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Surgical emergency department

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https://www.readbyqxmd.com/read/28547273/case-distribution-and-complications-of-mid-urethral-sling-surgery-in-a-canadian-city-before-and-after-the-health-canada-advisory-on-pelvic-floor-mesh
#1
Kevin Carlson, Richard Baverstock, Andrea Civitarese, R Trafford Crump
INTRODUCTION AND HYPOTHESIS: Increased incidences of complications related to the use of mid-urethral slings (MUS) for the treatment of stress urinary incontinence resulted in both the Food and Drug Administration (FDA) and Health Canada issuing advisories in 2008 and 2010 respectively. The purpose of this study was to assess the effect these advisories had on the number of surgeons performing MUS surgery and post-surgical complications in Calgary, Canada. METHODS: In this study, we conducted a retrospective analysis of administrative data between 2006 and 2011...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28538639/development-of-the-emergency-preservation-and-resuscitation-for-cardiac-arrest-from-trauma-epr-cat-clinical-trial
#2
Samuel A Tisherman, Hasan B Alam, Peter M Rhee, Thomas M Scalea, Tomas Drabek, Raquel M Forsythe, Patrick M Kochanek McCm
BACKGROUND: Patients who suffer a cardiac arrest from trauma rarely survive, even with aggressive resuscitation attempts, including an Emergency Department (ED) thoracotomy. Emergency Preservation and Resuscitation (EPR) was developed to utilize hypothermia to buy time to obtain hemostasis before irreversible organ damage occurs. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10°C during exsanguination cardiac arrest can allow up to 2 hours of circulatory arrest and repair of simulated injuries with normal neurologic recovery...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538629/outcomes-following-traumatic-injury-in-patients-with-preexisting-psychiatric-illness
#3
Erika Falsgraf, Kenji Inaba, Amory de Roulet, Megan Johnson, Elizabeth Benjamin, Lydia Lam, Kazuhide Matsushima, Aaron Strumwasser, Demetrios Demetriades
BACKGROUND: Patients with psychiatric illness have been shown to experience higher rates of traumatic injury. Injury patterns, treatment decisions, and outcomes have not been well characterized in patients with psychiatric illness after injury, in particular those who undergo acute surgical intervention. The purpose of this analysis was to determine mortality, complications, and surgical intervention rates in patients with psychiatric illness following traumatic injury. METHODS: This is a retrospective study of trauma patients ≥18 years old admitted to LAC+USC Medical Center between January 2008 and March 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538455/operative-fixation-for-clavicle-fractures-socioeconomic-differences-persist-despite-overall-population-increases-in-utilization
#4
William W Schairer, Benedict U Nwachukwu, Russell F Warren, David M Dines, Lawrence V Gulotta
BACKGROUND: Clavicle fractures were traditionally treated conservatively, but recent evidence has shown improved outcomes with surgical management. The purpose of this study was to evaluate the recent trends in operative treatment of clavicle fractures, and to analyze for patient related factors that may affect treatment strategy. METHODS: The Healthcare Cost and Utilization Project (HCUP) California and Florida inpatient, outpatient, and the Emergency Department databases were used to identify all patients with clavicle fractures between 2005 and 2010...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28537570/safe-and-uncomplicated-inguinal-hernia-surgery-in-the-elderly-message-from-anesthesiologists-to-general-surgeons
#5
Tomasz Chlebny, Piotr Zelga, Mateusz Pryt, Marta Zelga, Adam Dziki
Introduction Elderly patients are often discouraged from surgery due to the risk of complications that increases with age. Aim We wanted to assess mortality, morbidity, and complications in patients older than 75 years who underwent elective or emergency inguinal hernia repair in a single center. Methods All patients older than 75 years who were operated on because of inguinal hernia in the Department of General and Colorectal Surgery, Medical University of Lodz between 2003 and 2015 were analyzed. Detailed information was collected with regard to patient demographics, mode of admission, comorbidities, type of intervention, applied anesthesia, and 30-day outcomes...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28536211/pathological-fracture-of-the-femoral-neck-following-septic-coxitis-and-chronic-osteomyelitis-a-potential-complication-of-lemierre-s-syndrome
#6
Dominik Maximilian Vogt, Ludger Tüshaus, Martin Kaiser, Martin Russlies
We portray the case of a 16-year-old girl who was initially admitted to the paediatric emergency department with non-specific symptoms of a severe cold and was first treated symptomatically on an ambulatory basis. Within 6 days she developed the full clinical picture of Lemierre's syndrome with the extraordinary manifestation of involvement of her right hip. Despite an interdisciplinary coordinated treatment as well as surgical therapy, a full-blown sepsis evolved within a short time period and resulted in almost 2 months of intensive care...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28533990/anomalous-origin-of-right-coronary-artery-originating-from-the-pulmonary-trunk-arcapa-an-incidental-finding-in-a-patient-presenting-with-chest-pain
#7
Pragathi Balakrishna, Michael Illovsky, Youssef M Al-Saghir, Abdul M Minhas
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly with an estimated prevalence of 0.002%. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. We present a case of a 55-year-old female with a history of hypertension who presented to the emergency department with intermittent chest discomfort for three days...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28533989/iatrogenic-spinal-subdural-extra-arachnoid-hygroma-following-uncomplicated-lumbar-decompression
#8
Benjamin D Elder, Wataru Ishida, Rory C Goodwin, Ali Bydon
Intradural spinal arachnoid cysts (ISACs) have been reported in the current literature as either an idiopathic disease or exceedingly rare sequelae after lumbar puncture, spinal trauma, or meningitis. Other studies have more appropriately termed the iatrogenic pathology as a spinal subdural extra-arachnoid hygroma (SSEH), as there is not often a clear cyst wall as in a true arachnoid cyst. However, to the best of our knowledge, none of the previous studies described an SSEH following uncomplicated posterior lumbar surgery, as they have previously involved clear durotomies during the initial operation...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28529538/emergency-surgery-due-to-diaphragmatic-hernia-case-series-and-review
#9
REVIEW
Mario Testini, Antonia Girardi, Roberta Maria Isernia, Angela De Palma, Giovanni Catalano, Angela Pezzolla, Angela Gurrado
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a congenital abnormality, rare in adults with a frequency of 0.17-6%. Diaphragmatic rupture is an infrequent consequence of trauma, occurring in about 5% of severe closed thoraco-abdominal injuries. Clinical presentation ranges from asymptomatic cases to serious respiratory or gastrointestinal symptoms. Diagnosis depends on anamnesis, clinical signs and radiological investigations. METHODS: From May 2013 to June 2016, six cases (four females, two males; mean age 58 years) of diaphragmatic hernia were admitted to our Academic Department of General Surgery with respiratory and abdominal symptoms...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28525247/-evaluations-by-hospital-ward-physicians-of-patient-care-management-quality-for-patients-hospitalized-after-an-emergency-department-admission
#10
M Bartiaux, P Mols
BACKGROUND: patient management in the acute and sub-acute setting of an Emergency Department is challenging. An assessment of the quality of provided care enables an evaluation of failings. It contributes to the identification of areas for improvement. OBJECTIVES: to obtain an analysis, by hospital-ward physicians, of adult patient care management quality, as well as of the correctness of diagnosis made during emergency admissions. To evaluate the consequences of inadequate patient care management on morbidity, mortality and cost and duration of hospitalization...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28523331/conventional-chondrosarcoma-in-the-right-hand-with-the-invasion-of-the-pisiform-and-the-hamate-bones-case-report
#11
Daniel LaurenŢiu Pop, Andrei Gheorghe Marius Motoc, Horia George Hărăguş, Bogdan Cătălin Ciupe, Mihaela Iacob, Dinu Vermeşan, Radu Prejbeanu, Daniel Claudiu MaliŢa, Carmen Lăcrămioara Zamfir, Roxana Folescu
Chondrosarcoma is a malignant hyaline cartilage forming tumor. It is a rare pathology, with an estimated incidence of one in 200 000 individuals per year. It appears in two forms: primary, representing 90% of all cases and secondary emergence that develops on preexistent lesions. Primary chondrosarcomas are uncommon in the hand, with a frequency of only 1.5-3.2% of all chondrosarcomas. In conventional chondrosarcoma (cCS), the histological malignancy grading represents the main prognostic factor for surgical planning and prognosis...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28523083/association-of-midfacial-fractures-with-ophthalmic-injury
#12
REVIEW
Constantinus Politis, Alexandra Kluyskens, Titiaan Dormaar
The aim of this study is to evaluate the incidence of ophthalmic complications following midfacial fractures and investigate its relation to surgical or nonsurgical treatment. This article is a retrospective study, describing the spectrum and incidence of ophthalmic injury in 106 patients presenting with midfacial fractures at the Department of Oral and Maxillofacial Surgery of the University Hospitals Leuven over a period of 16 months (January 2013 to April 2014). The mean age of the patients was 45.6 years with a gender distribution of 68 men and 38 women...
June 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28514960/segmental-testicular-infarction-a-case-report
#13
Tine Smets, Gina Reichman, Dirk P J Michielsen
BACKGROUND: Segmental testicular infarction is a very rare condition, which can mimic a testicular torsion or testicular cancer. Correct diagnosis is difficult but it is important to avoid unnecessary radical treatment. CASE PRESENTATION: We report a clinical case of a 36-year-old white man who presented at our emergency department with subacute testicular pain. A urine analysis, Doppler ultrasound, surgical exploration, blood analysis, and magnetic resonance imaging were performed to diagnose his condition, to exclude a testicular torsion, and to raise confidence in its non-malignancy...
May 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28512663/advancing-the-integration-of-hospital-it-pitfalls-and-perspectives-when-replacing-specialized-software-for-high-risk-environments-with-enterprise-system-extensions
#14
Carsten Engelmann, Dzifa Ametowobla
BACKGROUND: Planning and controlling surgical operations hugely impacts upon productivity, patient safety, and surgeons' careers. Established, specialized software for this task is being increasingly replaced by "Operating Room (OR)-modules" appended to enterprise-wide resource planning (ERP) systems. As a result, usability problems are re-emerging and require developers' attention. OBJECTIVE: Systematic evaluation of the functionality and social repercussions of a global, market-leading IT business control system (SAP R3, Germany), adapted for real-time OR process steering...
May 17, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28511550/ct-features-in-surgically-proven-cases-of-ovarian-torsion-a-pictorial-review
#15
Sunita Dhanda, Swee Tian Quek, Ying Ting Mok, Clement Yong Hsiang Rong, Yuik Sing Eric Ting, Pooja Jagmohan, Bernard Wee
Ovarian torsion is a surgical emergency characterized by a partial or complete rotation of the ovarian vascular pedicle, causing obstruction to venous outflow followed by arterial inflow. Clinically, ovarian torsion frequently mimics other causes of acute pelvic pain such as appendicitis, diverticulitis, renal colic etc. Ultrasonography (US) is the first line imaging modality of choice for evaluation of ovarian torsion. MRI is useful as a problem solving tool in patients with equivocal or non diagnostic US studies...
May 16, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28511450/emergency-peripartum-hysterectomy-indications-and-outcome-in-a-tertiary-care-setting
#16
Anshuja Singla, Rajlaxmi Mundhra, Latika Phogat, Sumita Mehta, Shalini Rajaram
INTRODUCTION: Emergency Peripartum Hysterectomy (EPH) is an important lifesaving procedure, mostly reserved for conditions deemed to be serious and life threatening, and not amenable to conservative methods. In the present scenario, the advent of newer medical and conservative surgical methods for controlling obstetric haemorrhage has influenced the incidence, trend and the outcomes of the procedure. AIM: To evaluate the demographic profile, indications, operative details, maternal morbidity and mortality and neonatal outcomes of women undergoing EPH...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28507966/ipsilateral-hip-and-knee-dislocation-with-open-tibial-fracture-a-case-report-of-a-limb-threatening-injury
#17
Ramesh Perumal, S R Sundararajan, J Vasudeva, S Rajasekaran
INTRODUCTION: Hip or knee dislocations are usually treated as a surgical emergency, but ipsilateral hip and knee dislocation should be considered a dual emergency that must be addressed immediately and reduced at the earliest. We present here the sequence of events and the final functional outcome of one such rare injury manages by us. CASE REPORT: A 22-year-old male was involved in a road traffic accident. He presented to the emergency department in 4 h injury time with painful deformities of the right hip and knee, along with Type I open wound right leg with abnormal mobility suggestive of fracture in the ipsilateral leg...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28506855/rates-and-risk-factors-for-opioid-dependence-and-overdose-after-urologic-surgery
#18
Arpeet S Shah, Robert H Blackwell, Paul C Kuo, Gopal N Gupta
INTRODUCTION: Effective pain management is a critical component of the perioperative process, with opioids representing a mainstay of therapy. The opioid epidemic is a growing concern in the United States. The goal of this study was to quantify the risk of opioid dependence or overdose (ODO) among patients undergoing urologic surgery and to identify risk factors of ODO. METHODS: A retrospective review of urologic surgery from 2007-2011. Data sources included the Healthcare Cost and Utilization Project Inpatient, Ambulatory Surgery, and Emergency Department datasets...
May 12, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28501386/atrioesophageal-fistula-after-ablation-for-atrial-fibrillation
#19
Trisha Mackle, Kevin Pistawka
BACKGROUND: Atrioesophageal fistula (AEF) is a rare and highly fatal complication of ablation procedures for atrial fibrillation. We report a diagnostically challenging case of AEF that highlights the unfortunate outcome that can be expected when this condition is not promptly diagnosed and managed accordingly. The varied clinical presentations are reviewed and recommended diagnostic and management approaches are presented. CASE REPORT: A 79-year-old female who was 5 weeks post-ablation presented to a community emergency department with chest pain and a transient episode of left-arm weakness...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28495813/trends-in-the-supply-of-california-s-emergency-departments-and-inpatient-services-2005-2014-a-retrospective-analysis
#20
Jessica L Chow, Matthew J Niedzwiecki, Renee Y Hsia
OBJECTIVES: Given increasing demand for emergency care, there is growing concern over the availability of emergency department (ED) and inpatient resources. Existing studies of ED bed supply are dated and often overlook hospital capacity beyond ED settings. We described recent statewide trends in the capacity of ED and inpatient hospital services from 2005 to 2014. DESIGN: Retrospective analysis. SETTING: Using California hospital data, we examined the absolute and per admission changes in ED beds and inpatient beds in all hospitals from 2005 to 2014...
May 11, 2017: BMJ Open
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