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https://www.readbyqxmd.com/read/29678565/simplification-of-first-line-antibacterial-regimen-for-complicated-appendicitis-in-children-was-associated-with-better-adherence-to-guidelines-and-reduced-use-of-antibiotics
#1
Marion Taleb, Nicolas Nardi, Alexis Arnaud, Nathalie Costet, Pierre-Yves Donnio, Charlotte Engrand, Edouard Habonimana, Eric Wodey, Pierre Tattevin
Acute appendicitis in children requires early surgery, and a short course of antibiotics active on Enterobacteriaceae and anaerobes. Although aminoglycoside-containing 3-drug regimen have been used successfully for decades, simpler regimens with similar efficacy are increasingly used. We aimed to evaluate the impact of a switch from the combination of cefotaxime, metronidazole, and gentamicin (regimen 1), to piperacillin-tazobactam (regimen 2), as first-line regimen for complicated acute appendicitis in children...
April 17, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29673677/torsion-of-pedunculated-subserous-uterine-leiomyoma-a-rare-complication-of-a-common-disease
#2
Yen-Ling Lai, Yu-Li Chen, Chi-An Chen, Wen-Fang Cheng
OBJECTIVE: To evaluate the clinical presentations, diagnosis, management, and outcomes of torsion of the pedunculated subserous uterine leiomyoma. MATERIALS AND METHODS: We retrospectively reviewed medical records of patients with subserous uterine leiomyomas undergoing surgeries at National Taiwan University Hospital from January 2001 to December 2015. RESULTS: Five cases of torsion of pedunculated subserous uterine leiomyoma were identified...
April 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29669701/crizotinib-in-patients-with-advanced-inoperable-inflammatory-myofibroblastic-tumours-with-and-without-anaplastic-lymphoma-kinase-gene-alterations-european-organisation-for-research-and-treatment-of-cancer-90101-create-a-multicentre-single-drug-prospective-non
#3
Patrick Schöffski, Jozef Sufliarsky, Hans Gelderblom, Jean-Yves Blay, Sandra J Strauss, Silvia Stacchiotti, Piotr Rutkowski, Lars H Lindner, Michael G Leahy, Antoine Italiano, Nicolas Isambert, Maria Debiec-Rychter, Raf Sciot, Thomas Van Cann, Sandrine Marréaud, Axelle Nzokirantevye, Sandra Collette, Agnieszka Wozniak
BACKGROUND: An inflammatory myofibroblastic tumour (IMFT) is a rare mesenchymal neoplasm characterised by anaplastic lymphoma kinase (ALK) gene rearrangements. We assessed the activity and safety of crizotinib, a tyrosine kinase inhibitor, targeting ALK in patients with advanced IMFT either with or without ALK alterations. METHODS: We did a multicentre, biomarker-driven, single-drug, non-randomised, open-label, two-stage phase 2 trial (European Organisation for Research and Treatment of Cancer 90101 CREATE) at 13 study sites (five university hospitals and eight specialty clinics) in eight European countries (Belgium, France, Germany, Italy, Netherlands, Poland, Slovakia, and the UK)...
April 12, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29664798/pouch-volvulus-in-patients-having-undergone-restorative-proctocolectomy-for-ulcerative-colitis-a-case-series
#4
Rachel M Landisch, Paul M Knechtges, Mary F Otterson, Kirk A Ludwig, Timothy J Ridolfi
BACKGROUND: Restorative proctocolectomy with IPAA improves quality of life in patients with medically refractory ulcerative colitis. Although bowel obstruction is common, pouch volvulus is rare and described only in case reports. Diagnosis can be challenging, resulting in delayed care and heightened morbidity. OBJECTIVE: The purpose of this study was to delineate the symptoms and successful management strategies used in patients with IPAA volvulus that result in pouch salvage...
April 16, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29664657/enterobius-vermicularis-a-cause-of-abdominal-pain-mimicking-acute-appendicitis-in-children-a-retrospective-cohort-study
#5
Mohamed Zouari, Hamid Louati, Imen Abid, Fatma Trabelsi, Mahdi Ben Dhaou, Mohamed Jallouli, Riadh Mhiri
BACKGROUND: Enterobius vermicularis (EV) is the most common helminthic infection in the world. This small parasite is predominant in the pediatric population. The presence of EV in the appendix can cause or mimick appendicitis. The aim of our study was to compare patients with EV infection and those without EV infection, and to identify predictive factors that may help the diagnosis of EV infection in patients presenting with right iliac fossa pain and avoid negative appendectomy. METHODS: A retrospective analysis of all the appendices removed between January 2012 and December 2016 was conducted at the department of pediatric surgery, Hedi Chaker Hospital, Sfax, Tunisia...
February 1, 2018: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29663944/repair-of-a-large-ventral-hernia-in-a-rhesus-macaque-macaca-mulatta-by-using-an-abdominal-component-separation-technique
#6
Steve J Kempton, Jacqueline S Israel, Saverio Capuano Iii, Samuel O Poore
Here we present a 32-y-old rhesus macaque (Macaca mulatta) with a large recurrent ventral incisional hernia. The initial surgery included midline celiotomy for treatment of endometriosis, in which the animal developed a hernia that was repaired with interposition of mesh. Hernia recurrence at 1 y resulted in a defect measuring 7 × 13 cm, with loss of abdominal domain. Skin breakdown was noted with areas of exposed mesh through the skin with associated acute on chronic infection. Clinically, the animal was lethargic, not eating, and failing to thrive...
April 2, 2018: Comparative Medicine
https://www.readbyqxmd.com/read/29662656/stereotactic-body-radiation-therapy-for-palliative-management-of-pancreatic-adenocarcinoma-in-elderly-and-medically-inoperable-patients
#7
John F Ryan, Lauren M Rosati, Vincent P Groot, Dung T Le, Lei Zheng, Daniel A Laheru, Eun J Shin, Juan Jackson, Joseph Moore, Amol K Narang, Joseph M Herman
Stereotactic body radiation therapy (SBRT) represents a promising treatment option for patients with localized pancreatic ductal adenocarcinoma (PDAC) who cannot tolerate surgical therapy. We retrospectively reviewed the records of patients with localized PDAC treated with SBRT at our institution between 2010 and 2016 to identify patients deemed medically inoperable due to poor performance status, advanced age, and/or comorbid conditions. Overall survival (OS), progression-free survival (PFS), and local progression-free survival (LPFS) were estimated using Kaplan-Meier curves...
March 27, 2018: Oncotarget
https://www.readbyqxmd.com/read/29659473/external-validation-of-a-5-variable-clinical-prediction-rule-for-identifying-children-at-very-low-risk-for-intra-abdominal-injury-following-blunt-abdominal-trauma
#8
Chase A Arbra, Adam M Vogel, Leah Plumblee, Jingwen Zhang, Patrick D Mauldin, Melvin S Dassinger, Robert T Russell, Martin L Blakely, Christian J Streck
BACKGROUND: A clinical prediction rule was previously developed by the Pediatric Surgery Research Collaborative (PedSRC) to identify patients at very low risk for intra-abdominal injury (IAI) and intra-abdominal injury receiving an acute intervention (IAI-I) who could safely avoid abdominal computed tomography (CT) scans following blunt abdominal trauma (BAT). Our objective was to externally validate the rule. METHODS: The public use dataset was obtained from the Pediatric Emergency Care Applied Research Network (PECARN) Intra-abdominal Injury Study...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659470/meta-analysis-of-perioperative-outcomes-of-acute-laparoscopic-vs-open-repair-of-perforated-gastroduodenal-ulcers
#9
Roberto Cirocchi, Kjetil Soreide, Salomone Di Saverio, Elena Rossi, Alberto Arezzo, Mauro Zago, Iosief Abraha, Nereo Vettoretto, Massimo Chiarugi
BACKGROUND: Surgery is the treatment of choice for perforated peptic ulcer disease (PUD). The aim of the present review is to compare the perioperative outcomes of acute laparoscopic versus open repair for PUD. METHODS: A systematic literature search was performed for randomized controlled trials (RCTs) published in PubMed, SCOPUS and Web of Science RESULTS: The search included eight RCTs: 615 patients comparing laparoscopic (307 patients) versus open peptic perforated ulcer repair (308 patients)...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#10
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29628572/impact-of-targeted-preoperative-optimization-on-clinical-outcome-in-emergency-abdominal-surgeries-a-prospective-randomized-trial
#11
Ashish Sethi, Miltan Debbarma, Neeraj Narang, Anudeep Saxena, Mamta Mahobia, Gaurav Singh Tomar
Background: Perforation peritonitis continues to be one of the most common surgical emergencies that need a surgical intervention most of the times. Anesthesiologists are invariably involved in managing such cases efficiently in perioperative period. Aims: The assessment and evaluation of Acute Physiology and Chronic Health Evaluation II (APACHE II) score at presentation and 24 h after goal-directed optimization, administration of empirical broad-spectrum antibiotics, and definitive source control postoperatively...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627774/acute-lower-limb-ischaemia-secondary-to-intestinal-occlusion
#12
Francois-Charles Malo, Philippe Acar, Véronique Lapie, Valérie Bédard
In general, acute lower limb ischaemia is caused by embolic, thrombotic or traumatic phenomena. Here, we describe the case of a 67-year-old woman in an emergency room setting who was initially assessed for paralysis and numbness of her lower left limb. On physical examination, the abdomen was distended and non-compressible. An abdominal AngioScan showed complete occlusion of the left iliac artery by extrinsic compression of the dilated small intestine. After a review of the literature, no case was found describing a lower limb ischaemia by extrinsic vascular compression secondary to a compartment syndrome caused by small bowel obstruction...
April 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29626245/a-new-method-for-surgical-abdominal-mass-closure-after-abdominal-fascial-dehiscence-using-nasogastric-tube-and-hemovac-perforator-a-case-series-study
#13
Jalal Vahedian, Sepideh Jahanian, Behrouz Banivaheb, Nima Hemmati, Mehrnaz Ghavamipour, Majid Chegini, Mahdi Alemrajabi
BACKGROUND: As the challenge for finding the best abdominal incision closure technique continues, surgeons are aiming to minimize postoperative wound complications such as wound dehiscence and hernia as an acute or late manifestation. In order to achieve this goal, several abdominal opening and closure techniques have been tried. In this article, we describe a method in which we used a nasogastric tube (NGT) in mass closure for patients with fascial dehiscence. METHODS: In this case-series study, a total number of 25 patients participated...
April 6, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29620475/vascular-injury-at-laparoscopy-a-guide-to-management
#14
Victoria Asfour, Edward Smythe, Rizwan Attia
Vascular laparoscopic injuries are rare (0.2/1000), however, they are associated with 6-13% morbidity and mortality. Commonest sites for catastrophic haemorrhage are the right iliac vessels, inferior vena cava and less commonly the abdominal aorta. The injuries commonly occur at entry using a Veress needle or insertion of trocars. These risks are inherent to all laparoscopic surgery. A systematic approach for managing these includes prompt recognition, communication within the operative team, immediate resuscitation and specific operative strategies for the control of vascular haemorrhage based on the location and severity of the injury...
April 5, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29619755/high-frequency-of-computer-tomography-and-surgery-for-abdominal-pain-after-roux-en-y-gastric-bypass
#15
Jorunn Sandvik, Torstein Hole, Christian A Klöckner, Bård E Kulseng, Arne Wibe
INTRODUCTION: Acute, intermittent, and chronic abdominal pain is a common complaint after Roux-en-Y gastric bypass (RYGB). OBJECTIVES: The aim of the study was to evaluate the use of medical imaging and the need for surgery treating abdominal pain after RYGB in a cohort with long-term follow-up. METHODS: Data from 569 patients who underwent RYGB as the primary bariatric procedure at a public hospital in Norway between April 2004 and June 2011 were prospectively registered in a local quality registry for bariatric surgery...
April 4, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29614507/renoprotective-postoperative-monitoring-what-is-the-best-method-for-computing-renal-perfusion-pressure-an-observational-prospective-multicentre-study
#16
Csaba Kopitko, Laszlo Medve, Tibor Gondos
BACKGROUND: Low mean arterial pressure (MAP) is a well-known risk factor for postoperative acute kidney injury (AKI), but probably it is not the sole hemodynamic parameter that can influence the development of renal failure. There are data in cardiac patients supporting the role of renal venous congestion in the development of AKI. The aim of our study was to determine a combination of factors best predicting the development of AKI. METHODS: Data were collected prospectively for adult patients admitted after major abdominal surgery to 9 Hungarian intensive care units...
April 3, 2018: Nephron
https://www.readbyqxmd.com/read/29613959/evaluation-and-management-of-traumatic-diaphragmatic-injuries-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#17
Amy A McDonald, Bryce R H Robinson, Louis Alarcon, Patrick L Bosarge, Heath Dorion, Elliott R Haut, Jeremy Juern, Firas Madbak, Srinivas Reddy, Patricia Weiss, John J Como
BACKGROUND: Traumatic diaphragm injuries (TDI) pose both diagnostic and therapeutic challenges in both the acute and chronic phases. There are no published practice management guidelines to date for TDI. We aim to formulate a practice management guideline for TDI using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. METHODS: The working group formulated five Patient, Intervention, Comparator, Outcome (PICO) questions regarding the following topics: 1) diagnostic approach (laparoscopy vs...
April 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29611896/outcomes-of-early-versus-delayed-laparoscopic-cholecystectomy-for-acute-cholecystitis-performed-at-a-single-institution
#18
Atsushi Kohga, Kenji Suzuki, Takuya Okumura, Kimihiro Yamashita, Jun Isogaki, Akihiro Kawabe, Taizo Kimura
INTRODUCTION: Debate continues regarding the clinical outcomes of early laparoscopic cholecystectomy (ELC) versus delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis (AC). The aim of this retrospective study was to compare clinical outcomes of ELC and DLC. METHODS: This study consisted of 465 patients who had undergone laparoscopic cholecystectomy for AC between January 2000 and February 2017. Patients were divided between an ELC group (patients who underwent laparoscopic cholecystectomy within 6 days of symptom onset, n = 288) and a DLC group (patients who underwent laparoscopic cholecystectomy at least 7 days from symptom onset, n = 177), and clinical outcomes were compared...
April 3, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29601328/statin-loading-in-cardiovascular-surgery-never-too-early-to-treat
#19
Niki Katsiki, Filippos Triposkiadis, Athanasios D Giannoukas, Dimitri P Mikhailidis
PURPOSE OF REVIEW: The effects of statin loading before, during or after vascular interventions on cardiovascular and renal outcomes are discussed. Furthermore, the selection of optimal statin type and dose, according to current evidence or guidelines, is considered. The importance of treating statin intolerance and avoiding statin discontinuation is also discussed. RECENT FINDINGS: Statin loading has been shown to beneficially affect cardiovascular outcomes, total mortality and/or contrast-induced acute kidney injury, in patients undergoing vascular procedures such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), carotid endarterectomy (CEA), carotid artery stenting, endovascular aneurysm repair, open abdominal aortic aneurysms (AAA) repair and lower extremities vascular interventions...
March 29, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29594001/urinary-ascites-in-late-onset-of-bladder-injury-post-laparoscopic-hysterectomy
#20
Josette C Dawkins, Gregory K Lewis, Benjamin Christensen, Morris Wortman
Urinary tract injuries are unfortunate complications of pelvic surgery. With the increasing popularity of minimally invasive surgery, a thorough understanding of electrosurgical instrumentation and their thermal spread is important to reduce patient injuries. The index patient was a 50 year old woman who underwent a supracervical hysterectomy 5 years prior to her presentation with pelvic pain and dysuria. When her symptoms failed to improve despite antibiotic and analgesic therapy, an abdominal CT scan revealed an ovarian cyst and ascites...
October 2017: Case Reports in Women's Health
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