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https://www.readbyqxmd.com/read/29227173/changes-in-platelet-function-with-inflammation-in-patients-undergoing-vascular-surgery
#1
Bartosz Olechowski, Vikram Khanna, Mark Mariathas, Alexander Ashby, Richard T Dalton, Ian Nordon, Nicola Englyst, Scott Harris, Zoe Nicholas, Kala Thayalasamy, Michael Mahmoudi, Nick Curzen
The role of platelets in ischaemic events is well established. Aspirin represents the default antiplatelet and blocks the metabolism of arachidonic acid (AA) at the cyclo-oxygenase enzyme (COX). AA is commonly used as a test of response to aspirin, but recent data raise uncertainty about the validity of this approach. Specifically, in some patients AA-induced clotting is not suppressed, but the level of COX-dependent AA metabolite, thromboxane B2 (TXB2) is negligible. Furthermore, AA-induced whole blood clotting varies dynamically in individuals, who are aspirin responsive according to TXB2 levels...
December 11, 2017: Platelets
https://www.readbyqxmd.com/read/29216529/sessile-serrated-adenoma-polyp-leading-to-acute-appendicitis-with-multiple-pyogenic-liver-abscesses-a-case-report
#2
Koki Sato, Masataka Banshodani, Masahiro Nishihara, Junko Nambu, Yasuo Kawaguchi, Fumio Shimamoto, Kiyohiko Dohi, Keizo Sugino, Hideki Ohdan
INTRODUCTION: Although appendicitis is a common disease, appendicitis concurrent with liver abscesses and sessile serrated adenoma/polyp (SSA/P) is rare. PRESENTATION OF CASE: A 69-year-old man presented with symptoms of abdominal pain and fever. Computed tomography (CT) revealed multiple liver abscesses and an enlarged appendix with a pseudotumoral appearance, which suggested acute appendicitis. In the emergency operation, ileocecal resection was performed for the perforated appendicitis with an inflammatory mass in the ileocecum...
December 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#3
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29205688/integration-of-radiological-findings-and-a-clinical-score-in-pediatric-appendicitis
#4
Derya Aydin, Caner Turan, Ali Yurtseven, Petek Bayindir, Bade Toker, Zafer Dokumcu, Murat Sezak, Eylem Ulas Saz
BACKGROUND: The efficacy of ultrasonography (US) and abdominal X-ray in combination with PAS is complicated in the diagnosis of acute appendicitis. Abdominal X-ray is as useful as US with clinical assessment when evaluated by experienced pediatric radiologist in acute appendicitis. We aimed to determine the value of US and abdominal X-ray for appendicitis in children when combined with clinical assessment based on the Pediatric Appendicitis Score (PAS). We also aimed to establish a practical pathway for acute appendicitis in childhood...
December 5, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29202817/use-of-cardiovascular-magnetic-resonance-in-the-evaluation-of-a-giant-right-atrial-appendage-aneurysm-a-case-report-and-review-of-the-literature
#5
Lojan Sivakumaran, Karl Sayegh, Emile Mehanna, Frank W Sanchez, Jonathan Fields, Ricardo Cury
BACKGROUND: Right atrial appendage aneurysms are rare entities that may have significant clinical consequences. When co-existing with atrial fibrillation, patients are at risk of developing pulmonary or paradoxical systemic emboli. CASE PRESENTATION: An elderly patient presented to medical attention with symptoms of acute diverticulitis. On abdominal computed tomography, a massively enlarged right atrial appendage aneurysm was discovered incidentally. The aneurysm caused marked compression of the right ventricle and contained an area of hypoenhancement concerning for an intraluminal thrombus...
December 4, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#6
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29197194/the-role-of-self-expandable-metallic-stents-as-bridge-to-surgery-for-the-treatment-of-acute-malignant-colorectal-obstruction-our-experience
#7
Gianpasquale Gallo, Giuseppe Sammarco, Alessandro Paolo Chiriatti, Ferdinando Calabria, Rosario Sacco
INTRODUCTION: Despite the widespread use of screening programs, the colorectal cancer occurs in 7-29% of cases with a bowel obstruction, needing an immediate decompression treatment by emergency surgery; unfortunately, the emergency surgery is characterized by high morbidity and mortality rates. The endoscopic placement of self-expandable metallic stents can be a useful alternative, allowing to decompress the acute obstruction in a short time, in order to correct dehydration, electrolytic imbalance and to improve the overall clinical conditions prior to adequately plan the intervention of elective surgery...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29191200/emergency-general-surgery-in-rwandan-district-hospitals-a-cross-sectional-study-of-spectrum-management-and-patient-outcomes
#8
Christophe Mpirimbanyi, Alexandre Nyirimodoka, Yihan Lin, Bethany L Hedt-Gauthier, Jackline Odhiambo, Theoneste Nkurunziza, Joaquim M Havens, Jack Omondi, Emile Rwamasirabo, Faustin Ntirenganya, Gabriel Toma, Joel Mubiligi, Scheilla Bayitondere, Robert Riviello
BACKGROUND: Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. METHODS: This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions...
December 1, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29188353/-quality-indicators-for-surgery-of-rectal-cancer-evidence-based-development-of-a-set-of-indicators-for-quality
#9
REVIEW
A Wiegering, H-J Buhr, C Klinger, A Fürst, T Schiedeck, O Schwandner, S Stelzner, C-T Germer
The definition of valid quality indicators is an essential task of medical self-administration and quality assurance. Based on the literature and the results of the Study, Documentation, and Quality Center (StuDoQ) Rectal Cancer Registry, we suggest the following QIs: rate of circumferential resection margin (CRM) positive resected material, rate of anastomotic leak in patients with anastomoses, rate of abdominal wound healing disorders and rate of patients with newly established permanent urinary diversion...
November 29, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29185407/duodenal-perforation-due-to-ingested-partial-denture
#10
Muhammad Siddiq, Ahmad Uzair Qureshi, Muhammad Shahid Farooq, Abrar Ashraf Ali
Ingestion of foreign bodies including dentures can be a cause of morbidity and mortality. We report a case of poor-fit denture in an elderly male with pulmonary and musculoskeletal comorbidities, who presented as an acute abdomen. The pin attached to the denture caused perforation of first part of duodenum. The only positive finding prior to surgery was a radiopaque density in the abdominal radiograph of the patient and air under the diaphragm. It is important for all the surgeons dealing with acute care patients to be aware of different designs and constructions of dentures...
December 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29174884/preoperative-progressive-pneumoperitoneum-in-obese-patients-with-loss-of-domain-hernias
#11
Antonio Carlos Valezi, Barbara Godinho Ferreira de Melo, Antonio Cesar Marson, Mario Liberatti, Ascencio Garcia Lopes
BACKGROUND: Repair of hernias with loss of domain in obese patients can lead to acute respiratory failure. OBJECTIVES: The objective of this study was to analyze preoperative progressive pneumoperitoneum (PPP) in increasing abdominal cavity volume and its impact on respiratory function. SETTING: The study was conducted at the University Hospital, State University of Londrina, Brazil, which is a referral center for the treatment of obesity...
October 16, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29171831/physical-performance-following-acute-high-risk-abdominal-surgery-a-prospective-cohort-study
#12
Line Rokkedal Jønsson, Lina Holm Ingelsrud, Line Toft Tengberg, Thomas Bandholm, Nicolai Bang Foss, Morten Tange Kristensen
BACKGROUND: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical performance and barriers to independent mobilization among patients who received AHA surgery (postoperative days [POD] 1-7). METHODS: Patients undergoing AHA surgery were consecutively enrolled from a university hospital in Denmark...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29171828/analysis-of-postdischarge-costs-following-emergent-general-surgery-in-elderly-patients
#13
Gilgamesh J Eamer, Fiona Clement, Jenelle L Pederson, Thomas A Churchill, Rachel G Khadaroo
BACKGROUND: As populations age, more elderly patients will undergo surgery. Frailty and complications are considered to increase in-hospital cost in older adults, but little is known on costs following discharge, particularly those borne by the patient. We examined risk factors for increased cost and the type of costs accrued following discharge in elderly surgical patients. METHODS: Acute abdominal surgery patients aged 65 years and older were prospectively enrolled...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29165775/re-operative-abdominal-predictive-score-a-prognostic-model-combining-acute-re-intervention-predictive-index-and-intra-abdominal-pressure
#14
Caridad de Dios Soler-Morejón, Tomás Ariel Lombardo-Vaillant, Teddy Osmín Tamargo-Barbeito, Robert Wise, Manu L N G Malbrain
BACKGROUND: The decision to re-operate after abdominal surgery is still difficult, especially in the setting of intra-abdominal sepsis. Mathematical models provide a good aid to both diagnosis and decision-making. METHODS: A prospective observational study was conducted with 300 patients consecutively admitted to the intensive care unit of an academic institution affiliated to Calixto García Medical Faculty following abdominal surgery from January 2008 to January 2010...
November 22, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29164078/internal-hernia-masquerading-as-necrotizing-enterocolitis
#15
Ranjit I Kylat
In extremely preterm infants, acute abdominal emergencies are fortunately less common with improving care. Spontaneous intestinal perforation and necrotizing enterocolitis are conditions where emergency surgery is most often needed. Conservative medical management and placement of temporary drain are often used in the initial management. Internal hernia (IH) is an uncommon cause of bowel obstruction in neonates, is difficult to diagnose and unfortunately are found only at autopsy. The presentation in preterm infants, distinction between these conditions, and the need for early diagnosis of IH are discussed...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29155635/case-248-cystic-duodenal-dystrophy-with-groove-pancreatitis
#16
Aruna R Patil, Shrivalli Nandikoor, Govindarajan Mallarajapatna, Swarna Shivakumar
History A 59-year-old man presented to the gastroenterology outpatient department with acute abdominal pain centered in the epigastrium. He had experienced similar episodes of abdominal pain in the past that had been treated with surgery. He reported multiple failed attempts at upper gastrointestinal endoscopy. Laboratory tests were performed at the time of admission and revealed a serum glutamic-oxaloacetic transaminase level of 9 U/L [0.15 μkat/L] (normal range, 5-40 U/L [0.08-0.67 μkat/L]), a serum glutamic-pyruvic transaminase level of 34 U/L [0...
December 2017: Radiology
https://www.readbyqxmd.com/read/29155250/surgical-management-of-acute-appendicitis-in-adults-a-review-of-current-techniques
#17
REVIEW
Maximilian Sohn, Ayman Agha, Stefan Bremer, Kai S Lehmann, Marcus Bormann, Alfred Hochrein
Acute appendicitis is one of the most frequent disorders in abdominal surgery. Therefore, appendectomy is a matter of significant interest in that field. Yet, four different techniques are available: open appendectomy, (conventional) laparoscopic appendectomy, single port laparoscopic appendectomy and NOTES-appendectomy with its different variations. To evaluate the current state of the art in appendectomy a bibliographic search was conducted. All prospectively randomized trials and national register cohort studies published between 1/2010 and 5/2016 were included into the analysis...
November 18, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29148099/circulating-pcsk9-is-lowered-acutely-following-surgery
#18
Irena Druce, Hussein Abujrad, Seham Chaker, Hilary Meggison, Andrew Hill, Angela Raymond, Janice Mayne, Teik Chye Ooi
BACKGROUND: A decrease in serum low-density lipoprotein cholesterol (LDL-C) is well documented after acute stress. Plasma proprotein convertase subtilisin kexin 9 (PCSK9), which promotes degradation of low-density lipoprotein receptor (LDL-R) resulting in reduced plasma clearance of low-density lipoproteins (LDL) and an increase in serum LDL-C, would be predicted to decrease. Yet, a few studies have demonstrated an increase 1-8 days after acute stress. Our objective was to assess the earlier status of plasma PCSK9, within the first 24 hours of onset of stress...
November 17, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29147897/vacuum-assisted-wound-closure-with-mesh-mediated-fascial-traction-achieves-better-outcomes-than-vacuum-assisted-wound-closure-alone-a-comparative-study
#19
Giuseppe Salamone, Leo Licari, Giovanni Guercio, Albert Comelli, Mirko Mangiapane, Nicolò Falco, Roberta Tutino, Noemi Bagarella, Sofia Campanella, Calogero Porrello, Roberto Gullo, Gianfranco Cocorullo, Gaspare Gulotta
BACKGROUND: Open abdomen (OA) permits the application of damage control surgery principles when abdominal trauma, sepsis, severe acute peritonitis and abdominal compartmental syndrome (ACS) occur. METHODS: Non-traumatic patients treated with OA between January 2010 and December 2015 were identified in a prospective database, and the data collected were retrospectively reviewed. Patients' records were collected from charts and the surgical and intensive care unit (ICU) registries...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29147478/abdominal-pain-with-a-twist-a-rare-presentation-of-acute-gastric-volvulus
#20
David P Chen, Saqib Walayat, Imran L Balouch, Daniel K Martin, Teresa J Lynch
Acute gastric volvulus is a life threatening condition requiring early diagnosis and aggressive management. Diagnosis of gastric volvulus remains a challenge for clinicians due to variable, non-specific clinical presentation, which requires a high level of suspicion. It should be considered in patients presenting with chest pain and/or epigastric pain, especially in the elderly population. Endoscopic de-rotation could be initially attempted as a therapeutic modality especially in patients who cannot undergo surgery...
2017: Journal of Community Hospital Internal Medicine Perspectives
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