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Acute care Surgery

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By Yasser Abbas Sr Consultant general surgery
https://www.readbyqxmd.com/read/28591533/management-of-septic-shock
#1
Rebecca E Berger, Emanuel Rivers, Mitchell M Levy
New England Journal of Medicine, Volume 376, Issue 23, Page 2282-2285, June 2017.
June 8, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/27919449/nonsteroidal-anti-inflammatory-drugs-may-affect-cytokine-response-and-benefit-healing-of-combat-related-extremity-wounds
#2
COMPARATIVE STUDY
Felipe A Lisboa, Matthew J Bradley, Matthew T Hueman, Seth A Schobel, Beverly J Gaucher, Edda L Styrmisdottir, Benjamin K Potter, Jonathan A Forsberg, Eric A Elster
BACKGROUND: After adequate operative debridement and antimicrobial therapies, combat-related extremity wounds that either heal or fail are both associated with a distinct inflammatory response. Short-term use of nonsteroidal anti-inflammatory drugs in postoperative pain management may affect this response and, by consequence, the healing potential of these wounds. We investigated whether patients treated with nonsteroidal anti-inflammatory drugs had a distinct inflammatory response; different rates of critical colonization, defined as >10(5) colony forming units on quantitative bacteriology; and healing potential...
April 2017: Surgery
https://www.readbyqxmd.com/read/28436602/accuracy-of-circulating-histones-in-predicting-persistent-organ-failure-and-mortality-in-patients-with-acute-pancreatitis
#3
T Liu, W Huang, P Szatmary, S T Abrams, Y Alhamdi, Z Lin, W Greenhalf, G Wang, R Sutton, C H Toh
BACKGROUND: Early prediction of acute pancreatitis severity remains a challenge. Circulating levels of histones are raised early in mouse models and correlate with disease severity. It was hypothesized that circulating histones predict persistent organ failure in patients with acute pancreatitis. METHODS: Consecutive patients with acute pancreatitis fulfilling inclusion criteria admitted to Royal Liverpool University Hospital were enrolled prospectively between June 2010 and March 2014...
August 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28528561/angiotensin-ii-for-the-treatment-of-vasodilatory-shock
#4
RANDOMIZED CONTROLLED TRIAL
Ashish Khanna, Shane W English, Xueyuan S Wang, Kealy Ham, James Tumlin, Harold Szerlip, Laurence W Busse, Laith Altaweel, Timothy E Albertson, Caleb Mackey, Michael T McCurdy, David W Boldt, Stefan Chock, Paul J Young, Kenneth Krell, Richard G Wunderink, Marlies Ostermann, Raghavan Murugan, Michelle N Gong, Rakshit Panwar, Johanna Hästbacka, Raphael Favory, Balasubramanian Venkatesh, B Taylor Thompson, Rinaldo Bellomo, Jeffrey Jensen, Stew Kroll, Lakhmir S Chawla, George F Tidmarsh, Adam M Deane
BACKGROUND: Vasodilatory shock that does not respond to high-dose vasopressors is associated with high mortality. We investigated the effectiveness of angiotensin II for the treatment of patients with this condition. METHODS: We randomly assigned patients with vasodilatory shock who were receiving more than 0.2 μg of norepinephrine per kilogram of body weight per minute or the equivalent dose of another vasopressor to receive infusions of either angiotensin II or placebo...
August 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28139311/fluid-resuscitation-of-trauma-patients-how-much-fluid-is-enough-to-determine-the-patient-s-response
#5
Yasuaki Mizushima, Shota Nakao, Koji Idoguchi, Tetsuya Matsuoka
No abstract text is available yet for this article.
June 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28237047/percutaneous-cholecystostomy-in-the-management-of-high-risk-patients-presenting-with-acute-cholecystitis-timing-and-outcome-at-a-single-institution
#6
Shiri Zarour, Ashraf Imam, Guennadi Kouniavsky, Guy Lin, Andrew Zbar, Eli Mavor
BACKGROUND: Cholecystectomy is the standard of care in acute cholecystitis (AC). Percutaneous cholecystostomy (PC) is an effective alternative for high-risk surgical cases. METHODS: A retrospective analysis is presented of AC patients treated with PC drainage at a single tertiary institution over a 21 month period, assessing outcome and complications. RESULTS: Of 119 patients, 103 had clinical improvement after PC insertion. There were 7 peri-procedural deaths (5...
September 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/21354752/psychiatric-drug-induced-fatal-abdominal-compartment-syndrome
#7
Sophie Jambet, Boris Guiu, Pierre Olive-Abergel, Aurélie Grandvuillemin, Jean-Michel Yeguiayan, Pablo Ortega-Deballon
Several drugs used in psychiatry may induce constipation, paralytic ileus, or acute megacolon (Ogilvie's syndrome). We report here 2 cases of patients presenting with fatal abdominal compartment syndrome related to the absorption of antidepressants and benzodiazepines. Two patients (a 27-year-old man and a 57-year-old woman) with a previous psychiatric history and treatment with psychiatric drugs were admitted to the emergency department for coma. Both presented hypothermia; a hard, distended abdomen; and ischemia of the lower limbs...
March 2012: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/22452903/acute-anterior-compartment-syndrome-associated-with-psychogenic-polydipsia
#8
Licia Maiocchi, Elsa Bernardi
OBJECTIVE: The aim of this paper is to describe the association of psychogenic polydipsia with anterior compartment syndrome. METHOD: Case report. RESULTS: A 31-year-old man with glucose-6-phosphate-dehydrogenase (G6PD) deficiency had a history of paranoid schizophrenia from age 16 complicated by the use of drugs. Four years after the initial diagnosis of schizophrenia, he developed psychogenic polydipsia. This was complicated by episodic severe acute hyponatraemia with seizures and, on one occasion, by generalized rhabdomyolysis...
April 2012: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27762448/cost-effectiveness-of-emergency-versus-delayed-laparoscopic-cholecystectomy-for-acute-gallbladder-pathology
#9
COMPARATIVE STUDY
A J Sutton, R S Vohra, M Hollyman, P J Marriott, A Buja, D Alderson, S Pasquali, E A Griffiths
BACKGROUND: The optimal timing of cholecystectomy for patients admitted with acute gallbladder pathology is unclear. Some studies have shown that emergency cholecystectomy during the index admission can reduce length of hospital stay with similar rates of conversion to open surgery, complications and mortality compared with a 'delayed' operation following discharge. Others have reported that cholecystectomy during the index acute admission results in higher morbidity, extended length of stay and increased costs...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/26841720/mortality-from-trauma-haemorrhage-and-opportunities-for-improvement-in-transfusion-practice
#10
MULTICENTER STUDY
S J Stanworth, R Davenport, N Curry, F Seeney, S Eaglestone, A Edwards, K Martin, S Allard, M Woodford, F E Lecky, K Brohi
BACKGROUND: The aim of this study was to describe the prevalence, patterns of blood use and outcomes of major haemorrhage in trauma. METHODS: This was a prospective observational study from 22 hospitals in the UK, including both major trauma centres and smaller trauma units. Eligible patients received at least 4 units of packed red blood cells (PRBCs) in the first 24 h of admission with activation of the massive haemorrhage protocol. Case notes, transfusion charts, blood bank records and copies of prescription/theatre charts were accessed and reviewed centrally...
March 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/26460664/diagnosis-and-treatment-of-acute-extremity-compartment-syndrome
#11
REVIEW
Arvind G von Keudell, Michael J Weaver, Paul T Appleton, Paul T Appelton, Donald S Bae, George S M Dyer, Marilyn Heng, Jesse B Jupiter, Mark S Vrahas
Acute compartment syndrome of the extremities is well known, but diagnosis can be challenging. Ineffective treatment can have devastating consequences, such as permanent dysaesthesia, ischaemic contractures, muscle dysfunction, loss of limb, and even loss of life. Despite many studies, there is no consensus about the way in which acute extremity compartment syndromes should be diagnosed. Many surgeons suggest continuous monitoring of intracompartmental pressure for all patients who have high-risk extremity injuries, whereas others suggest aggressive surgical intervention if acute compartment syndrome is even suspected...
September 26, 2015: Lancet
https://www.readbyqxmd.com/read/27090535/a-deliberately-restricted-laryngeal-view-with-the-glidescope%C3%A2-video-laryngoscope-is-associated-with-faster-and-easier-tracheal-intubation-when-compared-with-a-full-glottic-view-a-randomized-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Yuqi Gu, Joshua Robert, George Kovacs, Andrew D Milne, Ian Morris, Orlando Hung, Kirk MacQuarrie, Sean Mackinnon, J Adam Law
INTRODUCTION: During video laryngoscopy (VL) with angulated or hyper-curved blades, it is sometimes difficult to complete tracheal intubation despite a full view of the larynx. When using indirect VL, it has been suggested that it may be preferable to obtain a deliberately restricted view of the larynx to facilitate passage of the endotracheal tube. We used the GlideScope® GVL video laryngoscope (GVL) to test whether deliberately obtaining a restricted view would result in faster and easier tracheal intubation than with a full view of the larynx...
August 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27162071/a-systematic-review-comparing-laparoscopic-vs-open-adhesiolysis-in-patients-with-adhesional-small-bowel-obstruction
#13
REVIEW
Muhammad S Sajid, Amir H Khawaja, Parv Sains, Krishna K Singh, Mirza K Baig
BACKGROUND AND OBJECTIVE: To evaluate whether surgical outcomes differ between laparoscopic vs open approach for adhesiolysis in patients presenting with adhesional small bowel obstruction (ASBO). DATA SOURCE: A systematic review of literature on published studies reporting the surgical outcomes after laparoscopic vs open adhesiolysis for ASBO was undertaken using the principles of meta-analysis. RESULTS: Fourteen comparative studies on 38,057 patients, evaluating the surgical outcomes in patients undergoing laparoscopic vs open adhesiolysis for ASBO were analyzed...
July 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/26237037/vasopressors-for-the-treatment-of-septic-shock-systematic-review-and-meta-analysis
#14
REVIEW
Tomer Avni, Adi Lador, Shaul Lev, Leonard Leibovici, Mical Paul, Alon Grossman
OBJECTIVE: International guidelines recommend dopamine or norepinephrine as first-line vasopressor agents in septic shock. Phenylephrine, epinephrine, vasopressin and terlipressin are considered second-line agents. Our objective was to assess the evidence for the efficiency and safety of all vasopressors in septic shock. METHODS: Systematic review and meta-analysis. We searched electronic database of MEDLINE, CENTRAL, LILACS and conference proceedings up to June 2014...
2015: PloS One
https://www.readbyqxmd.com/read/26602425/lidocaine-induced-cardiac-arrest-in-the-emergency-department-effectiveness-of-lipid-therapy
#15
Kevin James Tierney, Tiffany Murano, Brenda Natal
BACKGROUND: Local anesthetics are commonly used in the emergency department (ED). Overdoses can lead to disastrous complications including cardiac toxicity and arrest. Recognition of local anesthetic systemic toxicity (LAST) is important; however, prevention is even more critical. Knowledge of proper lidocaine dosage can prevent LAST. LAST may be effectively treated with lipid emulsion therapy. Although the mechanism is not well understood, its use may have a profound impact on morbidity and mortality...
January 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25499245/the-value-of-ultrasonography-in-the-diagnosis-of-appendicitis
#16
N D'Souza, C D'Souza, D Grant, E Royston, M Farouk
INTRODUCTION: Ultrasonography is a commonly used investigation in the UK for patients with right iliac fossa pain where the diagnosis of appendicitis is unclear. The published sensitivity and specificity of ultrasonography is higher than the results observed by clinicians in every day practice. The aim of this study was to elucidate the real-world value of ultrasonography in the diagnosis of appendicitis, and its impact on negative appendicectomy rates (NAR). METHODS: A retrospective multicentre audit was conducted at three UK hospitals over a twelve month period in 2012...
January 2015: International Journal of Surgery
https://www.readbyqxmd.com/read/24953265/a-simple-algorithm-reduces-computed-tomography-use-in-the-diagnosis-of-appendicitis-in-children
#17
Stephanie F Polites, Mohamed I Mohamed, Elizabeth B Habermann, James L Homme, Jana L Anderson, Christopher R Moir, Michael B Ishitani, Abdalla E Zarroug
BACKGROUND: A diagnostic algorithm for appendicitis in children was created to reduce computed tomography (CT) use owing to the risk of cancer from radiation exposure and cost of CT. This study evaluates the impact of the algorithm on CT use and diagnostic accuracy of appendicitis. METHODS: Patients ≤18 years who underwent appendectomy for suspected appendicitis after presenting to the emergency department for 2 years before and 3 years after algorithm implementation were identified...
August 2014: Surgery
https://www.readbyqxmd.com/read/26931338/incidental-appendectomy-microscopy-tells-another-story-a-retrospective-cohort-study-in-patients-presenting-acute-right-lower-quadrant-abdominal-pain
#18
Dario Tartaglia, Andrea Bertolucci, Christian Galatioto, Matteo Palmeri, Gregorio Di Franco, Rita Fantacci, Niccolò Furbetta, Massimo Chiarugi
BACKGROUND: Optimal management of macroscopically normal appendix encountered during laparoscopy for acute abdominal pain is still unclear. METHODS: 164 acute abdominal pain cases in which laparoscopy showed a normal appendix were reviewed. No other intra-peritoneal acute disease was present in 50 patients (Group 1) whereas a miscellanea of intra-peritoneal conditions was identified in the other 114 (Group 2). All the patients underwent appendectomy with specimen examination...
April 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27020900/open-abdomen-with-negative-pressure-device-vs-primary-abdominal-closure-for-the-management-of-surgical-abdominal-sepsis-a-retrospective-review
#19
COMPARATIVE STUDY
Michael S Bleszynski, Tiffany Chan, Andrzej K Buczkowski
BACKGROUND: Open abdomen with temporary abdominal closure remains a controversial management strategy for surgical abdominal sepsis compared with primary abdominal closure (PAC) and on-demand laparotomy. The primary objective was to compare mortality between PAC and open abdomen with vacuum assisted closure (VAC). METHODS: Retrospective review of a tertiary center intensive care unit database (2006 to 2010) including suspected/diagnosed severe abdominal sepsis/septic shock requiring source control laparotomy...
May 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27102328/resuscitative-thoracotomy
#20
REVIEW
Gerd Daniel Pust, Nicholas Namias
Resuscitative thoracotomy is often performed on trauma patients with thoracoabdominal penetrating or blunt injuries arriving in cardiac arrest. The goal of this procedure is to immediately restore cardiac output and to control major hemorrhage within the thorax and abdominal cavity. Only surgeons with experience in the management of cardiac and thoracic injuries should perform this procedure.
September 2016: International Journal of Surgery
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