764 research outputs found
A "Beehive" in the Abdomen
No full textA 22 years-old woman presenting with intestinal occlusion by a giant fecaloma. Fecal impaction is often misdiagnosed, especially in non collaborating patients. This demonstrates the necessity of particular attention to avoid unnecessary surgical intervention. © 2012 Association of Surgeons of India
Isn't it time to start speaking about "European surgeons"?
No full textAbstract Background Emergency surgery has become a neglected specialization in Europe and in many other parts of the world. In certain medical fields, emergency surgery isn't even considered an autonomous specialization. However every emergency surgeon must have a good formation in General Surgery but exist huge disparities between different European surgical formative systems. Methods An analysis of the main problems of the European surgical formative system was conducted. Results This discrepancy between formative systems is absolutely unacceptable and presents a notable hazard for the European Union, considering that surgical certifications are reciprocally recognized between programs within all European Union states. Conclusion Considering the increasing possibilities to move inside the European Union, is necessary to improve the European surgical formative system to warrant an uniform formation for all surgeons.</p
Reversing the Effect of Anticoagulants Safety in Patients Undergoing Emergency Surgery
No full textAnticoagulants are widely used, especially in the elderly, for the prevention and treatment of thromboembolic complications and in high-risk post myocardial infarction. Above all, Vitamin K antagonists (VKAs) are predominantly prescribed in the general population. Unfortunately, due to VKAs intrinsic pharmacodynamic and pharmacokinetic properties (high interindividual variability, food interaction, narrow therapeutic window), routine management of VKAs can be challenging both for the patients and for the clinicians, consequently, the number of patients taking non-vitamin K oral anticoagulants (i.e., direct oral anticoagulants) is increased in the last years. In fact, direct oral anticoagulants (DOACs) have progressively been used owing to their shorter half-lives, rapid onset, and predictable pharmacodynamics.
In the elderly, the incidence of pharmacologically induced coagulopathy, in trauma or emergency invasive procedure, is responsible for a huge increase of bleeding complications that can be life-threatening. Consequently, the perioperative management of patients taking anticoagulant agents and undergoing surgery is particularly challenging. A precise balance has to be reached between the risk of bleeding and the risk of thromboembolism. Then, when a decision of stopping anticoagulant has been made, it is vital to determine the time of anticoagulation interruption, resumption, and the necessity of bridging. Furthermore, in emergency scenario, the reversal of the anticoagulant should be mandatory, not only to prevent but also to treat perioperative bleeding. In this situation, a specific reversal strategy has to be chosen on the basis of the type of anticoagulants.
In this chapter, we aimed to provide an overview of the current knowledge regarding the perioperative management of patients receiving anticoagulants and undergoing surgery
Antimicrobial management of intra-abdominal infections: Literature's guidelines
No full textAntimicrobial management of severe intra-abdominal infections (IAIs) involves a delicate balance of optimizing empirical therapy, which has been shown to improve clinical outcomes, while simultaneously reducing unnecessary antimicrobial use. Two sets of guidelines for the management of intra-abdominal infections were recently published. In 2010, the Surgical Infection Society and the Infectious Diseases Society of America (SIS-IDSA) created guidelines for the diagnosis and management of complicated IAIs. The new SIS-IDSA guidelines replace those previously published in 2002 and 2003. The World Society of Emergency Surgery (WSES) guidelines represent additional contributions, made by specialists worldwide, to the debate regarding proper antimicrobial drug methodology. These guidelines represent the conclusions of the consensus conference held in Bologna, Italy, in July 2010 during the first congress of the WSES. © 2012 Baishideng. All rights reserved
Acute Peritonitis
No full textImproving outcomes in emergency surgery for the geriatric population is a great challenge for healthcare systems worldwide.
Elderly patients often have multiple concomitant illnesses and are usually also in poor clinical condition due to poor physiological reserve and the additional stress caused by sepsis response.
Short- and long-term outcomes of elderly patients with acute peritonitis are often associated with higher mortality, increased morbidity, higher utility of intensive care resources and longer hospital stays and often with limitations on the ability to live an independent life after the septic insult
Gastrointestinal stromal tumor and mitosis, pay attention
No full textThe difference between stages I and III of gastric gastrointestinal stromal tumor depends principally on the number of mitosis. According with TNM classification, the presence in the tumor of high mitotic rate determines the upgrading. Many studies exposed different count techniques in evaluating the number of mitosis. An international standardized method to assess mitotic rate is needed. © 2012 Baishideng. All rights reserved
Comment on: SARS-Cov-2 in peritoneal fluid: an important finding in the Covid-19 pandemic
No full textArtificial intelligence may enhance emergency triage and management
No full text: The entry of Artificial Intelligence (AI) into Intensive Care has become a reality. We think that only with robust validation studies accomplished by a multidisciplinary team the gap between clinical research and clinical practice can be bridged
Twelve-month results of laparoscopic lavage in perforated acute diverticulitis - Update of meta-analysis results. New evidences, which perspectives?
No full textAbracadabra
No full textA voluminous radiopaque foreign body (7 cm in diameter bowl) in the rectum of a 45-year-old male patient was removed uneventfully by a transanal approach with an obstetric forceps
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