Factors leading to the use of alternate treatment modalities following transoral laser excision of T1 and T2 glottic squamous cell carcinoma
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ConclusionTransoral laser excision is a safe, function‐preserving treatment of early glottic SCC. Anterior commissure involvement was the major factor for potential failure with laser resection in T1 and T2 glottic tumours. (Source: ANZ Journal of Surgery)
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Early experience with laparoscopic lavage for perforated diverticulitis
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ConclusionLaparoscopic lavage for perforated diverticulitis was feasible in the majority of patients, but identification of an overt sigmoid perforation and patient selection are of critical importance. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)
Relationship between serum fibronectin levels and carnitine administration: an experimental study in rats
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We aimed to investigate the relationship between dorsal flap viability and serum fibronectin levels in carnitine‐administered rats. A total of 24 rats were divided into three groups equally and operated on. Group 1 (sham group n = 8): following surgery, no agent was given. Group 2 (control group, n = 8): following surgery, sterile saline solution at 0·9% with a dose of 100 mg/kg per day for 7 days was administered intraperitoneally. Group 3 (study group, n = 8): following surgery, carnitine with a dose of 100 mg/kg per day for 7 days was administered intraperitoneally. The flap model used was a 10 × 3 cm dorsal flap extending from the tip of the scapula to the hip joint. This was elevated, and then sutured back to its original site. At the end of postoperative d...
Biological effects of bariatric surgery on obesity-related comorbidities.
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Authors: Noria SF, Grantcharov T Abstract The prevalence of obesity has increased so rapidly over the last few decades that it is now considered a global epidemic. Obesity, defined as a body mass index (BMI) of 30 or more, is associated with several comorbid conditions that decrease life expectancy and increase health care costs. Diet therapies have been reported to be ineffective in the long-term treatment of obesity, and guidelines for the surgical therapy of morbid obesity (BMI ≥ 40 or BMI ≥ 35 in the presence of substantial comorbidities) have since been established. Considering the number of bariatric surgical procedures has dramatically increased since these guidelines were established, we review the types of bariatric surgical procedures and their impact on diabetes, sle...
Podiatrist care and outcomes for patients with diabetes and foot ulcer
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We examined whether outcomes of care (amputation and hospitalisation) among patients with diabetes and foot ulcer differ between those who received pre‐ulcer care from podiatrists and those who did not. Adult patients with diabetes and a diagnosis of a diabetic foot ulcer were found in the MarketScan Databases, 2005–2008. Multivariate Cox proportional hazard models estimated the hazard of amputation and hospitalisation. Logistic regression estimated the likelihood of these events. Propensity score weighting and regression adjustment were used to adjust for potentially different characteristics of patients who did and did not receive podiatric care. The sample included 27 545 patients aged 65+ (Medicare‐eligible patients with employer‐sponsored supplemental insurance) and 20 208...
Postoperative complication rates and invasiveness of laparoscopy‐assisted distal gastrectomy and open distal gastrectomy based on the American Society of Anesthesiologists classification system
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ConclusionLADG may be less invasive than ODG, even in ASA3 patients. Hence, LADG may reduce the incidence of postoperative complications in ASA1, ASA2, and ASA3 patients. (Source: Asian Journal of Endoscopic Surgery)
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Translumenal Single-Incision Laparoscopy Radical Gastrectomy with D2 Lymph Node Dissection for Early Gastric Cancer—Primary Experience with Less Invasive Surgery in China
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Journal of Laparoendoscopic & Advanced Surgical Techniques Feb 2013, Vol. 23, No. 2: 141-145. (Source: Journal of Laparoendoscopic)
Effects of Infliximab and Hydrocortisone on In Vitro Cytokine Responses after Stimulation with Lipopolysaccharide
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Surgical Infections , Vol. 0, No. 0. (Source: Surgical Infections)
Transduction Efficiency of Pseudotyped Adeno-Associated Viral Vectors for Gene Transfer in Dermal Fibroblasts to Modulate Wound Healing
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Sustained transgene expression and cell specific gene transfer are goals of cutaneous gene therapy. We and others have demonstrated that using a pseudotyping strategy with AAV vectors has the potential to confer a unique cellular tropism and transduction efficiency profile. We hypothesize that pseudotyped AAV vectors may have differential tropism and transduction efficiency under normal and wound conditions. (Source: Journal of Surgical Research)
Preoperative detection and predictors of level V lymph node metastasis in patients with papillary thyroid carcinoma (Br J Surg 2013; 100: 497-503).
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Authors: Kirkby-Bott J PMID: 23378202 [PubMed - in process] (Source: The British Journal of Surgery)
Foreword
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Although acute appendicitis continues to be among our most common surgical emergencies, the most appropriate management remains controversial. In fact, with the evolution of diagnostic technology and surgical approaches, new controversies continue to arise. In this issue of Current Problems in Surgery, Drs Curtis Wray, Lillian Kao, Stefanos Millas, Kuojen Tsao, and Tien Ko from the University of Texas Medical School at Houston address these areas of controversy in a thought-provoking perspective on this topic entitled, “Acute Appendicitis: Controversies in Diagnosis and Management.” Beginning with a discussion of the challenges in the diagnosis of acute appendicitis, the roles of scoring systems, ultrasound, and computerized tomography are carefully defined. They move on to an intrigui...
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Use of locally made off‐loading techniques for diabetic plantar foot ulcer in Karachi, Pakistan
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Abstract The aim of this study was to evaluate the effectiveness of applying locally made pressure off‐loading techniques on plantar foot ulcer in individuals with diabetes. This prospective study of 70 diabetic patients was conducted at the foot clinic of Baqai Institute of Diabetology & Endocrinology. Plantar foot ulcer, stages 1A and 2A according to the University of Texas classification, is treated by using three off‐loading techniques: modified foot wear (sandal), modified plaster of Paris cast with plywood platform and Scotchcast boot. The outcome was assessed at either complete wound healing (defined as complete epithelialisation) or at 12 weeks, whichever came first. Of the 70 patients, 24 were in modified foot wear group, 23 in modified plaster of Paris cast and 23 in Sc...
Compressive Symptoms Due to Thrombosed or Hypertrophic Collateral Circulation in Infrarenal Inferior Vena Cava Agenesis
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Agenesis of the infrarenal segment of inferior vena cava is an uncommon and often asymptomatic congenital abnormality with an approximate incidence of 0.005–1% in the general population. Presentation of this condition as deep venous thrombosis associated with symptoms secondary to thrombosis or hypertrophy of collateral vessels is a rare clinical form. Two cases of this rare form are described, and an analysis of the related literature is presented. The first case was that of a 35-year-old man with symptoms of acute obstructive pyelonephritis with no apparent cause and swelling of the lower limb. The second case involved a 30-year-old man with lower limb swelling associated with paresthesia and motor deficit. Both patients were found to have infrarenal inferior vena cava agenesis associa...
Aberrant wound healing in the horse: Naturally occurring conditions reminiscent of those observed in man
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Abstract Impaired wound healing represents an enormous clinical and financial problem for companion animals and humans alike. Unfortunately, most models used to study healing rely on rodents, which have significant differences in the healing and scarring process and rarely develop complications. In order to better simulate impaired healing, the model should strive to reproduce the natural processes of healing and delayed healing. Wounds on the limbs of horses display similarities to wounds in humans in their epithelialization/contraction ratio, genetic influence as well as dysregulated cytokine profile and the spontaneous development of fibroproliferative disorders. Veterinarians have access to advanced wound therapies that are often identical to those provided to human patients. Wound res...
Resolution of Clinical and Laboratory Abnormalities after Diagnosis of Ventilator-Associated Pneumonia in Trauma Patients
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Surgical Infections , Vol. 0, No. 0. (Source: Surgical Infections)
Repeated Colonization by Multi-Drug-Resistant Acinetobacter calcoaceticus–A. baumannii Complex and Changes in Antimicrobial Susceptibilities in Surgical Intensive Care Units
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Surgical Infections , Vol. 0, No. 0. (Source: Surgical Infections)
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Endovascular Aneurysm Repair of Tuberculous Mycotic Abdominal Aortic Aneurysm on a Patient With Renal Transplant
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The case report describes a gentleman with renal transplant who presented with pulmonary tuberculosis (TB) and mycotic aneurysm of abdominal aorta. The aneurysm was successfully treated with endovascular aneurysm repair. A multidisciplinary approach with renal physicians and infectious diseases unit was necessary to treat TB and maintain immunosuppression. The technique used for deployment of the stent graft in the presence of infection and a transplanted kidney is described. The satisfactory outcome at 5 years follow-up indicates that endovascular option for TB mycotic aneurysm is durable and safe option particularly when major open surgery is associated with significant mortality and morbidity. (Source: Vascular and Endovascular Surgery)
Management of Stage 1 Esophageal Cancer
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Barrett esophagus surveillance programs and more liberal use of upper endoscopy are leading to the identification of more patients with high-grade dysplasia or early stage esophageal adenocarcinoma. These patients have several options for therapy, including endoscopic mucosal resection, vagal-sparing esophagectomy, and a combination of endoscopic resection and ablation. Factors that should be considered include the length of the Barrett segment, the presence of a nodule or ulcer within the Barrett segment, and the age and overall physical condition of the patient. Of particular importance will be the incidence of recurrent Barrett esophagus or cancer in the long-term in patients that were initially successfully treated endoscopically. (Source: Surgical Clinics of North America)
[Sacral insufficiency, unexpected clinical entity as a cause of low back pain. Report of two cases].
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Conclusions: sacral insufficiency is an underdiagnosed disease, caused by wide range of diseases, mainly osteoporosis. The studies of choice for diagnosis are MRI and bone scans. Techniques, such as percutaneous sacroplasty, produce significant improvements in pain scores and seem a suitable alternative for managing this disease. PMID: 23336152 [PubMed - in process] (Source: Cirugia y Cirujanos)
A prospective window into medical device‐related pressure ulcers in intensive care
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In conclusion, device‐related ulcer prevalence was 3·1%, similar to that reported in the limited literature available, indicating an ongoing problem. Systematic assessment and repositioning of devices are the mainstays of care. We recommend continued prevalence determination and that nurses remain vigilant to prevent device‐related ulcers, especially in patients with NG and ET tubes. (Source: International Wound Journal)