A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Pathological Conditions, Signs and Symptoms - Top 30 Publications

Approach to the Patient with Chronic Groin Pain.

Chronic postoperative inguinal pain has become a primary outcome parameter after elective inguinal hernia repair with significant consequences affecting patient productivity, employment, and quality of life. A systematic and thorough preoperative evaluation is important to identify the etiologies and types of pain. Owing to the complex nature of chronic pain, a multimodal and multidisciplinary treatment approach is recommended. Patients with chronic pain refractory to conservative measures may be considered for surgical intervention. Triple neurectomy remains the most definitive and accepted remedial operation performed and provides effective relief in the majority of patients.

Minimally Invasive Approaches to Inguinal Hernias.

Both the transabdominal preperitoneal approach and the total extraperitoneal approach to inguinal hernias provide an effective means of repairing inguinal hernias. The robotic platform can be used and may help to decrease immediate postoperative pain; however, as this is a fairly new technique, more research will help further determine long-term outcomes. In all methods of fixation, we ensure adequate fixation medially with tacks placed on the Cooper ligament. Awareness of the nerves and vessels helps to guide dissection as well as prevent inadvertent injury during mesh fixation.

Inguinal Hernia: Four Open Approaches.

Open inguinal hernia approaches are varied. The best studied approaches are reviewed herein. The common factor among them is the imperative anatomy knowledge of the surgeon. This knowledge is key to improved outcomes. A tailored approach is best to determine which open technique, if any, is most appropriate for the patient. Although the anterior mesh approach is the most commonly applied, there is support in using the posterior approach or a tissue repair for subsets of patients, such as women.

Inguinal Hernia: Mastering the Anatomy.

The success of an inguinal hernia repair is defined by the permanence of the operation while creating the fewest complications at minimal cost and allowing patients an early return to activity. This success relies and depends on the surgeon's knowledge and understanding of groin anatomy and physiology. This article reviews relevant anatomy to inguinal hernia repair and technical steps to open tissue and mesh repairs as well as minimally invasive approaches.

Flank and Lumbar Hernia Repair.

Flank and lumbar hernias are challenging because of their rarity and anatomic location. Several challenges exist when approaching these specific abdominal wall defects, including location, innervation of the lateral abdominal wall musculature, and their proximity to bony landmarks. These hernias are confined by the costal margin, spine, and pelvic brim, which makes closure of the defect, including mesh placement, difficult. This article discusses the anatomy of lumbar and flank hernias, the various etiologies for these hernias, and the procedural steps for open and robotic preperitoneal approaches. The available clinical evidence regarding outcomes for various repair techniques is also reviewed.

Surgical Management of Parastomal Hernias.

Parastomal hernias are a common complication after ostomy formation that can require surgical repair when they become symptomatic. Operative planning and a thorough understanding of the anatomy of the abdominal wall are important. Simple fascial repair is associated with an unacceptably high recurrence rate and should be used as a temporary measure only. Stoma relocation has a high recurrence rate. Prophylactic mesh can and should be used. At this time, the use of mesh is considered the standard of care in the repair of parastomal hernias.

Umbilical Hernia Repair: Overview of Approaches and Review of Literature.

Umbilical hernias are ubiquitous, and surgery is indicated in symptomatic patients. Umbilical hernia defects can range from small (<1 cm) to very large/complex hernias, and treatment options should be tailored to the clinical situation. Open, laparoscopic, and robotic options exist for repair, with each having its advantages and disadvantages. In general, mesh should be used for repair, because it has been shown to decrease recurrence rates, even in small hernias. Although outcomes are generally favorable after umbilical hernia repairs, some patients have chronic complaints that are mostly related to recurrences.

Incisional Hernia Repair: Minimally Invasive Approaches.

A common surgical procedure, ventral hernia repair has long been a vexing problem, with no clear standard for repair and significant postoperative morbidity. Laparoscopic repair has the clear advantage of lower postoperative morbidity. However, application of laparoscopic ventral hernia repair is often limited by patient factors and hernia morphology. Long-term complications of intraperitoneal mesh and recurrence are concerning. Robotic-assisted surgery is the latest advance in minimally invasive hernia repair, combining the advantages of open repair with complete abdominal wall reconstruction and restoration of functional anatomy with the wound morbidity and decreased recovery time of laparoscopy.

Incisional Hernia Repair: Open Retromuscular Approaches.

In this article, we discuss concepts, surgical techniques and published literature about the most common abdominal wall reconstructive techniques performed with retromuscular mesh placement through an open approach.

Enhanced Recovery After Surgery Protocols: Rationale and Components.

Enhanced recovery after surgery (ERAS) protocols are spreading throughout various fields in surgery. ERAS protocols involve the implementation of evidence-based elements of care that are applied throughout the entire perioperative period to facilitate optimal recovery for the patient. ERAS protocols have been associated with improvements in quality of care, patient-reported and operative outcomes, and patient safety as well as reductions in cost. Thus, ERAS protocols have led to an overall improvement in health care value for the patient and the health care system.

Preoperative Planning and Patient Optimization.

This article reviews the literature that supports routine expectations for smoking cessation; weight loss; diabetic, nutritional, or metabolic optimization; and decolonization techniques before ventral hernia repair. These methods diminish postoperative complications. In an era of value-centric care, an upfront investment in patient optimization can improve the quality of the repair by reducing wound morbidity and hernia recurrence, naturally translating to a reduction in cost. The adoption of these practices and further study aimed at identifying other effective optimization techniques are encouraged.

Role of Prophylactic Mesh Placement for Laparotomy and Stoma Creation.

Incisional and parastomal hernias are a cause of significant morbidity and have a substantial effect on quality of life and economic costs for patients and hospital systems. Although many aspects of abdominal hernias are understood, prevention is a feature that is still being realized. This article reviews the current literature and determines the utility of prophylactic mesh placement in prevention of incisional and parastomal hernias.

Epidemiology and Disparities in Care: The Impact of Socioeconomic Status, Gender, and Race on the Presentation, Management, and Outcomes of Patients Undergoing Ventral Hernia Repair.

More research is needed with regards to gender, race, and socioeconomic status on ventral hernia presentation, management, and outcomes. The role of culture and geography in hernia-related health care remains unknown. Currently existing nationwide registries have thus far yielded at best a modest overview of disparities in hernia care. The significant variation in care relative to gender, race, and socioeconomic status suggests that there is room for improvement in providing consistent care for patients with hernias.

Development of weight and height in Norwegian children: The Health Oriented Pedagogical Project (HOPP).

High prevalence of overweight and obesity increases the disease burden with higher risk for an expanding set of chronic diseases, including cardiovascular disease, diabetes mellitus, chronic kidney disease, certain types of cancers and an array of musculoskeletal disorders. Over the last decades, trends in children's weight have changed worldwide.

Waist circumference in 6-12-year-old children: The Health Oriented Pedagogical Project (HOPP).

With overweight and obesity increasing worldwide, it has become ever more important to monitor the development and distribution of adiposity in children. This study investigated how the measurements of waist circumference (WC) and waist-to-height ratio (WHtR) in children 6-12 years old relate to earlier studies.

Hemorrhagic Shock.

Hemorrhagic Shock.

Hemorrhagic Shock.

Hemorrhagic Shock.

Association between obesity with disease-free survival and overall survival in triple-negative breast cancer: A meta-analysis.

To investigate the relationship between obesity and disease-free survival (DFS) and overall survival (OS) of triple-negative breast cancer.

Complications in transorbital penetrating injury by bamboo branch: A case report.

Wooden transorbital penetrating injury is an uncommon and serious trauma that may cause multiply complications.

IGF and IGFBP as an index for discrimination between vitamin D supplementation responders and nonresponders in overweight Saudi subjects.

Vitamin D deficiency is common in the Kingdom of Saudi Arabia (KSA). Therefore, it is significant to recognize which biochemical markers modulate serum 25 hydroxyvitamin D (25(OH)D) in response to vitamin D supplementation in such a population. Our aim was to study the correlation of insulin-like growth factor (IGF) and insulin growth factor binding protein (IGFBP) with serum 25(OH)D in response to vitamin D supplementation in a Saudi population. A total of 199 (89 males/110 females) vitamin D deficient subjects (25(OH)D level <50 nmol/L), aged 40.4 ± 11.4 years, were given vitamin D supplements (50,000 IU/mL every week) for the first 2 months, then twice a month for 2 months, followed by daily 1000 IU in the last 2 months. Fasting blood samples were taken at baseline and 6 months after the final dose of vitamin D. Serum 25(OH)D, IGF-1 and IGF-2, and IGFBPs 2-5 were measured. Vitamin D response was computed for all subjects as the difference in levels of serum 25(OH)D concentration at the end of 6 months compared to baseline. After intervention, serum 25(OH)D concentration significantly increased from 35.6 nmol/L (26.6-43.5) to 61.8 nmol/L (54.8-73.3) in responder subjects (P < .01) and from 35.1 nmol/L (21.2-58.2) to 38.3 nmol/L (25.5-48.3) in nonresponders (P = .13). Subjects with lower baseline serum IGF-II, IGFBP-2, and IGF-1/IGFBP-3 ratio are more sensitive to acute vitamin D status changes. IGF1 and IGF-1/IGFBP-3 ratio significantly increased in all subjects after 6 months (P = .01). Changes in 25(OH)D was significantly associated with changes in IGFBP-2 and IGF-1/IGFBP-3 ratio in responders only. This study proposes that changes in circulating IGF-I and IGFBP-3 are modulated by vitamin D supplementation and can be taken into consideration in investigations involving vitamin D correction. Moreover, increase in serum 25(OH)D and IGF-I/IGFBP-3 molar ratio are more sensitive markers for the response to vitamin D supplementation in Saudi population.

Sacral epiduroscopic laser decompression for complex regional pain syndrome after lumbar spinal surgery: A case report.

CRPS after a lumbar surgery has symptoms that are similar to PSSS. However, standard criteria for distinguishing CRPS from PSSS do not exist. We present a case report of a 31-year-old female with CRPS symptoms after lumbar spinal surgery treated by performing SELD.

Cauda equina syndrome following an uneventful spinal anesthesia in a patient undergoing drainage of the Bartholin abscess: A case report.

Neuraxial anesthesia is a commonly used type of regional anesthesia. Cauda equina syndrome is an unusual and severe complication of neuraxial anesthesia, and is caused by damage to the sacral roots of the neural canal. We present a case of cauda equina syndrome following spinal anesthesia in a patient who underwent Bartholin abscess drainage.

Efficacy of electroacupuncture compared with transcutaneous electric nerve stimulation for functional constipation: Study protocol for a randomized, controlled trial.

To treat functional constipation, both electroacupuncture (EA) therapy and transcutaneous electric nerve stimulation (TENS) are safe and effective. However, no head-to-head comparison trial has been conducted. This trial compares the efficacy of electroacupuncture relative to transcutaneous electric nerve stimulation for functional constipation.

Pituitary apoplexy following lumbar fusion surgery in prone position: A case report.

Pituitary apoplexy (PA) is a syndrome caused by acute hemorrhage or infarction of the pituitary gland, generally within a pituitary adenoma. PA following spinal surgery is a very rare complication and may be difficult to diagnose. However, early diagnosis of PA is essential for the timely treatment of pan-hypopituitarism and prevention of severe neurologic complications.

Surgical treatment for metastasis from lymphoepithelioma-like cholangiocarcinoma in the liver: A case report.

Lymphoepithelioma-like cholangiocarcinoma (LEL-CC) is a rare variant of intrahepatic cholangiocarcinoma (ICC), which is characterized by the better outcome than normal ICC. There is no report about the treatment for the metastasis of the LEL-CC. Here, we describe a rare case of LEL-CC of the liver and report the treatment for metastasis of it.

Earlier surgery improves outcomes from painful chronic pancreatitis.

The timing of surgery for painful chronic pancreatitis (CP) may affect outcomes.Clinical course, Izbicki pain scores, and pancreatic function were retrospectively compared and analyzed between patients undergoing either early or late surgery (< 3 or ≥ 3 years from diagnosis) for painful CP in a single center from 2007 to 2012.The early surgery group (n = 98) more frequently than the late group (n = 199) had abdominal pain with jaundice (22.4% vs 9.5%, P = .002) and pancreatic mass +/- ductal dilatation (47% vs 27%, P < .001), but less frequently abdominal pain alone (73.5% vs 85.9%, P = .009), ductal dilatation alone (31% vs 71%, P < .001), parenchymal calcification (91.8% vs 100%, P < .001) or exocrine insufficiency (60% vs 72%, P = .034); there were no other significant differences. The early group had longer hospital stay (14.4 vs 12.2 days, P = .009), but no difference in complications. Significantly greater pain relief followed early surgery (complete 69% vs 47%, partial 22% vs 37%, none 8% vs 16%, P = .01) with lower rates of exocrine (60% vs 80%, P = .005) and endocrine insufficiency (36% vs 53%, P = .033).Our data indicate that early surgery results in higher rates of pain relief and pancreatic sufficiency than late surgery for chronic pancreatitis patients. Frey and Berne procedures showed better results than other surgical procedures.

Characteristics and management of pyogenic liver abscess: A European experience.

Pyogenic liver abscess (PLA) are space-occupying lesions in the liver associated with high morbidity and mortality. The aim of this study is to review an Italian hospital experience in epidemiological, clinical patterns, and management of PLA.We performed a retrospective, descriptive case series at a single center assessing demographic characteristics, presentation patterns, etiological factors, microbiological etiology, and management for patients treated for PLA between 2000 and 2016.Around 109 patients were identified. The majority of patients presented with fever (73%); right upper abdominal pain in 63.3%, vomiting and nausea in 28.4%. The most common laboratory abnormality among included items was increased C-reactive protein and fibrinogen blood levels, respectively, in 98% and 93.9% of cases. Abdominal ultrasound was the diagnostic investigation in 42.4% of cases; CT scan and MR imaging were performed in 51.1% and 3.3% of cases respectively. We observed blood or pus culture study in 99 cases of which only 53.5% came with positive microbial reports. The most common organism identified was Escherichia coli (26.5%), followed by Streptococcus spp (13.2%). Early antibiotic treatment started on all patients and 66.7% of cases required different approaches, Ultrasound or CT-guided needle aspiration of PLA was performed in 13 patients (11%) and percutaneous abscess drainage was performed on 72 patients (67%).PLA is a diagnostically challenging problem due to nonspecific presenting characteristics. The microbiological yield identified was a typical European spectrum with a preponderance of Escherichia coli infections. Once recognized, percutaneous drainage and antibiotic treatment are the mainstay of management for PLA.

Giant malignant pheochromocytoma in an elderly patient: A case report.

Malignant pheochromocytoma is a rare disease and surgical resection is the only curative treatment.