-
Neurobiology of Stress May 2024[This corrects the article DOI: 10.1016/j.ynstr.2023.100556.].
Corrigendum to "Cross-sectional study of retrospective self-reported childhood emotional neglect and inhibitory neurometabolite levels in the pregenual anterior cingulate cortex in adult humans" [Neurobiol. Stress, 25 (July 2023), 100556].
[This corrects the article DOI: 10.1016/j.ynstr.2023.100556.].
PubMed: 38884012
DOI: 10.1016/j.ynstr.2024.100630 -
SAGE Open Medical Case Reports 2024Adrenal gland cysts are rare and uncommon manifestations. Mostly asymptomatic, discovered incidentally during radiological studies or at autopsy, or without...
Adrenal gland cysts are rare and uncommon manifestations. Mostly asymptomatic, discovered incidentally during radiological studies or at autopsy, or without characteristic symptoms. The spectrum of these entities may include benign cysts or malignant cystic neoplasms. They are classified into four types: pseudocysts, endothelial cysts, epithelial cysts, and parasitic cysts. Though pseudocysts are reported to be the most frequently clinically recognized adrenal cysts in surgical series, endothelial cysts are more frequent in autopsy series. Even with advanced imaging modalities, it is still difficult to differentiate a benign adrenal neoplasm from a malignant one. As a result, getting a definitive diagnosis and starting treatment is challenging. In both symptomatic and asymptomatic cases with a large diameter or increasing sizes during follow-up, or with any abnormality of adrenal hormones, surgery is the treatment of choice in symptomatic. Herein, we present a 47-year-old female with a nonfunctional left adrenal endothelial cyst, who was incidentally found during a computerized tomography scan. The patient presented with left-sided nephritic colic due to renal lithiasis. The objective of this paper is to recall the clinical characteristics and to specify the diagnostic contribution of imaging as well as the therapeutic modalities of this entity.
PubMed: 38881974
DOI: 10.1177/2050313X241261510 -
Surgery Jun 2024Some observational data have suggested that anastomotic leak may be reduced with triple-row staple technology compared to double-row staple technology. We aimed to... (Review)
Review
BACKGROUND
Some observational data have suggested that anastomotic leak may be reduced with triple-row staple technology compared to double-row staple technology. We aimed to investigate this further by performing a systematic review comparing double- and triple-row staple technology for colorectal anastomoses.
METHODS
This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched up to November 2023. Articles were eligible for inclusion if they were comparing double-row staple and triple-row staple technology for left-sided colo-colic, colorectal, or coloanal anastomosis. The main outcomes included anastomotic leak, anastomotic hemorrhage, 30-day mortality, and reoperation. Meta-analyses with inverse variance random effects were performed. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development, and Evaluations.
RESULTS
After reviewing 340 relevant citations, 6 retrospective cohort studies met inclusion. Overall, 19,372 patients (mean age: 60.2 years, 52.7% female sex) had anastomoses with double-row staple technology, and 2,298 patients (mean age: 61.3 years, 50.3% female sex) with triple-row staple technology. Most operations were anterior resections (double-row: 55.3%; triple-row: 43.6%). Across all included studies, the risk of anastomotic leak was reduced with triple-row staple technology (6.3% vs 7.5%, risk ratio 0.54, 95% confidence interval 0.31-0.94, P = .03, I=75%). There were no significant differences in anastomotic hemorrhage (risk ratio 0.47, 95% confidence interval 0.15-1.49, P = .20, I = 57%), 30-day mortality (risk ratio 0.66, 95% confidence interval 0.17-2.55, P = .55, I = 0%), or reoperation (risk ratio 1.05, 95% confidence interval 0.42-2.64, P = .91, I = 56%).
CONCLUSION
Triple-row staple technology may reduce the risk of anastomotic leak in left-sided colorectal anastomoses.
PubMed: 38876899
DOI: 10.1016/j.surg.2024.04.039 -
Experimental and Therapeutic Medicine Aug 2024Desmopressin is a synthetic analogue of vasopressin and a selective vasopressin receptor 2 agonist. It was first synthesised in 1967 and utilised for its antidiuretic... (Review)
Review
Desmopressin is a synthetic analogue of vasopressin and a selective vasopressin receptor 2 agonist. It was first synthesised in 1967 and utilised for its antidiuretic properties. It is also used in bleeding disorders to enhance clotting. Other potential uses of the drug have been reported. The present review aims to provide a broad overview of the literature on potential further uses of oral forms of desmopressin. Key therapeutic areas of interest were identified based on known physiological activities/targets of desmopressin or reports of an effect of desmopressin in the literature. The feasibility of adequate dosing with oral forms of the drug was also considered. Systematic literature searches were carried out using the silvi.ai software for the identified areas, and summaries of available papers were included in tables and discussed. The results of the searches showed that desmopressin has been investigated for its efficacy in a number of areas, including bleeding control, renal colic, the central nervous system and oncology. Evidence suggests that oral desmopressin may have the potential to be of clinical benefit for renal colic and bleeding control in particular. However, further research is needed to clarify its effect in these areas, including randomised controlled studies and studies specifically of oral formulations (and doses). Further research may also yield findings for cancer, cognition and overactive bladder.
PubMed: 38873038
DOI: 10.3892/etm.2024.12592 -
Biomedical Reports Aug 2024Laparoscopic cholecystectomy (LC) is one of the most commonly performed surgeries and is considered the standard treatment for cholelithiasis. However, it is associated...
Laparoscopic cholecystectomy (LC) is one of the most commonly performed surgeries and is considered the standard treatment for cholelithiasis. However, it is associated with a risk of bile duct or hepatic artery injuries. This study evaluated the safety of LCs and the conversion rate (CR) by achieving a critical view of safety (CVS) and identification of Rouviere's sulcus (RS). This was a single-group cohort study that included consecutive patients undergoing LC at Smart Health Tower (Sulaimani, Iraq) from January 2021 to January 2023. The data were prospectively collected from patients' profiles or surgical notes within the hospital's database. A total of 419 patients underwent LC, of which females were the predominant gender (78.5%). The mean and median ages of the cases were 46.3±15.8 and 45 years, with a range of 2-90 years, respectively. The most common indications for surgery were biliary colic (69.5%), followed by acute cholecystitis (23.9%). The duration of the operations was significantly shorter for cases in which the CVS (45.6±17.9 min) or identification of RS (45.6±18.6 min) was achieved compared to those where the CVS (63.7±27.7 min) or RS (50.7±21.7 min) was not observed. Surgeries for patients with both CVS achievement and RS identification were also significantly less time-consuming (44.3±17.6) than counterparts (53.3±22.6). Among the cases without CVS achievement or RS identification (n=97, 23%), eight (8.2%) had adhesions, 12 (12.4%) had a distended gallbladder (GB) and 10 (10.3%) had thick GB walls. In addition, four (4.1%) experienced GB perforation, two (2.1%) had bleeding and one (1%) had stone spillage. There was no conversion. The achievement of CVS and identification of RS are practical landmarks in performing safe LC and decreasing the CR.
PubMed: 38872852
DOI: 10.3892/br.2024.1798 -
Journal of the American Veterinary... Jun 2024To compare 3 perioperative feeding regimens and their effect on anesthetic complications, manure output, and colic proportion in healthy horses.
OBJECTIVE
To compare 3 perioperative feeding regimens and their effect on anesthetic complications, manure output, and colic proportion in healthy horses.
METHODS
45 horses presenting for elective orthopedic procedures were randomly assigned to 1 of 3 groups: not fasted (NF; continuous access to hay perioperatively), fasted muzzled (FM; 10-hour preoperative fast with slow refeeding postoperatively and muzzle placement), or fasted not muzzled (FNM; same as FM without muzzle placement). Anesthetic protocol was standardized. Outcomes compared between groups included anesthesia time, arterial oxygenation, duration of hypotension, perioperative manure output, time to first passage of manure postoperatively, pain scores, and colic proportion. Comparisons were made with a mixed model and Fisher exact test with statistical significance considered at P ≤ .05.
RESULTS
No differences were seen in pain scores, oxygenation, hypotension, or colic between groups. Groups FM and FNM had a significantly greater mean reduction in postoperative manure weight (-81% and -70%; P = .003) and number of manure piles (-63% and -55%; P = .005) compared to group NF (-39% and -22%; P < .001; weight and piles, respectively). Mean ± SD minutes to passage of manure postoperatively was significantly shorter in group NF (238 ± 13 minutes) than groups FM (502 ± 174 minutes; P < .001) and FNM (444 ± 171 minutes; P = .003).
CLINICAL RELEVANCE
Horses with continuous access to hay prior to and following recovery from anesthesia passed more manure and passed manure sooner after surgery than their fasted counterparts without detrimental effect on anesthetic parameters and postoperative complications. Continuous access to hay perioperatively supports manure production in healthy horses without increase in anesthetic complications.
PubMed: 38866041
DOI: 10.2460/javma.24.04.0235 -
Digestion Jun 2024Patients with Crohn's disease (CD) require an assessment of small bowel lesions, while difficulties exist in performing small intestinal examinations especially in...
INTRODUCTION
Patients with Crohn's disease (CD) require an assessment of small bowel lesions, while difficulties exist in performing small intestinal examinations especially in small-sized medical offices. Small bowel capsule endoscopy (SBCE) is handy and can be performed in most clinical settings. The only drawback of SBCE is a requirement of patency testing prior to the exam because it sometimes requires CT scanning to localize the ingested patency capsule (PC), which may be a substantial burden for the patient. We have developed a novel PC detection system named PICS (Patency capsule, Ileo-Colonoscopy and Small bowel capsule endoscopy) method by which we can avoid CT scanning. In the PICS method, Ileo-Colonoscopy (ICS) is performed after 30 to 33 hours of PC ingestion and the PC can be localized by ICS in patients who have not excreted the PC, and the entire intestine can be examined in combination with subsequent SBCE without additional bowel preparation. The aim of this study was to assess the usefulness and safety of the PICS method for CD patients.
METHODS
CD patients who underwent PICS method from April 2021 to March 2023 were reviewed for clinical data, outcome of PICS method including the rates of PC detection by ICS, the number of patients underwent SBCE, and adverse events. Lewis score was used to assess SBCE results.
RESULTS
The PICS method was performed in 54 patients. The median age of patients was 28.5 years old and 64.8% of them were ileo-colic type. The median disease duration was 10.5 months and 24.1% had history of small bowel resection. Five cases (9.3%) confirmed gastrointestinal patency by ICS and none of the cases required CT scanning. One patient who could not be confirmed patency by ICS, and the other patient who excreted PC but was found ileal stenosis by ICS did not undergo SBCE. Remaining 52 patients received SBCE and the median Lewis score of them was 0 (IQR 0, 450). There were no adverse events including small bowel obstruction by PC and SBCE retention in this series.
CONCLUSION
The PICS method is not only feasible and safe but also convenient to assess disease extent in patients with CD. By localizing PC with ICS, additional CT scanning could be unnecessary for SBCE, which benefits both physicians and CD patients.
PubMed: 38857573
DOI: 10.1159/000539682 -
The Journal of Manual & Manipulative... Jun 2024An international taskforce of clinician-scientists was formed by specialty groups of World Physiotherapy - International Federation of Orthopaedic Manipulative Physical... (Review)
Review
INTRODUCTION
An international taskforce of clinician-scientists was formed by specialty groups of World Physiotherapy - International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) & International Organisation of Physiotherapists in Paediatrics (IOPTP) - to develop evidence-based practice position statements directing physiotherapists clinical reasoning for the safe and effective use of spinal manipulation and mobilisation for paediatric populations (<18 years) with varied musculoskeletal or non-musculoskeletal conditions.
METHOD
A three-stage guideline process using validated methodology was completed: 1. Literature review stage (one scoping review, two reviews exploring psychometric properties); 2. Delphi stage (one 3-Round expert Delphi survey); and 3. Refinement stage (evidence-to-decision summative analysis, position statement development, evidence gap map analyses, and multilayer review processes).
RESULTS
Evidence-based practice position statements were developed to guide the appropriate use of spinal manipulation and mobilisation for paediatric populations. All were predicated on clinicians using biopsychosocial clinical reasoning to determine when the intervention is appropriate.1. It is not recommended to perform:• Spinal manipulation and mobilisation on infants.• Cervical and lumbar spine manipulation on children.•Spinal manipulation and mobilisation on infants, children, and adolescents for non-musculoskeletal paediatric conditions including asthma, attention deficit hyperactivity disorder, autism spectrum disorder, breastfeeding difficulties, cerebral palsy, infantile colic, nocturnal enuresis, and otitis media.2. It may be appropriate to treat musculoskeletal conditions including spinal mobility impairments associated with neck-back pain and neck pain with headache utilising:• Spinal mobilisation and manipulation on adolescents;• Spinal mobilisation on children; or• Thoracic manipulation on children for neck-back pain only.3. No high certainty evidence to recommend these interventions was available.Reports of mild to severe harms exist; however, risk rates could not be determined.
CONCLUSION
Specific directives to guide physiotherapists' clinical reasoning on the appropriate use of spinal manipulation or mobilisation were identified. Future research should focus on trials for priority conditions (neck-back pain) in children and adolescents, psychometric properties of key outcome measures, knowledge translation, and harms.
Topics: Humans; Manipulation, Spinal; Child; Adolescent; Infant; Child, Preschool; Physical Therapists; Evidence-Based Practice; Pediatrics; Delphi Technique; Musculoskeletal Diseases
PubMed: 38855972
DOI: 10.1080/10669817.2024.2332026 -
Journal of Equine Veterinary Science Jun 2024A study comprising 74 colic and 74 control horses admitted to an animal hospital was performed. Faecal samples were collected and analysed for dry matter concentration,...
A study comprising 74 colic and 74 control horses admitted to an animal hospital was performed. Faecal samples were collected and analysed for dry matter concentration, particle size distribution using wet-sieving, and sand presence through a sand sedimentation test. Data on horse breed, age, gender and basic feeding variables was collected and analysed using χ-tests. Faecal dry matter concentration, particle size distribution and sand score was compared between colic and non-colic horses, and between horses with different colic types, using one-way ANOVA. Results showed that colic and non-colic horse groups were similar in breed, age, gender and basic feeding variables. Faecal dry matter concentration, particle size distribution and sand score were similar among colic and non-colic horses. Horses diagnosed with "unknown colic cause" had higher proportion of particles >0.5 <1.0 mm size compared to horses with colic due to impactions in caecum or colon, torsion or gas accumulation (P<0.05), but this difference was very small and most likely not of biological importance. Faecal dry matter concentration and sand score were similar among horses with different types of colic. Increased knowledge of the composition of particles of different size in equine faeces may enhance our understanding of digesta passage rate in colic and non-colic horses, which is needed to develop preventative measures of certain types of colic.
PubMed: 38852928
DOI: 10.1016/j.jevs.2024.105126 -
Journal of Equine Veterinary Science Jun 2024Surgical site infection (SSI) is a common complication after celiotomy in horses, leading to increased morbidity and costs. Increased concern about antibiotic resistance...
Surgical site infection (SSI) is a common complication after celiotomy in horses, leading to increased morbidity and costs. Increased concern about antibiotic resistance justifies evaluation of alternative preventive approaches, such a Manuka honey which has displayed antimicrobial properties. Pectin-Honey Hydrogels (PHH), composed by Manuka honey and pectin provide a moist wound environment and microbial growth inhibition. The aim of the study was to evaluate the effectiveness of PHHs in preventing SSI in horses subjected to emergency laparotomy. Horses undergoing laparotomy were evaluated. Horses were randomly divided into two groups: Group 1 received PHH application onto the sutured linea alba before skin closure, while Group 2 received no treatment. Horses with postoperative antimicrobial administration or survival of less than 5 days were excluded. The incidence of SSIs was reported as percentages and compared between groups. Out of 44 horses enrolled in the study, only thirty-six were ultimately included. Exclusions occurred either due to death before 5 days postoperatively (2 horses) or the administration of postoperative antimicrobials (6 horses). The median length of hospitalization was 9 days (range 8-14 days). The overall occurrence of SSI was 19.4 %. One out of eighteen horses (5.5 %) in Group 1 and 6 out of 18 (33.3 %) horses in Group 2 developed SSI. Group 2 had an 8.5-fold increased risk of SSI (p = 0.035, OR = 8.5, 95 % CI. 0.9-80.07). No macroscopically visible adverse reactions were associated with PHH. PHH placed at the abdominal incision during surgery was safe and reduced the prevalence of SSI in horses.
PubMed: 38852926
DOI: 10.1016/j.jevs.2024.105128