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Gastrointestinal Trauma

Lindsay B Wilson, Mark R Cox, Matthew V Benns, Christina M Pinkston, Leigh A Scherrer
Serotonin-modulating antidepressants have been associated with increased risk of gastrointestinal bleeding and increased blood loss during elective surgery. This study sought to investigate the effect of preinjury selective-serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor (SSRI/SNRI) use on transfusion requirements after trauma, and to evaluate whether resumption of SSRI/SNRI after trauma may worsen bleeding risk. This was a retrospective matched-cohort study evaluating patients with solid organ injury...
November 1, 2018: American Surgeon
Aylin Hande Gökçe
Gastrointestinal stromal tumors (GISTs) are among the rare tumors of gastrointestinal (GI) tract. GISTs occur respectively in the stomach, small intestines, colon and rectum, omentum and mesentery, esophagus, retroperitoneal space, and abdominal cavity. However, they may occur anywhere along the GI tract. Typically, these tumors generally do not cause symptoms; however symptomatic patients may show stomach pain, GI bleeding, and palpable abdominal masses. These patients usually undergo surgery for obstruction symptoms or some other diagnosis...
January 2019: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Freddy Francis, Natallia Varankovich, Byron Brook, Nelly Amenyogbe, Rym Ben-Othman, Bing Cai, Danny Harbeson, Aaron C Liu, Ben Dai, Shelly McErlane, Kris Andrews, Tobias R Kollmann, Pinaki Panigrahi
Adult mouse models have been widely used to understand the mechanism behind disease progression in humans. The applicability of studies done in adult mouse models to neonatal diseases is limited. To better understand disease progression, host responses and long-term impact of interventions in neonates, a neonatal mouse model likely is a better fit. The sparse use of neonatal mouse models can in part be attributed to the technical difficulties of working with these small animals. A neonatal mouse model was developed to determine the effects of probiotic administration in early life and to specifically assess the ability to establish colonization in the newborn mouse intestinal tract...
January 27, 2019: Journal of Visualized Experiments: JoVE
Raevin K Ravindra, Atandrila Das, Grace L Chew, Eric Daniel
Phytobezoars are a rare cause of small bowel obstruction (SBO), which consists of vegetable matter such as seeds, skins, fibres of fruit and vegetables that have solidified. We present the case of a 61-year-old man with no previous surgery who presented with central abdominal pain, nausea and vomiting. An abdominal CT scan demonstrated SBO with a transition point in the left anterior abdomen. He proceeded to a laparoscopy, which revealed multiple perforations throughout the small bowel, from the proximal jejunum to the terminal ileum...
February 3, 2019: BMJ Case Reports
Daniel Chandramohan, Alassane Dicko, Issaka Zongo, Issaka Sagara, Matthew Cairns, Irene Kuepfer, Modibo Diarra, Amadou Barry, Amadou Tapily, Frederic Nikiema, Serge Yerbanga, Samba Coumare, Ismaila Thera, Abdourhamane Traore, Paul Milligan, Halidou Tinto, Ogobara Doumbo, Jean-Bosco Ouedraogo, Brian Greenwood
BACKGROUND: Mass administration of azithromycin for trachoma control led to a sustained reduction in all-cause mortality among Ethiopian children. Whether the addition of azithromycin to the monthly sulfadoxine-pyrimethamine plus amodiaquine used for seasonal malaria chemoprevention could reduce mortality and morbidity among African children was unclear. METHODS: We randomly assigned children 3 to 59 months of age, according to household, to receive either azithromycin or placebo, together with sulfadoxine-pyrimethamine plus amodiaquine, during the annual malaria-transmission season in Burkina Faso and Mali...
January 30, 2019: New England Journal of Medicine
Andrea Perren, Patrick Zürcher, Joerg C Schefold
Swallowing disorders and respective consequences (including aspiration-induced pneumonia) are often observed in extubated ICU patients with data indicating that a large number of patients are affected. We recently demonstrated in a large-scale analysis that the incidence of post-extubation dysphagia (PED) is 12.4% in a general ICU population and about 18% in emergency admissions to the ICU. Importantly, PED was mostly sustained until hospital discharge and independently predicted 28- and 90-day mortality. Although oropharyngeal/laryngeal trauma, neuromuscular ICU-acquired weakness, reduced sensation/sensorium, dyssynchronous breathing, and gastrointestinal reflux, are all considered to contribute to PED, little is known about the underlying pathomechanisms and risk factors leading to PED in critically ill patients...
January 25, 2019: Dysphagia
Gil Hameiri, Mahmoud Salman, Yaakov Daskal, Oded Olsha, Mickey Dudkiewicz, Boris Kessel
INTRODUCTION: Gastrointestinal perforation is a well-known phenomenon among patients presented to emergency rooms. Common causes for perforation are gastric and duodenal ulcers, colon tumors and trauma. Some patients are operated on immediately due to the clear clinical picture of acute abdomen. The most accurate imaging is the abdominal CT scan. Conventional X-rays remain the first choice in the case of GI tract perforations. Our clinical observation is that in many cases X-ray studies are not sufficient for the decision-making process in patients with previous abdominal surgeries...
January 2019: Harefuah
Jiayue Bai, Wei Zhang, Xiangzhou Liu, Jinghang Cheng, Xianzheng Wang, Wenyuan Ding, Yong Shen
The aim of the current study was to analyze the efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar degenerative disc disease for senior patients. The clinical and follow-up data of senior patients were retrospectively reviewed. Patients were divided into a PTED group and an open surgery group. Parameters were analyzed, including surgery time, intraoperative fluoroscopy time, intraoperative blood loss, postoperative complications, visual analog scale (VAS) and Japan Orthopedic Association (JOA) scores...
January 2019: Experimental and Therapeutic Medicine
Zoë A Launcelott, Jonathan Lustgarten, Jed Sung, Sirrika Samuels, Spencer Davis, Garrett J Davis
Two similar populations of dogs were evaluated in either a retrospective or prospective manner for 2 weeks after gastrointestinal foreign body surgery to determine the impact of a surgical checklist on the surgical site infection (SSI) rate. The medical records of 201 gastrointestinal foreign body surgeries were reviewed to determine the SSI rate without the use of a surgical checklist (SC-) and 101 consecutive gastrointestinal foreign body surgeries were performed using a surgical checklist (SC+). The SSI rate had a significant decrease from 19...
January 2019: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
Paulo Roberto Prette, Felipe Borges Fagundes, Livia Ramos Carvalho Marchon, Rodrigo de Rezende Teixeira Maciel, Igor Miguel Martins, Cristina Ribeiro Riguetti-Pinto
Pseudoaneurysm of the splenic artery is a rare entity, with little more than 150 cases described in the literature. Pancreatitis is the most common etiology, followed by trauma. In contrast with true aneurysms, pseudoaneurysms are frequently symptomatic, with a 47% risk of rupture and 90% mortality if left untreated. We describe the case of a 48-year-old female patient who suffered a gastrointestinal hemorrhage associated with acute-on-chronic pancreatitis. During workup, endoscopy revealed signs of recent bleeding and magnetic resonance angiography of the abdomen showed a large pseudoaneurysm of the splenic artery...
July 2018: Jornal Vascular Brasileiro
John Bedson, Ying Chen, Julie Ashworth, Richard A Hayward, Kate M Dunn, Kelvin P Jordan
BACKGROUND: Long-term opioid prescribing for musculoskeletal pain is controversial due to uncertainty regarding effectiveness and safety. This study examined the risks of a range of adverse events in a large cohort of patients prescribed long-term opioids using the UK Clinical Practice Research Datalink. METHODS: Patients with musculoskeletal conditions starting a new long-term opioid episode (defined as ≥3 opioid prescriptions within 90 days) between 2002 and 2012 were included...
January 8, 2019: European Journal of Pain: EJP
Shuo Wang, Binghou Yang, Xiang Li, Yufei Sun, Shuguang Cao, Tianhua Zhu, Minjun Xu, Xueyin Li, Tianyu Li, Junxiang Zhao
OBJECTIVE: To retrospectively analyze the injury characteristics of victims and treatment strategies in the explosion accident on the 17th May 2018 in Xixia county (Xixia "May 17th" explosion accident). METHODS: Completion the Level Three treatment on time, which was depended on the leading role played by the regional trauma centers was the main rescuing mode of the work in Xixia county, where the primary and secondary treatments were the key parts. The three-level treatment model includes: the local hospital acts as a level-one emergency medical institution, county hospitals function as secondary emergency medical institutions, and other higher medical institutions are the tertiary first aid medical institutions...
December 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Haiyan Liu, Zheng Zhou
Most of the intra-abdominal infections are benign and critical diseases caused by trauma, surgery and gastrointestinal diseases, which require the attention of surgeons. The increase of drug resistance of pathogens is a common clinical problem. The intra-abdominal infection caused by multidrug-resistant bacteria is a huge challenge faced by clinicians, and is mainly found in hospital-acquired abdominal infections, of which gram-negative bacteria are the most common. This paper firstly summarizes the common types, early diagnosis and risk factors of multidrug-resistant bacteria according to the literature, and then describes the treatment strategy of intra-abdominal infection caused by multidrug-resistant bacteria from four aspects: anti-infective medication, infection source control, resuscitation and organ support, and nutritional support treatment...
December 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Marcello Covino, Carmine Petruzziello, Graziano Onder, Alessio Migneco, Benedetta Simeoni, Francesco Franceschi, Veronica Ojetti
OBJECTIVES: Globally, the average age of the population is increasing. Patients aged >65 years attending hospital emergency departments (EDs) differ from younger patients; in particular, they often present with multiple comorbidities. Our retrospective study evaluates the number of attendances at our ED by elderly patients in the 12 years from January 2005 to December 2017. Our first aim was to evaluate differences presented by elderly patients regarding symptoms, clinical features, color code (i...
February 2019: Maturitas
Yisrael Katz, Ohad Avni, David Ramati, Amichai Berkovitz
BACKGROUND: Since 1970, written (Step 1) and oral (Step 2) examinations have been part of the requirements for board certification in Israel. OBJECTIVES: To compare the content of Step 1 examinations in family medicine, that was derived from their blueprints in 2010-2016, with the content of family practice in the Jerusalem district in 2015, that was derived from the electronic database of Clalit Health Services. RESULTS: (a) The blueprints indicated that a Step 1 examination totaled 150 items...
December 2018: Harefuah
Claude Martin, Andrea Cortegiani, Cesare Gregoretti, Ignacio Martin-Loeches, Carole Ichai, Marc Leone, Gernot Marx, Sharon Einav
BACKGROUND: Fluids are by far the most commonly administered intravenous treatment in patient care. During critical illness, fluids are widely administered to maintain or increase cardiac output, thereby relieving overt tissue hypoperfusion and hypoxia. MAIN TEXT: Until recently, because of their excellent safety profile, fluids were not considered "medications". However, it is now understood that intravenous fluid should be viewed as drugs. They affect the cardiovascular, renal, gastrointestinal and immune systems...
December 22, 2018: BMC Anesthesiology
Tiffany Ju, Bruce D Naliboff, Wendy Shih, Angela P Presson, Cathy Liu, Arpana Gupta, Emeran A Mayer, Lin Chang
BACKGROUND: Irritable bowel syndrome (IBS) is a stress-sensitive disorder of brain-gut interactions associated with a higher prevalence of early adverse life events (EALs). However, it is incompletely understood how trauma severity or disclosure influence the risk of developing IBS or symptom severity. AIMS: To determine whether (1) IBS patients report a greater number of EALs compared with healthy controls; (2) trauma severity and first age of EAL increase the odds of IBS; (3) confiding in others reduces the odds of IBS; (4) the number, trauma severity, and first age of EAL are associated with symptom severity; (5) sex differences exist...
December 19, 2018: Journal of Clinical Gastroenterology
Theodoros Kratimenos, Constantine N Antonopoulos, Dimitrios Tomais, Panagiotis Dedeilias, Vasileios Patris, Ilias Samiotis, John Kokotsakis, Dimosthenis Farsaris, Michalis Argiriou
OBJECTIVE: The aim of the study was to present the results for patients with atherosclerotic aneurysm of the descending thoracic aorta (DTA) treated with a novel thoracic stent graft. METHODS: A single-center retrospective review of prospectively collected data was performed. We extracted demographic variables as well as atherosclerotic comorbidities and operation-related and imaging-related data from patients' medical records. We estimated technical success rate, in-hospital and 30-day mortality, and mortality at the end of follow-up as well as complication and reintervention rate in our study cohort...
October 24, 2018: Journal of Vascular Surgery
Andrew Davies, Wei Sheng Pang, Timothy Fowler, Ffion Dewi, Thomas Wright
Preoperative fasting is necessary to reduce the risk of regurgitation of gastric contents and pulmonary aspiration in patients undergoing general anaesthetic and procedural sedation. Excessive fasting is associated with metabolic, cardiovascular and gastrointestinal complications and patient discomfort. We aimed to reduce the fasting time for patients on the plastic surgery trauma list. Adult inpatients awaiting surgery were asked to complete a preoperative assessment sheet. Questions included the length of preoperative fasting, clarity of instructions and wellness scores...
2018: BMJ Open Quality
Brian W Powers, Jiali Yan, Jingsan Zhu, Kristin A Linn, Sachin H Jain, Jennifer L Kowalski, Amol S Navathe
BACKGROUND: There is a growing focus on improving the quality and value of health care delivery for high-cost patients. Compared to fee-for-service Medicare, less is known about the clinical composition of high-cost Medicare Advantage populations. OBJECTIVE: To describe a high-cost Medicare Advantage population and identify clinically and operationally significant subgroups of patients. DESIGN: We used a density-based clustering algorithm to group high-cost patients (top 10% of spending) according to 161 distinct demographic, clinical, and claims-based variables...
December 3, 2018: Journal of General Internal Medicine
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