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Acute care Surgery

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42 papers 500 to 1000 followers
https://www.readbyqxmd.com/read/27762448/cost-effectiveness-of-emergency-versus-delayed-laparoscopic-cholecystectomy-for-acute-gallbladder-pathology
#1
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...
October 20, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/26841720/mortality-from-trauma-haemorrhage-and-opportunities-for-improvement-in-transfusion-practice
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/26935319/minor-blunt-cervical-spine-trauma-associated-with-esophageal-perforation-and-epidural-empyema
#13
André Beer-Furlan, Roger S Brock, Lucas S Mendes, Eduardo G Mutarelli
No abstract text is available yet for this article.
March 2, 2016: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/26581011/images-in-clinical-medicine-tension-pneumoperitoneum
#14
Haytham M A Kaafarani
A 65-year-old woman who had undergone colonoscopy with removal of multiple polyps had become unresponsive at the end of the procedure and was transferred to the emergency department for evaluation. She regained consciousness but remained in distress with diaphoresis. On physical examination, the..
November 19, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/26390160/massive-transfusion-red-blood-cell-to-plasma-and-platelet-unit-ratios-for-resuscitation-of-massive-hemorrhage
#15
REVIEW
Colin H Murphy, John R Hess
PURPOSE OF REVIEW: The aim of this short study is to review recently published data bearing on how to resuscitate massive uncontrolled hemorrhage. RECENT FINDINGS: New data inform our understanding of the mechanisms of the acute coagulopathy of trauma, the median time to death of trauma patients with uncontrolled hemorrhage, the effects of blood product composition on the coagulation capacity of infused resuscitation mixtures, the outcomes of patients resuscitated according to common massive transfusion protocols in clinical situations associated with massive hemorrhage, and who might benefit from balanced, blood-product-based resuscitation...
November 2015: Current Opinion in Hematology
https://www.readbyqxmd.com/read/26474547/trauma-center-variation-in-the-management-of-pediatric-patients-with-blunt-abdominal-solid-organ-injury-a-national-trauma-data-bank-analysis
#16
COMPARATIVE STUDY
Arash Safavi, Erik D Skarsgard, Peter Rhee, Bardiya Zangbar, Narong Kulvatunyou, Andrew Tang, Terence O'Keeffe, Randall S Friese, Bellal Joseph
BACKGROUND: Nonoperative management of hemodynamically stable children with Solid Organ Injury (SOI) has become standard of care. The aim of this study is to identify differences in management of children with SOI treated at Adult Trauma Centers (ATC) versus Pediatric Trauma Centers (PTC). We hypothesized that patients treated at ATC would undergo more procedures than PTC. METHODS: Patients younger than 18 years old with isolated SOI (spleen, liver, kidney) who were treated at level I-II ATC or PTC were identified from the 2011-2012 National Trauma Data Bank...
March 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26477755/a-new-2-step-risk-stratification-clinical-score-for-suspected-appendicitis-in-children
#17
Te-Lu Yap, Yong Chen, Wilson Wei Xin Low, Caroline Choo Phaik Ong, Shireen Anne Nah, Anette S Jacobsen, Liang Shen, Yee Low
AIM: The aim of this study was to develop a new Children's Appendicitis Score (CAS) by combining 3 inflammatory markers and a set of predictors for suspected appendicitis in children. METHODS: 374 children aged 4-16years with suspicion of appendicitis were prospectively enrolled for the derivation cohort. Demographic characteristics, clinical features, laboratory, and histology data were collected. The outcome measure was the histological presence or absence of appendicitis...
December 2015: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26151526/2014-consensus-conference-on-viscoelastic-test-based-transfusion-guidelines-for-early-trauma-resuscitation-report-of-the-panel
#18
Kenji Inaba, Sandro Rizoli, Precilla V Veigas, Jeannie Callum, Ross Davenport, John Hess, Marc Maegele
There has been an increased interest in the use of viscoelastic testing to guide blood product replacement during the acute resuscitation of the injured patient. Currently, no uniformly accepted guidelines exist for how this technology should be integrated into clinical care. In September 2014, an international multidisciplinary group of leaders in the field of trauma coagulopathy and resuscitation was assembled for a 2-day consensus conference in Philadelphia, Pennsylvania. This panel included trauma surgeons, hematologists, blood bank specialists, anesthesiologists, and the lay public...
June 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26334607/guidelines-for-the-management-of-a-pregnant-trauma-patient
#19
Venu Jain, Radha Chari, Sharon Maslovitz, Dan Farine, Emmanuel Bujold, Robert Gagnon, Melanie Basso, Hayley Bos, Richard Brown, Stephanie Cooper, Katy Gouin, N Lynne McLeod, Savas Menticoglou, William Mundle, Christy Pylypjuk, Anne Roggensack, Frank Sanderson
OBJECTIVE: Physical trauma affects 1 in 12 pregnant women and has a major impact on maternal mortality and morbidity and on pregnancy outcome. A multidisciplinary approach is warranted to optimize outcome for both the mother and her fetus. The aim of this document is to provide the obstetric care provider with an evidence-based systematic approach to the pregnant trauma patient. OUTCOMES: Significant health and economic outcomes considered in comparing alternative practices...
June 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/26453292/postoperative-antibiotics-are-not-associated-with-decreased-wound-complications-among-patients-undergoing-appendectomy-for-complicated-appendicitis
#20
Dennis Y Kim, Nariman Nassiri, Darin J Saltzman, Michael P Ferebee, Ian T Macqueen, Camille Hamilton, Hamid Alipour, Amy H Kaji, Ashkan Moazzez, David S Plurad, Christian de Virgilio
BACKGROUND: The objective of this study was to determine the role of postoperative antibiotics in reducing complications in patients undergoing appendectomy for complicated appendicitis. METHODS: We performed a 5-year retrospective cohort study of adult patients who underwent appendectomy for acute appendicitis. Patients with complicated appendicitis (perforated or gangrenous) were analyzed on the basis of whether they received postoperative antibiotics. Main outcome measures were wound complications, length of stay (LOS), and readmission to hospital...
December 2015: American Journal of Surgery
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