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https://www.readbyqxmd.com/read/28944933/emergency-department-management-of-body-packers-and-body-stuffers
#1
Liv Heymann-Maier, Lionel Trueb, Sabine Schmidt, Pierre-Nicolas Carron, Olivier Hugli, Eric Heymann, Bertrand Yersin
Trafficking and sale of narcotics frequently involves the intra-abdominal transport of large quantities of drugs, usually cocaine or heroin ("body packing"), or, when there is a risk of being arrested, the oral ingestion of minor quantities of narcotics dedicated for immediate resale ("body stuffing"). This study aimed to describe the characteristics, complications and medical follow through of 132 cases of body packing (n = 36), cases of body stuffing (n = 83) or mixed cases (n = 13), referred by the authorities to our emergency department over the course of 12 years...
September 25, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28943213/evaluating-the-feasibility-of-phrenoesophagopexy-during-hiatal-hernia-repair-in-sleeve-gastrectomy-patients
#2
Nathaniel R Ellens, Joshua E Simon, Kimberly D Kemmeter, Tyler W Barreto, Paul R Kemmeter
BACKGROUND: Both hiatal hernias (HH) and morbid obesity significantly contribute to gastroesophageal reflux disease, which increases the risk for esophagitis and esophageal cancer. Therefore, concomitant HH repair is recommended during bariatric surgery procedures. Unfortunately, recurrence of HH after repair is not uncommon and the optimal surgical technique has yet to be established. OBJECTIVE: To evaluate the feasibility of recreating the phrenoesophageal ligaments by adding phrenoesophagopexy to HH repair during sleeve gastrectomy...
August 26, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28943019/-outlier-patient-admissions-and-their-relationship-with-the-emergence-of-clinical-complications-and-prolonged-hospital-stays
#3
Enrique Cabrera Torres, María Aránzazu García Iglesias, María Teresa Santos Jiménez, Miguel González Hierro, María Luisa Diego Domínguez
OBJECTIVE: To analyze the relationship between the type of hospital admission (outlier and non-outlier admissions) and the appearance of clinical complications and the average stay. METHODS: From a retrospective epidemiological study of a cohort of patients admitted to the Hospital Complejo Asistencial Universitario de Salamanca (Salamanca, Spain) over a six-month period, outlier and non-outlier patients were identified. This project had access to the admissions department database, the hospital's CMBD (in Spanish, Conjunto Mínimo Básico de Datos) for hospitalisation, the AP-DRG (All Patient-Diagnosis Related Groups) and ALCOR (a clinical-statistics analytics tool)...
September 21, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28942942/-management-of-unintentional-pediatric-female-genital-trauma
#4
D Guerre, C Bréhin, E Gurrera, K Pinnagoda, P Galinier, I Claudet, O Abbo
INTRODUCTION: Unintentional pediatric female genital trauma is frequent in the daily practice of emergency wards. However, scientific data are rare in the literature, leading to variability in their management. The aim of this study was to evaluate our practice in order to obtain epidemiological data and define clinical guidelines. MATERIAL AND METHODS: We conducted a retrospective study from March 2013 to January 2015 and identified all emergency visits for this pathology...
September 21, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28942396/microbubble-enhanced-ultrasound-to-demonstrate-urethral-transection-in-a-case-of-penile-fracture
#5
Oliver Czarnecki, Conrad Brice von Stempel, Pippa Sangster, Miles Walkden
A 47-year-old man attended the emergency department following trauma during sexual intercourse after which he developed penile swelling and haematuria several hours later. A penile fracture was suspected but given the slightly atypical history, ultrasound was performed to look for a fracture. Given the history of haematuria, both a standard Doppler ultrasound and a microbubble-enhanced retrograde ultrasound urethrogram were performed. The Doppler confirmed the suspected diagnosis of penile fracture, and microbubble urethrogram demonstrated a urethral injury...
September 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28941121/do-instability-markers-predict-satisfactory-reduction-and-requirement-for-later-surgery-in-emergency-department-patients-with-wrist-fracture
#6
Amar Winayak, Alyza Gossat, Jenny Cooper, Peter Ritchie, Wei Lim, Sharon Klim, Anne-Maree Kelly
OBJECTIVE: Research suggests that the presence of instability markers in patients with displaced distal radial fractures is associated with poorer outcome. Our aims were to determine whether the presence of previously defined instability markers could predict the likelihood of successful ED reduction and requirement for a secondary procedure after ED reduction. METHODS: Retrospective cohort study performed by medical record review. Adult ED patients coded as having an isolated wrist fracture and having fracture reduction in ED were eligible for inclusion...
September 23, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28939398/the-emergency-medicine-focused-review-of-cholangitis
#7
Rachel Ely, Brit Long, Alex Koyfman
BACKGROUND: Cholangitis is a life-threatening infection of the biliary tract. Historically, the mortality secondary to cholangitis approached 100%. However, with early recognition, antibiotics, resuscitation, and surgical or endoscopic intervention, patient outcomes have significantly improved, although there is still progress to be made. OBJECTIVE OF REVIEW: The objective of this review is to provide an emergency medicine-centered approach to the risk factors, presentations, and various diagnostic and treatment modalities in cholangitis...
September 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28930037/regional-consolidation-of-orthopedic-surgery-impacts-on-hip-fracture-surgery-access-and-outcomes
#8
Sara A Kreindler, Lanette Siragusa, Eric Bohm, Wendy Rudnick, Colleen J Metge
BACKGROUND: Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. METHODS: We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28928927/unusual-cause-of-acute-scrotum-in-children-a-case-report
#9
Salahoudine Idrissa, Mohamed Amine Oukhouya, Mohamed Tazi, Abdelhalim Mahmoudi, Aziz Elmadi, Khalid Khattala, Youssef Bouabdallah
A 13-year-old boy was presented in the pediatric emergency with a 2-week history of swelling of the right scrotal contents of simple evolution, which was worsened by the appearance of an acute scrotal pain 48 h prior to his consultation. The doppler ultrasound and computed tomography (CT) scan revealed an incarceration of the omentum in an inguinal hernia. Acute scrotal pain and swelling is a common reason for surgical consultation in the emergency department of children. However, omentum is a rare content of inguinal hernia in children and infarct is exceptional...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#10
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927566/low-rates-of-adverse-events-following-ambulatory-outpatient-total-hip-arthroplasty-at-a-free-standing-surgery-center
#11
Patrick C Toy, Matthew N Fournier, Thomas W Throckmorton, William M Mihalko
BACKGROUND: We proposed to determine the complication and hospital admission rates for patients with total hip arthroplasty (THA) done by a single surgeon in a stand-alone ambulatory surgical center with same-day discharge. Given the recent emphasis on bundled payments for a 90-day episode of care, this same time frame after surgery was chosen to determine patient outcomes. METHODS: The records of patients with THAs done through a direct anterior approach by a single surgeon at 2 separate ambulatory surgery centers were reviewed...
August 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28927439/barriers-and-facilitators-towards-implementing-the-sepsis-six-care-bundle-bliss-1-a-mixed-methods-investigation-using-the-theoretical-domains-framework
#12
Neil Roberts, Guy Hooper, Fabiana Lorencatto, Wendell Storr, Michael Spivey
BACKGROUND: The 'Sepsis 6', a care bundle of basic, but vital, measures (e.g. intravenous fluid, antibiotics) has been implemented to improve sepsis treatment. However, uptake has been variable. Tools from behavioral sciences, such as the Theoretical Domains Framework (TDF) may be used to understand and address such implementation issues. This study used a behavioral science approach to identify barriers and facilitators towards Sepsis Six implementation at a case study hospital. METHODS: Semi-structured interviews based on the TDF were conducted with a sample group of consultants, junior doctors and nurses from Emergency Department, Medical and Surgical Admissions, to explore barriers/facilitators to Sepsis Six performance...
September 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28927352/an-acute-presentation-of-pediatric-mesenteric-lymphangioma-a-case-report-and-literature-overview
#13
Céline Clement, Rob Snoekx, Pieter Ceulemans, Inez Wyn, Jan Matheï
INTRODUCTION: Lymphangioma accounts for 5% of benign pediatric tumors and less than 1% is located in the abdomen. While mesenteric lymphatic malformation or mesenteric lymphangioma (ML), mostly appears asymptomatic in adults, an acute clinical presentation is seen more often in children. Symptoms can mimic obstruction or peritonitis and diagnosis can therefore be challenging. Imaging studies are performed to exclude other causes of obstruction or peritonitis. Diagnosis of ML is always made by histology...
September 19, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28926505/do-all-clavicle-fractures-in-children-need-to-be-managed-by-orthopedic-surgeons
#14
John Adamich, Andrew Howard, Mark Camp
OBJECTIVES: Although many uncomplicated pediatric fractures do not require routine long-term follow-up with an orthopedic surgeon, practitioners with limited experience dealing with pediatric fractures will often defer to a strategy of frequent clinical and radiographic follow-up. Development of an evidence-based clinical care pathway can help unnecessary radiation exposure to this patient population and reduce costs to patient families and the health care system. METHODS: A retrospective analysis including patients who presented to the Hospital for Sick Children (SickKids) for management of clavicle fractures was performed...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28923679/inguinal-hernia-containing-urinary-bladder-a-case-report
#15
Milena Taskovska, Jurij Janež
INTRODUCTION: Inguinal bladder hernia is rare condition found in about 1-5% of inguinal hernias. The condition is usually diagnosed intraoperatively. Patients rarely have symptoms regarding urinary tract. The best management is surgical, open surgical technique is preferred over laparoscopic. Possible urinary tract damage during surgery should be recognized and resolved. CASE PRESENTATION: The following paper presents case of inguinal bladder hernia in 82-year old Caucasian male...
September 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28923678/a-case-report-on-gastric-volvulus-of-a-17-years-old-boy-from-bangladesh
#16
M Tasdik Hasan, S M Tajdit Rahman, Hasan M Shihab, Hassan Rushekh Mahmood, Tanni Chowdhury, Quamrul Akhtar Sanju
INTRODUCTION: Gastric volvulus is a rare and true surgical emergency which is life threatening if not recognized and treated quickly. There have been approximately 300 reported cases globally till now. This condition most often occurs during 5th decade of life but there are over 100 reported pediatric cases also. This following rare incidence was such a case of a young patient in Bangladesh. It was the first case of gastric volvulus managed by the surgery department of the concerned hospital...
September 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28923097/impact-of-perioperative-nutritional-status-on-the-outcome-of-abdominal-surgery-in-a-sub-saharan-africa-setting
#17
Christian Gael Mambou Tebou, Mazou N Temgoua, Agnès Esiene, Blondel Oumarou Nana, Jean Jacques Noubiap, Eugène Sobngwi
BACKGROUND: Malnutrition is a clinical condition of multifactorial etiologies and it is associated with several adverse outcomes. In high-income countries, malnutrition has been described as a determinant of delayed wound healing, surgical site infections and mortality in the postoperative period. There is limited information available regarding the outcome of surgery in malnourished patients in sub-Saharan Africa. METHODS: A cross-sectional analytic study was carried out between March and August 2014 in the visceral surgery and the emergency departments of the Yaounde Central Hospital in Cameroon...
September 18, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28920034/the-use-of-intraoperative-transesophageal-echocardiography-in-thoracic-aortic-dissection-due-to-chronic-cocaine-abuse
#18
Ali Dabbagh, Mohammad Kazem Arabnia, Mahnoosh Foroughi, Mehran Shahzamani, Hassan Rahmian
INTRODUCTION: Aortic dissection is a life threatening disease and is usually accompanied by a high rate of mortality and morbidity. Here we present a case report in which intraoperative tranesophageal echocardiography was used for intraoperative assessments of thoracic aortic dissection due to cocaine abuse. CASE PRESENTATION: A 45- year- old male was admitted to a university hospital due to severe chest pain. He was suffering from severe excruciating chest pain that had started after a psychological stress, leading to heavy cocaine abuse...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28919603/current-trends-of-using-antimicrobials-at-obstetrics-and-gynaecology-department-in-a-tertiary-care-hospital
#19
M M Islam, S K Saha, S Saha, U A Wahid, R R Gomes, K S Ahmed, A N Naushad, S E Suchi, C Saha, D Mondal
This cross-sectional descriptive study was done to analyse the current trends of using antimicrobials in various surgical procedures at Obstetrics and Gynaecology department in Mymensingh Medical College Hospital, Mymensingh from July 2014 to June 2015. Among 300 postoperative obstetrics and gynaecological surgery cases, samples were selected as non-random purposive selection method where pattern of using antimicrobials were analysed by SPSS method 20.1 versions. The incidence of antimicrobial resistance is on continued rise with a threat to return to the pre-antibiotic era...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28919600/modified-blatchford-score-for-risk-stratification-in-adult-patient-with-nonvariceal-upper-gastrointestinal-haemorrhage-and-their-short-term-hospital-outcome
#20
M S Islam, M Z Uddin, M S Ali, M N Islam, M H Rahman, I H Robi, M M Haque, M W Rahman, M A Uddin, F Ahamed, M S Malek, M A Kabir, M S Rahman, A U Khan, F A Doel
Upper gastrointestinal hemorrhage (UGIH) is one of the most common and life-threatening gastrointestinal emergency. There are several risk scores for risk stratification in UGIB patients. The Modified Blatchford score, which relies only on clinical and laboratory parameters, is practical in the emergency setting The Modified Blatchford scoring system also known as Glasgow Blatchford Scoring (GBS) have been developed to stratify risk of non variceal upper gastrointestinal hemorrhage or need of medical or surgical intervention, endoscopic therapy...
July 2017: Mymensingh Medical Journal: MMJ
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