Acute Surgery

2021 ◽  
Author(s):  
Shelly Griffiths
Keyword(s):  
Acute Surgery

scholarly journals suPAR is associated with risk of future acute surgery and post-operative mortality in acutely admitted medical patients

2018 ◽  
Vol 26 (1) ◽  
Author(s):  
Jeppe Meyer ◽  
Morten Alstrup ◽  
Line J. H. Rasmussen ◽  
Martin Schultz ◽  
Steen Ladelund ◽  
...  
Keyword(s):  
Operative Mortality ◽  
Medical Patients ◽  
Acute Surgery

scholarly journals Decreased TLR3 in Hyperplastic Adipose Tissue, Blood and Inflamed Adipocytes is Related to Metabolic Inflammation

2018 ◽  
Vol 51 (3) ◽  
pp. 1051-1068 ◽  
Author(s):  
Jèssica Latorre ◽  
José M. Moreno-Navarrete ◽  
Mónica Sabater ◽  
Maria Buxo ◽  
José I. Rodriguez-Hermosa ◽  
...  
Keyword(s):  
Weight Loss ◽  
Adipose Tissue ◽  
Low Grade ◽  
Metabolic Inflammation ◽  
Fat Depots ◽  
Acute Surgery ◽  
Obese Subjects ◽  
Anti Inflammatory ◽  
The Impact

Background/Aims: Obesity is characterized by the immune activation that eventually dampens insulin sensitivity and changes metabolism. This study explores the impact of different inflammatory/ anti-inflammatory paradigms on the expression of toll-like receptors (TLR) found in adipocyte cultures, adipose tissue, and blood. Methods: We evaluated by real time PCR the impact of acute surgery stress in vivo (adipose tissue) and macrophages (MCM) in vitro (adipocytes). Weight loss was chosen as an anti-inflammatory model, so TLR were analyzed in fat samples collected before and after bariatric surgery-induced weight loss. Associations with inflammatory and metabolic parameters were analyzed in non-obese and obese subjects, in parallel with gene expression measures taken in blood and isolated adipocytes/ stromal-vascular cells (SVC). Treatments with an agonist of TLR3 were conducted in human adipocyte cultures under normal conditions and upon conditions that simulated the chronic low-grade inflammatory state of obesity. Results: Surgery stress raised TLR1 and TLR8 in subcutaneous (SAT), and TLR2 in SAT and visceral (VAT) adipose tissue, while decreasing VAT TLR3 and TLR4. MCM led to increased TLR2 and diminished TLR3, TLR4, and TLR5 expressions in human adipocytes. The anti-inflammatory impact of weight loss was concomitant with decreased TLR1, TLR3, and TLR8 in SAT. Cross-sectional associations confirmed increased V/ SAT TLR1 and TLR8, and decreased TLR3 in obese patients, as compared with non-obese subjects. As expected, TLR were predominant in SVC and adipocyte precursor cells, even though expression of all of them but TLR8 (very low levels) was also found in ex vivo isolated and in vitro differentiated adipocytes. Among SVC, CD14+ macrophages showed increased TLR1, TLR2, and TLR7, but decreased TLR3 mRNA. The opposite patterns shown for TLR2 and TLR3 in V/ SAT, SVC, and inflamed adipocytes were observed in blood as well, being TLR3 more likely linked to lymphocyte instead of neutrophil counts. On the other hand, decreased TLR3 in adipocytes challenged with MCM dampened lipogenesis and the inflammatory response to Poly(I:C). Conclusion: Functional variations in the expression of TLR found in blood and hypertrophied fat depots, namely decreased TLR3 in lymphocytes and inflamed adipocytes, are linked to metabolic inflammation.

scholarly journals ‘Hobson’s choice’: a qualitative study of consent in acute surgery

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037657
Author(s):  
Anthony Howard ◽  
Jonathan Webster ◽  
Naomi Quinton ◽  
Peter V Giannoudis
Keyword(s):  
Surgical Intervention ◽  
First Language ◽  
Trauma Centre ◽  
Consent Process ◽  
Individual Risk ◽  
Acute Surgery ◽  
Major Trauma Centre ◽  
Language Data ◽  
Data Saturation ◽  
Past Experiences

ObjectivesThe study aimed to understand through qualitative research what patients considered material in their decision to consent to an acute surgical intervention.Participants, setting and interventionThe patients selected aged between 18 and 90, having been admitted to a major trauma centre to undergo an acute surgical intervention within 14 days of injury, where English was their first language. Data saturation point was reached after 21 patients had been recruited. Data collection and analysis were conducted simultaneously, through interviews undertaken immediately prior to surgery. The data were coded using NVIVO V.12 software.ResultsThe key theme that originated from the data analysis was patients were unable to identify any individual risk that would modify their decision-making process around giving consent. The patient’s previous experience and the experience of others around them were a further theme. Patients sensed that there were no non-operative options for their injuries.ConclusionThis is the first study investigating what patient considered a material risk in the consent process. Patients in this study did attribute significance to past experiences of friends and family as material, prompting us to suggest that the surgeon asks about these experiences as part of the consent process. Concern about functional recovery was important to patients but insufficient to stop them from consenting to surgery, thus could not be classified as material risk.

Malrotation in Congenital Diaphragmatic Hernia: Is It Really a Problem?

2019 ◽  
Vol 30 (05) ◽  
pp. 434-439 ◽  
Author(s):  
Ivo de Blaauw ◽  
Julia van Ling ◽  
Sanne M. B. I. Botden ◽  
Kim Heiwegen
Keyword(s):  
Small Bowel ◽  
Congenital Diaphragmatic Hernia ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Diaphragmatic Hernia ◽  
High Volume ◽  
Acute Surgery ◽  
High Volume Center ◽  
Acute Small Bowel Obstruction ◽  
Intestinal Rotation

Abstract Introduction Congenital diaphragmatic hernia (CDH) has been associated with other congenital malformations, such as intestinal rotation abnormalities. However, there is no standard evaluation and treatment of intestinal rotation during initial CDH repair. This study evaluates intestinal malrotation in CDH patients. Materials and Methods All patients with a CDH treated in a high-volume center between 2000 and 2015 were retrospectively evaluated. Demographics, gastrointestinal characteristics, surgical treatment, and abdominal outcomes (acute surgery, small bowel obstruction, and volvulus) were described. Results A total of 197 CDH patients were surgically repaired. In 76 (39%) patients, a malrotation was described at initial CDH repair, in 39 (20%) patients, a normal rotation, but 82 patients (42%) had no report on intestinal rotation. During follow-up (range: 2–16 years), 12 additional malrotations were diagnosed, leading to a prevalence of at least 45% (n = 88). These were mostly diagnosed due to acute small bowel obstruction, of which three had a volvulus. Of the 12 later diagnosed malrotations, 58% required acute surgery, compared to 3% of the 76 initially diagnosed patients (p < 0.001). Conclusion Malrotation is associated with CDH, with a prevalence of at least 45% and in 21% a normal intestinal rotation. “Missed” malrotations have a higher risk on need for acute surgery later in life.

scholarly journals Arteria iliaca aneurysma nyitott és endovascularis kezelése

2018 ◽  
Vol 159 (13) ◽  
pp. 520-525
Author(s):  
Dávid Garbaisz ◽  
András Boros ◽  
Péter Legeza ◽  
Zoltán Szeberin
Keyword(s):  
Surgical Treatment ◽  
Retrospective Analysis ◽  
Iliac Artery ◽  
Open Surgery ◽  
Elective Surgery ◽  
Artery Aneurysm ◽  
Complication Rates ◽  
Iliac Artery Aneurysm ◽  
Term Survival ◽  
Acute Surgery

Abstract: Introduction and aim: Iliac artery aneurysms make up 2% of all aneurysms. There are only a few data available on the results of surgical treatment, therefore the optimal treatment is unclear. Our objective was the retrospective analysis of the perioperative morbidity and mortality of patients who underwent iliac artery surgery as well as the comparison of elective open surgery and endovascular iliac aneurysm repair (EVIAR). Method: Retrospective analysis of patients who underwent surgery for iliac artery aneurysm between 1 January 2005 and 31 December 2014. Results: During the 10-year period, 62 patients with a mean age of 68.9 years underwent elective surgery for iliac artery aneurysm (54 males, 87.1%). In 10 cases acute surgery was performed due to aneurysm ruptures (13.9%), 3 patients died within the perioperative period (30%). Regarding anatomical localisation, aneurysm developed mostly on the common iliac artery (80.6%). As an elective surgery, 35 patients (56.5%) underwent open surgery, 25 (40.3%) underwent EVIAR and other endovascular interventions were performed in 2 cases (3.2%). Postoperative complications (1 patient [4.0%] vs. 17 patients [48.5%]; p<0.001) and intensive care treatment (29 patients [82.8%] vs. 2 patients [8.0%]; p<0.001) were significantly rarer after EVIAR than after open surgery. Furthermore, EVIAR resulted in considerably shorter postoperative hospital stays (4.7 ± 2.3 days vs. 11.8 ± 12.2 days; p = 0.006) and significantly less blood transfusion demand (1 patient [4.0%] vs. 26 patients [74.2%]; p<0.001). There were no significant differences regarding long-term survival rates between EVIAR and open surgery (81.4% vs. 71.4%; p = 0.95). Conclusion: In case of the surgical treatment of iliac artery aneurysms, owing to the lower complication rates and shorter postoperative length of stay, EVIAR is primarily recommended. Orv Hetil. 2018; 159(13): 520–525.

MON-PP271: A Perioperative Infusion of Glucagon Like Peptide 1 Diminishes Acute Surgery-Induced Insulin Resistance in Pigs

2015 ◽  
Vol 34 ◽  
pp. S227
Author(s):  
M. Hagve ◽  
P.F. Gjessing ◽  
M.J. Hole ◽  
O.M. Fuskevåg ◽  
T. Larsen ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Acute Surgery ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Low risk, but not no risk, of umbilical hernia complications requiring acute surgery in childhood

2013 ◽  
Vol 50 (4) ◽  
pp. 291-293 ◽  
Author(s):  
Amanda Ireland ◽  
Ian Gollow ◽  
Parshotam Gera
Keyword(s):  
Umbilical Hernia ◽  
Low Risk ◽  
Acute Surgery
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