Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high.The 2013 update of the World Society ...of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections.
The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012).This preliminary report ...overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period.Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.912 patients with a mean age of 54.4 years (range 4-98) were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified.The overall mortality rate was 6.4% (58/912). According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock) as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality.White Blood Cell counts (WBCs) greater than 12,000 or less than 4,000 and core body temperatures exceeding 38°C or less than 36°C by the third post-operative day were statistically significant indicators of patient mortality.
Carcinoid tumor of the common bile duct Ayllón-Terán, M.ª Dolores; Valverde-Martínez, Amparo; Díaz-Nieto, Rafael ...
Revista española de enfermedades digestivas,
12/2014, Letnik:
106, Številka:
8
Journal Article
Introduction
Uterine leiomyosarcoma is an aggressive malignant tumor that often leads to metastatic dissemination, generally in the lungs, liver, brain, and bones. Despite the fact that pancreatic ...neoplasms spread easily, the pancreas is not a usual target organ from other neoplasms.
Case Report
We present a rare case of metastasis to the pancreas from uterine leiomyosarcoma treated with segmental resection with no recurrence at this stage. A review of the literature is later presented showing no similar case to what has been reported.
Discussion
Surgical resection of unique pancreatic metastases is a safe practice. An increase in the survival rate has been demonstrated after resection of metastases from renal cell carcinoma, although it has not been proved with metastases from other locations. Further trials are needed.
Minimally invasive surgery has experienced a significant expansion in the last decades. Robotic surgery has evolved in parallel to traditional laparoscopic surgery offering additional technical ...advantages. Some specific aspect of Hepatobiliary Surgery led to a limited implementation of minimally invasive liver surgery in the early years of laparoscopic surgery whilst we are experiencing an exponential increase in the use of minimally invasive approaches to this type of intervention. In this chapter we describe the key aspect of robotic liver surgery with a meticulous description of the supporting evidence, its limitation and future perspectives.
El presente artículo persigue mostrar las reflexiones sobre las políticas públicas implementadas por el Estado colombiano en el departamento de Atlántico, en relación a los desplazados, frente al ...estado de cosas inconstitucional a partir de la sentencia T- 025 del 2004. Se sustentó en los supuestos teóricos de Acnur (2009) y (2014), Aguilar y Ander-Egg (1992), Bejaramo (1997), y Celis (2006), entre otros. Metodológicamente se categorizó como un estudio cualitativo de corte documental, con técnicas fenomenológicas, bajo un paradigma crítico interpretativo. Entre las reflexiones finales se destacaron, que en la mayoría de los casos, el Estado olvida la responsabilidad que le compete en el cuidado de esta población, no solo en el encargo de garantizar la seguridad en las zonas donde fueron desplazados, sino en la creación de políticas sociales en las zonas donde se encuentran asentados. De allí se desprenden algunas reflexiones tendientes recomendar que el Estado Colombiano debe apoyar el retorno voluntario y la reinserción a sus territorios de origen. Así como crear un centro de orientación para la atención psicosocial, jurídica y asistencial para la atención de mujeres víctimas de violencia de todo tipo. Fortalecer el Programa: “Atención a la Población damnificada” existente, para la atención de la población alojada y albergada en el Departamento.
Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The World Society of Emergency ...Surgery (WSES) has designed the CIAOW study in order to describe the clinical, microbiological, and management-related profiles of both community- and healthcare-acquired complicated intra-abdominal infections in a worldwide context. The CIAOW study (Complicated Intra-Abdominal infection Observational Worldwide Study) is a multicenter observational study currently underway in 57 medical institutions worldwide. The study includes patients undergoing surgery or interventional drainage to address complicated intra-abdominal infections. This preliminary report includes all data from almost the first two months of the six-month study period. Patients who met inclusion criteria with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 702 patients with a mean age of 49.2 years (range 18-98) were enrolled in the study. 272 patients (38.7%) were women and 430 (62.3%) were men. Among these patients, 615 (87.6%) were affected by community-acquired IAIs while the remaining 87 (12.4%) suffered from healthcare-associated infections. Generalized peritonitis was observed in 304 patients (43.3%), whereas localized peritonitis or abscesses was registered in 398 (57.7%) patients.The overall mortality rate was 10.1% (71/702). The final results of the CIAOW Study will be published following the conclusion of the study period in March 2013.
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