scholarly journals PREVENTION OF INCISIONAL HERNIA AFTER OPEN HEPATO-PANCREATO-BILIARY SURGERY: A SYSTEMATIC REVIEW

2021 ◽  
Author(s):  
Robert Memba ◽  
Olga Morató ◽  
Laia Estalella ◽  
Mihai C. Pavel ◽  
Erik Llàcer-Millán ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incisional Hernia ◽  
Animal Studies ◽  
Case Series ◽  
Current Evidence ◽  
Cochrane Library ◽  
Published Data ◽  
Open Approach ◽  
Biliary Surgery ◽  
Prophylactic Mesh

Introduction Most hepato-pancreato-biliary (HPB) procedures are still performed through open approach. Incisional hernia (IH) is one of the most common complications after open surgery. To date, published data on IH after HPB surgery are scarce, therefore the aim of this study was to assess the current evidence regarding incidence, risk factors, and prevention. Methods Medline/PubMed (1946-2020), EMBASE (1947-2020), and the Cochrane library (1995-2020)) were searched for studies on IH in open HPB surgery. Animal studies, editorials, letters, reviews, comments, short case series and liver transplant, laparoscopic or robotic procedures were excluded. The protocol was registered with PROSPERO (CRD42020163296). Results A total of 5 079 articles were retrieved. 8 studies were finally included for the analysis. The incidence of IH after HPB surgery ranges from 7.7% to 38.8%. The identified risk factors were body mass index, surgical site infection, ascites, Mercedes or reversed T incisions and previous IH. Prophylactic mesh might be safe and effective. Conclusions IH after open HPB surgery is still an important matter. Some of the risk factors are specific for the HPB operations and the incision type should be carefully considered. Randomised controlled trials are required to confirm the role of prophylactic mesh after HPB operations.

Department of Internal Medicine. University Hospital of Patras. Patras.

2022 ◽  
Vol 35 (13) ◽  
Author(s):  
Themistoklis Paraskevas ◽  
Eleousa Oikonomou ◽  
Maria Lagadinou ◽  
Vasileios Karamouzos ◽  
Nikolaos Zareifopoulos ◽  
...  
Keyword(s):  
Oxygen Therapy ◽  
Case Series ◽  
High Flow ◽  
University Hospital ◽  
Current Evidence ◽  
Cochrane Library ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
High Flow Oxygen

Introduction: Oxygen therapy remains the cornerstone for managing patients with severe SARS-CoV-2 infection and several modalities of non-invasive ventilation are used worldwide. High-flow oxygen via nasal canula is one therapeutic option which may in certain cases prevent the need of mechanical ventilation. The aim of this review is to summarize the current evidence on the use of high-flow nasal oxygen in patients with severe SARS-CoV-2 infection.Material and Methods: We conducted a systematic literature search of the databases PubMed and Cochrane Library until April 2021 using the following search terms: “high flow oxygen and COVID-19” and “high flow nasal and COVID-19’’.Results: Twenty-three articles were included in this review, in four of which prone positioning was used as an adjunctive measure. Most of the articles were cohort studies or case series. High-flow nasal oxygen therapy was associated with a reduced need for invasive ventilation compared to conventional oxygen therapy and led to an improvement in secondary clinical outcomes such as length of stay. The efficacy of high-flow nasal oxygen therapy was comparable to that of other non-invasive ventilation options, but its tolerability is likely higher. Failure of this modality was associated with increased mortality.Conclusion: High flow nasal oxygen is an established option for respiratory support in COVID-19 patients. Further investigation is required to quantify its efficacy and utility in preventing the requirement of invasive ventilation.

Incidence and risk factors for incisional hernia after temporary loop ileostomy closure: choosing candidates for prophylactic mesh placement

Hernia ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 93-98 ◽  
Author(s):  
A. G. Barranquero ◽  
E. Tobaruela ◽  
M. Bajawi ◽  
P. Muñoz ◽  
J. Die Trill ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incisional Hernia ◽  
Loop Ileostomy ◽  
Ileostomy Closure ◽  
Prophylactic Mesh ◽  
Mesh Placement

scholarly journals Isolated cortical vein thrombosis: case series

2015 ◽  
Vol 123 (2) ◽  
pp. 427-433 ◽  
Author(s):  
Ranjodh Singh ◽  
William P. Cope ◽  
Zhiping Zhou ◽  
Michelle E. De Witt ◽  
John A. Boockvar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intracranial Hypotension ◽  
Vasogenic Edema ◽  
Anticoagulation Therapy ◽  
Case Series ◽  
Published Data ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Presenting Symptoms ◽  
Cortical Vein Thrombosis

OBJECT Isolated cortical vein thrombosis (ICVT) accounts for less than 1% of all cerebral infarctions. ICVT may cause irreversible parenchymal damage, rendering early and accurate diagnosis critical. This case series and literature review presents the clinical and radiological findings in 7 patients with ICVT, and highlights risk factors and imaging modalities that may be most beneficial in rendering an accurate and timely diagnosis. METHODS Patients with CT and MRI findings consistent with ICVT examined between January 2011 and June 2014 were included in this retrospective review. RESULTS Seven patients (5 females, 2 males), ranging in age from 11 months to 34 years, met the inclusion criteria. The most common clinical presentations were headaches (n = 4) and seizures (n = 3). The most common comorbidities noted in these patients were hypercoagulable states (n = 4) and intracranial hypotension (n = 3). Five patients had intraparenchymal involvement. CT suggested the correct diagnosis in 4 patients, and MRI confirmed the diagnosis in all 7 patients. All patients who received anticoagulation therapy (n = 5) experienced complete resolution of their symptoms. CONCLUSIONS The majority of these patients were adult females, consistent with published data. Seizures and headaches were the most common presenting symptoms. Hypercoagulable state and intracranial hypotension, both known risk factors for thrombosis, were the most commonly noted ICVT risk factors. Intraparenchymal involvement was prevalent in nearly all ICVT cases and presented as vasogenic edema, early intraparenchymal hemorrhage, or hemorrhagic venous infarction. Susceptibility-weighted imaging was the most sensitive imaging technique in diagnosing ICVT.

scholarly journals Risk factors for open conversion of laparoscopic biliary surgery

2018 ◽  
Vol 5 (3) ◽  
pp. 846
Author(s):  
Asem F. Mohammed ◽  
Moharm A. Abdelshahid ◽  
Mohammed A. Elbalshy
Keyword(s):  
Risk Factors ◽  
Open Approach ◽  
Surgical Experience ◽  
University Hospitals ◽  
Biliary Surgery ◽  
Female Ratio ◽  
Open Conversion ◽  
Conversion Rates ◽  
Co Morbidity ◽  
Male To Female

Background: Conversion rates of laparoscopic to open biliary procedures vary according to different factors such as clinical presentation, co-morbidity, surgical experience and equipment.Methods: A prospective analysis of 464 laparoscopic cholecystectomies (LC) including 88 laparoscopic common bile duct explorations (LCBDE) over a period of 5 years was carried out in Menofia University Hospitals, between December 2012 to December 2017.Results: The male to female ratio in the series was 1:3.4 with a Median±SD age 51±16 years.  158 cases (34%) of all patients were admitted as an emergency including jaundice in 60 cases (13%), acute pancreatitis in 27 cases 6% and acute cholecystitis/empyema in 27 cases (6%). 153 cases (33%) had previous abdominal surgery. LCBDE was done in 88 cases. open conversion was necessary in 6/464 cases (1.3%) over 5 years; with no conversions in the last 2 years (130 cases). converted cases had a Median±SD age 53±17 years and 67% were female.Conclusions: Several risk factors favour conversion from laparoscopic to an open approach in biliary surgeries that has to be identified preoperative to provide a better surgery.

scholarly journals Resection of oesophageal and oesophagogastric junction cancer liver metastases — a summary of current evidence

2021 ◽  
Author(s):  
Andreas R. R. Weiss ◽  
Noel E. Donlon ◽  
Hans J. Schlitt ◽  
Christina Hackl
Keyword(s):  
Liver Metastases ◽  
Performance Status ◽  
Survival Rates ◽  
Neoadjuvant Treatment ◽  
Case Series ◽  
Current Evidence ◽  
Cochrane Library ◽  
Term Survival ◽  
Treatment Protocols ◽  
Oesophagogastric Junction

Abstract  Purpose Metastatic oesophageal cancer is commonly considered as a palliative situation with a poor prognosis. However, there is increasing evidence that well-selected patients with a limited number of liver metastases (ECLM) may benefit from a multimodal approach including surgery. Methods A systematic review of the current literature for randomized trials, retrospective studies, and case series with patients undergoing hepatectomies for oesophageal and oesophagogastric junction cancer liver metastases was conducted up to the 31st of August 2021 using the MEDLINE (PubMed) and Cochrane Library databases. Results A total of 661 articles were identified. After removal of duplicates, 483 articles were screened, of which 11 met the inclusion criteria. The available literature suggests that ECLM resection in patients with liver oligometastatic disease may lead to improved survival and even long-term survival in some cases. The response to concomitant chemotherapy and liver resection seems to be of significance. Furthermore, a long disease-free interval in metachronous disease, low number of liver metastases, young age, and good overall performance status have been described as potential predictive markers of outcome for the resection of liver metastases. Conclusion Surgery may be offered to carefully selected patients to potentially improve survival rates compared to palliative treatment approaches. Studies with standardized patient selection criteria and treatment protocols are required to further define the role for surgery in ECLM. In this context, particular consideration should be given to neoadjuvant treatment concepts including immunotherapies in stage IVB oesophageal and oesophagogastric junction cancer.

scholarly journals A systematic review of head-up tilt to improve consciousness in people with a prolonged disorder of consciousness

2020 ◽  
pp. 026921552094669
Author(s):  
Harriet Ng ◽  
Andrew King
Keyword(s):  
Systematic Review ◽  
Animal Studies ◽  
Case Series ◽  
Disorders Of Consciousness ◽  
Cochrane Library ◽  
Size Analysis ◽  
Inclusion Criteria ◽  
High Quality ◽  
Disorder Of Consciousness ◽  
Head Up Tilt

Objective: This systematic review analysed the evidence for the effect of head-up tilt (passive-standing) on consciousness among persons in prolonged disorders of consciousness. Data sources: Articles were identified through primary database searching (Medline, CINAHL, AMED, The Cochrane Library) and post-citation searching (Scopus). Review methods: This review followed the PRISMA statement. The search strategy was created to find articles that combined any conceivable passive standing device, any measure of consciousness and disorders of consciousness of any origin. Inclusion criteria were any papers that evaluated the use of head-up tilt in adults in defined disorders of consciousness. Exclusion criteria included active stand studies, paediatric studies and animal studies. The search was completed independently by two researchers. Data collection and risk of bias assessment was completed using the Downs and Black tool. Results: 6867 titles were retrieved (last search completed 21/6/20). Ten papers met the inclusion criteria: five examined the effects of a single head-up tilt treatment, and five the effects of head-up tilt regimes. Eighty-seven participants were randomised in three randomised controlled trials. In the remaining preliminary studies or case series, 233 participants were analysed. Quality was low, with only two high-quality studies available. Four studies were suitable for effect size analysis, where medium to large effect sizes were found. The two high-quality studies found head-up tilt had a large effect on consciousness. Conclusion: Overall there is some evidence that repeated passive standing on a tilt-table can improve consciousness, but the relevant studies provoke further questions.

Current Concepts on Tissue Adhesive Use for Meniscal Repair—We Are Not There Yet: A Systematic Review of the Literature

2021 ◽  
pp. 036354652110036
Author(s):  
Niv Marom ◽  
Gabriella Ode ◽  
Francesca Coxe ◽  
Bridget Jivanelli ◽  
Scott A. Rodeo
Keyword(s):  
Systematic Review ◽  
Primary Repair ◽  
Case Series ◽  
Meniscal Repair ◽  
Tissue Adhesive ◽  
Current Evidence ◽  
Cochrane Library ◽  
Meniscal Tears ◽  
High Quality ◽  
Promising Alternative

Background: Tissue adhesives (TAs) represent a promising alternative or augmentation method to conventional tissue repair techniques. In sports medicine, TA use has been suggested and implemented in the treatment of meniscal tears. The aim of this review was to present and discuss the current evidence and base of knowledge regarding the clinical usage of TAs for meniscal repair. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic literature search was performed using the PubMed, Embase, and Cochrane Library databases for studies reporting on clinical outcomes of TA usage for meniscal repair in humans in the English language published before January 2020. Results: Ten studies were eligible for review and included 352 meniscal repairs: 94 (27%) were TA-based repairs and 258 (73%) were combined suture and TA repairs. Concomitant anterior cruciate ligament reconstruction was performed in 224 repairs (64%). All included studies utilized fibrin-based TA. Of the 10 studies, 9 were evidence level 4 (case series), and 8 reported on a cohort of ≤40 meniscal repairs. Rates of meniscal healing were evaluated in 9 of 10 studies, with repair failure seen in 39 repairs (11%). Conclusion: The use of TAs, specifically fibrin-based TAs, for meniscal repair shows good results as either an augmentation or primary repair of various configurations of meniscal tears. However, this review reveals an absence of comparative high-quality evidence supporting the routine use of TAs for meniscal repair and emphasizes the lack of an ideal TA designed for that purpose. Further high-quality research, basic science and clinical, will facilitate the development of new materials and enable testing their suitability for use in meniscal repair.

scholarly journals PATHOGENETIC ASPECTS OF METABOLIC SYNDROME IN WOMEN OF REPRODUCTIVE AGE (A LITERATURE REVIEW)

2019 ◽  
Vol 26 (2) ◽  
pp. 162-172
Author(s):  
Nina D. Kastueva ◽  
Tatyana D. Tsidaeva ◽  
Zalina F. Belikova ◽  
Liana V. Maysuradze
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Pregnancy Outcomes ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
Published Data ◽  
Women Of Reproductive Age ◽  
Adverse Pregnancy

Aim. The aim of this work was to analyze recently published data on the risk factors and pathogenetic aspects of metabolic syndrome (MS) in women of reproductive age.Materials and methods. This review covers data presented in foreign and Russian literature, which has been published in electronic bibliographic databases Pubmed and the Cochrane Library over the past 10 years. Specifi cally, we carried out an analysis of works containing information on risk factors, pathogenetic aspects and diagnostic criteria of MS in women of reproductive age, as well as on methods currently used for the treatment of this condition.Results. We characterize modern theories that explain mechanisms triggering the development of MS complicated with diabetes 2 type and polycystic ovary syndrome (PCOS). Data on proteomic markers refl ecting the complex pathogenesis of PCOS is generalized, along with their role in the diagnosis and treatment of this disease. The possibility of using these markers for predicting pregnancy outcomes is shown. The importance of regulating metabolic processes for the preparation of women for pregnancy and fertility recovery is emphasized.Conclusion. Hyperandrogenism, insulin resistance, obesity, diabetes 2 type, dyslipidemia, PCOS are shown to be the most signifi cant factors determining pathological changes in fertile age women with metabolic syndrome. The correction of these factors should be included in the course of pregravid preparation for the prevention of adverse pregnancy outcomes. 

scholarly journals Incisional Hernia Following Open Abdominal Aortic Aneurysm Repair: A Contemporary Review of Risk Factors and Prevention

2020 ◽  
Vol 3 ◽  
Author(s):  
Thuy-My Nguyen ◽  
Saissan Rajendran ◽  
Kilian GM Brown ◽  
Prakash Saha ◽  
Raffi Qasabian
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Incisional Hernia ◽  
Surgical Techniques ◽  
Abdominal Aortic Aneurysm Repair ◽  
Current Evidence ◽  
Patient Morbidity ◽  
Abdominal Aortic ◽  
Number Of Patients

While the endovascular approach has been the treatment of choice for abdominal aortic aneurysm (AAA) repair in the modern era, open AAA repair remains a treatment option and may have a resurgence after the recent release of draft guidelines from the National Institute for Health and Care Excellence (NICE). Incisional hernia is a common long-term complication of open AAA repair and causes significant patient morbidity. As the number of patients undergoing open AAA repair increases, it is imperative that vascular surgeons are aware of and aim to reduce the complications associated with open surgery. This article summarises current evidence, highlighting the risk factors for incisional hernia and the modern surgical techniques that can prevent complications.

scholarly journals Breastfeeding of Infants Born to Mothers with COVID-19: A Rapid Review

2020 ◽  
Author(s):  
Nan Yang ◽  
Siyi Che ◽  
Jingyi Zhang ◽  
Xia Wang ◽  
Yuyi Tang ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Breast Milk ◽  
Close Contact ◽  
Case Reports ◽  
Case Series ◽  
Rapid Review ◽  
Current Evidence ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Viral Nucleic Acid

AbstractBackgroundExisting recommendations on whether mothers with COVID-19 should continue breastfeeding are still conflicting. We aimed to conduct a rapid review of mother-to-child transmission of COVID-19 during breastfeeding.MethodsWe systematically searched Medline, Embase, Web of Science, Cochrane library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang, and preprint articles up to March 2020. We included studies relevant to transmission through milk and respiratory droplets during breastfeeding of mothers with COVID-19, SARS, MERS and influenza. Two reviewers independently screened studies for eligibility, extracted data, assessed risk of bias and used GRADE to assess certainty of evidence.ResultsA total of 4481 records were identified in our literature search. Six studies (five case reports and one case series) involving 58 mothers (16 mothers with COVID-19, 42 mothers with influenza) and their infants proved eligible. Five case reports showed that the viral nucleic acid tests for all thirteen collected samples of breast milk from mothers with COVID-19 were negative. A case series of 42 influenza infected postpartum mothers taking precautions (hand hygiene and wearing masks) before breastfeeding showed that no neonates were infected with influenza during one-month of follow-up.ConclusionsThe current evidence indicates that SARS-CoV-2 viral nucleic acid has not been detected in breast milk. The benefits of breastfeeding may outweigh the risk of SARS-CoV-2 infection in infants. Mothers with COVID-19 should take appropriate precautions to reduce the risk of transmission via droplets and close contact during breastfeeding.

Sign in / Sign up

Export Citation Format

Share Document