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https://www.readbyqxmd.com/read/29053910/a-simplified-protocol-using-rituximab-and-immunoglobulin-for-abo-incompatible-low-titer-living-donor-liver-transplantation
#1
Seong Hoon Kim, Eung Chang Lee, Jae Ryong Shim, Sang Jae Park
BACKGROUND & AIMS: No consensus has been reached regarding optimal treatment strategies for ABO-incompatible (ABO-I) living donor liver transplantation (LDLT). We introduce a simplified protocol using rituximab and intravenous immunoglobulin (IVIG). METHODS: Data were analyzed on adult patients who underwent ABO-I LDLT of which protocol added rituximab (300 mg/m(2) ) before surgery and IVIG (0.8 g/kg) on postoperative days 1 and 4 to the conventional immunosuppressive regimen used in ABO-compatible (ABO-C) LDLT, without plasmapheresis, splenectomy, or graft local infusion...
October 20, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29052835/role-of-percutaneous-transhepatic-biliary-drainage-in-the-management-of-blunt-liver-trauma-a-case-report
#2
Şükrü Oğuz, Reyyan Yıldırım, Serdar Topaloğlu
The liver is the most commonly injured intra-abdominal organ after blunt trauma. The management of massive liver injury is complex. Percutaneous transhepatic biliary drainage is the first approach considered, particularly for proximal bile duct strictures after liver surgery. A 27-year-old female patient was transferred to our emergency department with grade V blunt injury. Regarding the patient's unresponsive hemodynamic instability, right hepatectomy was performed. The patient presented with benign biliary duct stricture after surgery that were treated via the percutaneous approach...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29051827/membrane-like-structure-in-the-urinary-bladder-neck-of-a-young-cat-diagnosis-and-treatment-using-balloon-dilatation-and-a-balloon-expandable-metallic-stent
#3
Matias Ruiz-Drebing, Fui Yap, Mayank Seth, Ruth Dennis, Elisabet Dominguez
CASE SUMMARY: A 33-month-old, spayed female domestic shorthair cat was referred to the Animal Health Trust for the investigation of urinary incontinence and straining to urinate. A membrane-like structure was detected in the bladder neck, which caused partial obstruction of the urinary bladder. A combination of different imaging techniques, including ultrasonography, radiography, CT and fluoroscopy, was essential in the diagnosis, surgical planning and treatment of this intravesicular stricture...
July 2017: JFMS open reports
https://www.readbyqxmd.com/read/29049233/pediatric-types-i-and-vi-choledochal-cysts-complicated-with-acute-pancreatitis-and-spontaneous-perforation-a-case-report-and-literature-review
#4
Ching-Chung Tsai, Po-Kai Huang, Hsien-Kuan Liu, Yu-Tsun Su, Ming-Chun Yang, Ming-Lun Yeh
RATIONALE: Choledochal cysts are a congenital disorder of the common bile duct that can cause progressive biliary obstruction and biliary cirrhosis. They were classified by Todani into five types. Of these, type VI choledochal cysts are rarely reported in the literature. PATIENT CONCERNS: A 22-month-old girl presented with intermittent epigastralgia for approximately 10 days and fever for three days. Fasting and total parenteral nutrition were administered after admission...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29047047/impact-of-bariatric-surgery-on-outcomes-of-patients-with-inflammatory-bowel-disease-a-nationwide-inpatient-sample-analysis-2004-2014
#5
Prabin Sharma, Thomas R McCarty, Basile Njei
PURPOSE: There is a paucity of data regarding the benefits of bariatric surgery in patients with inflammatory bowel disease (IBD). The primary aim of this study was to evaluate the role of bariatric surgery on clinical outcomes among hospitalized patients with IBD. MATERIALS AND METHODS: The United States (US) National Inpatient Sample database was queried between 2004 and 2014 for discharges with co-diagnoses of morbid obesity and IBD. Hospitalizations with a history of prior-bariatric surgery were also identified...
October 18, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29046958/laparoscopic-choledochoduodenostomy-as-a-reliable-rescue-procedure-for-complicated-bile-duct-stones
#6
Palanisamy Senthilnathan, Dhawal Sharma, Sandeep C Sabnis, S Srivatsan Gurumurthy, E Senthil Anand, V P Nalankilli, Natesan Anand Vijai, Palanivelu Praveen Raj, Ramakrishnan Parthasarathy, Subbaiah Rajapandian, Chinnusamy Palanivelu
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction is generally accepted as first line management for common bile duct (CBD) stones. CBD exploration, either by open or laparoscopic approach nowadays, is usually reserved for ERCP failures, complicated stone locations, along with altered anatomical situations. The aim of this study was to highlight the increasing role of laparoscopic choledochoduodenostomy which is not only a reliable but also as a rescue procedure for those failed ERCP cases due to complicated bile duct stones...
October 18, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29044576/long-term-outcomes-after-hand-sewn-versus-circular-stapled-25-and-29%C3%A2-mm-anastomotic-technique-after-esophagogastrectomy-for-esophageal-cancer
#7
Jack W Rostas, Beunca D Graffree, Charles R Scoggins, Kelly M McMasters, Robert C G Martin
BACKGROUND: Anastomotic stricture following esophagogastrectomy (EG) can lead to significant dysphagia, necessitating interventions such as endoscopic dilatation. These post-operative complications gain importance with the increased survival rate of patients after EG. This study aimed to assess the outcomes of both circular-stapled (CS: 25 and 29 mm) and hand-sewn (HS) anastomoses after EG. METHODS: We reviewed prospectively accrued data from December 2004 to December 2014 identifying all patients undergoing EG for esophageal cancer...
October 16, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29043578/duodenal-crohn-s-disease-a-diagnostic-conundrum
#8
Amy L Lightner, Joel G Fletcher
Gastroduodenal Crohn's disease is rare as most often the disease is found in the terminal ileum and colon rather than the upper gastrointestinal tract. The most common phenotype is stricturing disease which can lead to obstructive-like symptoms. Medical treatment options include proton pump inhibitors and biologic therapy. Endoscopic and surgical intervention may be needed to relieve the obstructive-like symptoms from the stricturing phenotype.
October 17, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29043576/submucosal-tunneling-endoscopic-resection-for-the-treatment-of-gastrointestinal-submucosal-tumors-originating-from-the-muscularis-propria-layer
#9
Chen Du, Enqiang Linghu
Surgical resection and endoscopic resection comprise two alternative options for the treatment of submucosal tumors (SMTs) originating from the muscularis propria (MP) layer. Endoscopic resection is minimally invasive compared with surgical resection. Conventional non-tunneling techniques, such as endoscopic submucosal dissection (ESD), endoscopic submucosal excavation (ESE), and endoscopic full-thickness resection (EFR) have been demonstrated to be safe and effective. However, these techniques fail to maintain the integrity of the mucosa and induce high risk of perforation, infection, and postoperative strictures...
October 17, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29042942/benefits-of-urethroplasty-for-managing-urethral-amyloidosis-a-case-report
#10
Xiaolin Yao, Yufang Yuan, Jiajie Fang, Hai Jiang
Urethral amyloidosis is a rare condition in which eosinophilic amyloid proteins are deposited in the urethra. Only a small number of reports on urethral amyloidosis have been published. Increased interest has been associated with this disease due to its clinical similarities with urothelial carcinoma. A biopsy of the lesion and a histological examination are essential for the correct diagnosis. Conservative management has been suggested by various urologists as the optimal treatment approach for urethral amyloidosis; however, recurrence and urethral stricture are common, and typically further treatment is required...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29040484/esophagocardioplasty-vagotomy-antrectomy-and-roux-en-y-gastrojejunostomy-indication-in-cases-with-severe-esophageal-motor-disfunction
#11
I Braghetto, O Korn, A Csendes, J C Frias
Almost 10% of patients with Crest syndrome associated with severe gastroesophageal reflux and 5-10% of patients with failed cardiomyotomy for achalasia present with cardial or distal esophageal organic stricture. Some of these cases are poor risk patients for surgery and therefore the surgeon must offer a safe procedure with low morbimortality, keeping in mind the pathophysiological motor pattern of these patients.In order to treat the stricture to improve the esophageal transit we treated patients with esophagocardioplasty associated with vagotomy-antrectomy and Roux-en-Y gastrojejunostomy, thereby avoiding the potential acid or biliary reflux in poor risk patients in whom esophagectomy would be a very deleterious procedure...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29039895/effects-of-copaiba-oil-in-the-healing-process-of-urinary-bladder-in-rats
#12
Denilson José Silva Feitosa, Luan Teles Ferreira de Carvalho, Ingrid Rodrigues de Oliveira Rocha, Camila Noura de Brito, Rodrigo Alencar Moreira, Charles Alberto Villacorta de Barros
INTRODUCTION: The appropriate closure of the urinary bladder is important to many urologic procedures to avoid the formation of fistulas and strictures by excessive fibrosis. This paper presents the alterations in the bladder healing process of rats after the topical use of Copaiba oil (Copaifera reticulata). MATERIAL AND METHODS: Ten male Wistar rats were used and randomly divided into two groups: Control group (CG): injected 1ml/kg of saline solution on the suture line; and Copaiba group (CpG): 0...
October 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29039894/ureteral-orifice-involvement-by-urothelial-carcinoma-long-term-oncologic-and-functional-outcomes
#13
Muammer Altok, Ali F Sahin, Mehmet I Gokce, Gokhan R Ekin, Rauf Taner Divrik
PURPOSE: Bladder cancer (BC) may involve the ureteral orifice, and the resection of the orifice has oncological and functional consequences such as development of upper tract urothelial carcinoma (UTUC), vesicoureteral reflux or ureteral stenosis. The aim of this study was to investigate the oncological and functional outcomes of the ureteral orifice resection in BC patients and determine the predictive factors for UTUC development. MATERIALS AND METHODS: A total of 1359 patients diagnosed with BC, between 1992 and 2012, were reviewed retrospectively...
October 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29039059/modified-tubularized-incised-plate-urethroplasty-reduces-the-risk-of-fistula-and-meatal-stenosis-for-proximal-hypospadias-a-report-of-63-cases
#14
Hamid Arshadi, Shabnam Sabetkish, Abdol-Mohammad Kajbafzadeh
PURPOSE: To report the feasibility of modified tubularized incised plate (TIP) urethroplasty technique for proximal hypospadias in 63 cases. METHODS: From January 2004 to March 2010, 63 patients underwent one-stage TIP urethroplasty (modified Snodgrass technique repair) using 2-3 of three covering layers (corpus spongiosum, dartos, and tunica vaginalis). The primary meatus was proximal penile, penoscrotal, scrotal, and perineal in 38, 13, 10, and 2 patients, respectively...
October 16, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29038643/current-diagnostic-and-treatment-strategies-for-eosinophilic-esophagitis
#15
Anna M Lipowska, Robert T Kavitt
Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder of the esophagus diagnosed by the presence of esophageal symptoms accompanied by an esophageal eosinophilic infiltrate. EoE has an increasing worldwide prevalence and can be a cause of dysphagia and food impactions. There is an important role for the use of proton pump inhibitors in the diagnostic pathway of EoE. Treatment paradigms for EoE aim to minimize esophageal inflammation and improve symptom control. Dietary therapy targets dietary allergens and encompasses the elemental diet, the allergy testing-directed elimination diet, and the empiric elimination diet...
September 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29034764/indeterminate-biliary-strictures-a-simplified-approach
#16
Chencheng Xie, Khalil Aloreidi, Bhavesh Patel, Timothy Ridgway, Thavam Thambi-Pillai, Gary Timmerman, Adeel Khan, Muslim Atiq
Pre-operative evaluation of biliary strictures remains challenging. The dilemma that exists is how to balance the risk of failing to detect malignancy and the potential morbidity caused by unnecessary surgery in patients with benign etiologies. With emerging novel diagnostic modalities, this study aims to assess the efficacy of diagnostic techniques and facilitate a clinical approach to indeterminate biliary strictures. Areas covered: Conventional imaging modalities are crucial in identifying the location of a stricture and are helpful for choosing further diagnostic modalities...
October 16, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29034088/emerging-dilemmas-in-the-diagnosis-and-management-of-gastroesophageal-reflux-disease
#17
REVIEW
Peter Kahrilas, Rena Yadlapati, Sabine Roman
Gastroesophageal reflux disease (GERD) is common, but less so than widely reported because of inconsistencies in definition. In clinical practice, the diagnosis is usually based on a symptom assessment without testing, and the extent of diagnostic testing pursued should be limited to that which guides management or which protects the patient from the risks of a potentially morbid treatment or an undetected early (or imminent) esophageal adenocarcinoma or which does both. When testing is pursued, upper gastrointestinal endoscopy is the most useful initial diagnostic test because it evaluates for the major potential morbidities (Barrett's, stricture, and cancer) associated with GERD and facilitates the identification of some alternative diagnostic possibilities such as eosinophilic esophagitis...
2017: F1000Research
https://www.readbyqxmd.com/read/29033756/progression-from-an-inflammatory-to-a-fibrostenotic-phenotype-in-eosinophilic-esophagitis
#18
Nathaniel T Koutlas, Evan S Dellon
Previous studies have suggested that eosinophilic esophagitis (EoE) progresses from chronic inflammation to fibrostenosis. However, natural history data illustrating this progression in individual patients are lacking. Here, we present 6 patients who progressed from an inflammatory to a fibrostenotic phenotype of EoE in the absence of treatment. At the time of diagnosis, none of the patients had significant evidence of fibrostenosis, but they did have other inflammatory findings of EoE such as edema, linear furrows, or exudates...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29032587/team-preparation-for-human-uterus-transplantation-autologous-transplantation-in-sheep-model
#19
Evgeny Solomonov, Naama Marcus Braun, Yariv Siman-Tov, Inbar Ben Shachar
We performed autologous uterus transplantation using the living-sheep donor model for team preparation before human uterine transplantation. Five sequential operations (in 3 ewes) were prospectively conducted. Surgical technique included uterus retrieval, graft preparation, and uterus transplantation. Anastomoses were performed at the level of the external iliac. At 3 weeks follow-up, the uterus and anastomoses were checked for strictures and thrombosis. Two successful auto-transplantations were made, and one failed because of undeveloped uterine arteries (< 1 mm in diameter)...
October 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29032582/national-cohort-study-comparing-severe-medium-term-urinary-complications-following-radical-prostatectomy-robot-assisted-versus-laparoscopic-versus-retropubic-open-radical-prostatectomy
#20
A Sujenthiran, J Nossiter, M Parry, S C Charman, A Aggarwal, H Payne, P Dasgupta, N W Clarke, J van der Meulen, P Cathcart
OBJECTIVES: Despite the rapid adoption of robot-assisted radical prostatectomy (RARP), there is little evidence about the occurrence of medium-term urinary complications with this type of surgery compared to laparoscopic (LRP) or retropubic open radical prostatectomy (ORP). The aim of this study was to evaluate the occurrence of severe urinary complications within two years of surgery in men undergoing RARP, LRP or ORP. PATIENTS AND METHODS: Population-based cohort study of men who underwent RARP (n=4,947), LRP (n= 5,479), or ORP (n=6,873) between 2008 and 2012 in the English National Health Service (NHS) using national cancer registry records linked to Hospital Episodes Statistics - an administrative database of admissions to NHS hospitals...
October 15, 2017: BJU International
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