancy...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28439483/whipple-s-disease-manifested-as-recurrent-ascites
#11
Ali Aamar, Kamraan Madhani, Muhammad S Anwar, Prabhdeep Singh, Joel Garsten
Whipple's disease commonly presents as chronic diarrhea and abdominal pain. Ascites is an uncommon presentation of Whipple's disease. Here, we report a rare case of a 47-year-old male who presented with diarrhea and abdominal distention for three months. The physical examination was significant for ascites. Serum albumin was low and serum-to-ascites albumin gradient was < 1.1 g/dl. This suggested that ascites was less likely to be present due to portal hypertension. Enteroscopy showed erythematous duodenum and jejunum; biopsy was suggestive of periodic acid-Schiff stain (PAS) positive macrophages consistent with Whipple's disease...
March 21, 2017: Curēus
https://www.readbyqxmd.com/read/28406793/population-level-incidence-and-predictors-of-surgically-induced-diabetes-and-exocrine-insufficiency-after-partial-pancreatic-resection
#12
Irmina A Elliott, Irene Epelboym, Megan Winner, John D Allendorf, Philip I Haigh
CONTEXT: Endocrine and exocrine insufficiency after partial pancreatectomy affect quality of life, cardiovascular health, and nutritional status. However, their incidence and predictors are unknown. OBJECTIVE: To identify the incidence and predictors of new-onset diabetes and exocrine insufficiency after partial pancreatectomy. DESIGN: We retrospectively reviewed 1165 cases of partial pancreatectomy, performed from 1998 to 2010, from a large population-based database...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28385924/genotypic-analysis-of-tropheryma-whipplei-from-patients-with-whipple-disease-in-the-americas
#13
Dominique C Rollin, Christopher D Paddock, Bobbi S Pritt, Scott A Cunningham, Amy M Denison
Tropheryma whipplei, the agent of Whipple disease, causes a rare bacterial disease that may be fatal if not treated. The classical form of the disease includes diarrhoea, weight loss, arthritis, endocarditis and neurological manifestations. Genotyping studies done in Europe, Africa and Asia showed high genetic diversity with no correlation between genotypes and clinical features, but contributed to a better understanding of the epidemiology of the disease. More than 70 genotypes have been described. No similar assessment of T...
April 6, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28383837/-clinical-approach-of-a-suspicion-of-hypoglycaemic-malaise-in-a-nondiabetic-adult
#14
A J Scheen, N Paquot, P J Lefèbvre
Malaises are often attributed to hypoglycaemia in nondiabetic people who don't have any other serious medical problem. However, such a diagnosis is often overused, because not really demonstrated in most instances. The diagnosis of hypoglycaemia should be structured, based upon the Whipple triad. First, the anamnesis must search for adrenergic and neuroglucopenic symptoms that suggest hypoglycaemia. Afterwards, hypoglycaemia must be authentified by a measurement of a low glucose level at the time of a malaise...
September 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28382437/diffuse-leptomeningeal-glioneuronal-tumor-dlgnt-mimicking-whipple-s-disease-a-case-report-and-literature-review
#15
Vega Karlowee, Manish Kolakshyapati, Vishwa Jeet Amatya, Takeshi Takayasu, Ryo Nosaka, Kazuhiko Sugiyama, Kaoru Kurisu, Fumiyuki Yamasaki
INTRODUCTION: Diffuse leptomeningeal glioneuronal tumor is a new entity under the neuronal and mixed neuronal-glial tumors in the WHO 2016 updated classification and commonly found in children and adolescents. The initial diagnosis is challenging because of its non-specific radiologic feature and negative CSF cytology analysis. A 17 years male was presented with intractable headache subsequently followed by back pain and joint pain. MRI showed enhancement of arachnoid membrane at basal cistern, bilateral sylvian fissure and cerebral cistern with slight enlargement of ventricles...
April 5, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28381450/management-of-endocrine-disease-pathogenesis-and-management-of-hypoglycemia
#16
REVIEW
Nana Esi Kittah, Adrian Vella
Glucose is the main substrate utilized by the brain and as such multiple regulatory mechanisms exist to maintain glucose concentrations. When these mechanisms fail or are defective, hypoglycemia ensues. Due to these robust mechanisms, hypoglycemia is uncommon and usually occurs in the setting of the treatment of diabetes using glucose-lowering agents such as sulfonylureas or insulin. The symptoms of hypoglycemia are non-specific and as such it is important to confirm hypoglycemia by establishing the presence of Whipple's triad before embarking on an evaluation for hypoglycemia...
July 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28375574/grass-inflorescence-architecture-and-evolution-the-origin-of-novel-signaling-centers
#17
REVIEW
Clinton J Whipple
Contents Summary I. II. III. IV. References SUMMARY: A central goal of evo-devo is to understand how morphological diversity arises from existing developmental mechanisms, requiring a clear, predictive explanatory framework of the underlying developmental mechanisms. Despite an ever-increasing literature on genes regulating grass inflorescence development, an effective model of inflorescence patterning is lacking. I argue that the existing framework for grass inflorescence development, which invokes homeotic shifts in multiple distinct meristem identities, obscures a recurring theme emerging from developmental genetic studies in grass models, that is that inflorescence branching is regulated by novel localized signaling centers...
April 4, 2017: New Phytologist
https://www.readbyqxmd.com/read/28351309/plasma-microrna192-in-combination-with-serum-ca19-9-as-non-invasive-prognostic-biomarker-in-periampullary-carcinoma
#18
K Murali Manohar, Mitnala Sasikala, Yesaswini Kvsrr, V Sunil, Rupjyoti Talukdar, Hvv Murthy, C Ramji, G V Rao, R Pradeep, D Nageshwar Reddy
In this study, circulating microRNAs (miRNAs) are being investigated as non-invasive biomarkers for early diagnosis and prognosis of human cancers. Since the prognosis for pancreatobiliary subtype of periampullary carcinoma is poor, we assessed the prognostic relevance of miRNAs in combination with CA19-9 as noninvasive biomarker in periampullary carcinoma. Circulating miRNAs in plasma and serum CA19-9 were evaluated in periampullary carcinoma patients (n = 109) undergoing Whipple's pancreaticoduodenectomy and in healthy volunteers (n = 92)...
March 2017: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
https://www.readbyqxmd.com/read/28337543/superiority-of-stapled-side-to-side-gastrojejunostomy-over-conventional-hand-sewn-end-to-side-gastrojejunostomy-for-reducing-the-risk-of-primary-delayed-gastric-emptying-after-subtotal-stomach-preserving-pancreaticoduodenectomy
#19
Yasuhiro Murata, Akihiro Tanemura, Hiroyuki Kato, Naohisa Kuriyama, Yoshinori Azumi, Masashi Kishiwada, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai, Shuji Isaji
BACKGROUND AND PURPOSE: Delayed gastric emptying (DGE) is the most common complication following pancreaticoduodenectomy (PD). The clinical efficacy of stapled side-to-side anastomosis using a laparoscopic stapling device during alimentary reconstruction in PD is not well understood and its superiority over conventional hand-sewn end-to-side anastomosis remains controversial. The objective of this study was to evaluate the effectiveness of the stapled side-to-side anastomosis in preventing the development of DGE after PD...
March 23, 2017: Surgery Today
https://www.readbyqxmd.com/read/28325722/misdiagnosing-whipple-s-disease-in-the-young
#20
Danai Papakonstantinou, Michael J Riste, Gerald Langman, Ed Moran
Whipple's disease is considered an infection of middle-aged white men of European ancestry. Cases are rare and disproportionately associated with occupational exposure to soil or animals. We report the case of a man aged 22 years with no risk factors, erroneously diagnosed with, and treated for, toxoplasmosis on the basis of consistent lymph node histology. The correct diagnosis was delayed by the dramatic symptomatic improvement resulting from this therapy. Whipple's disease should be considered in cases of granulomatous lymphadenopathy of unknown cause, even if the age of the patient does not fit the classic presentation of the disease...
March 21, 2017: BMJ Case Reports
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