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Abstract
Background. To avoid the adverse consequences of abdominal compartment syndrome and to reduce the high mortality the celiotomy wound
in patients with abdominal sepsis was closed without tension using prosthetic mesh. This produces a semiopen situation that
permits staged reinterventions together with the functional reconstitution of the continuity of the abdominal wall.
Material and Methods. Twenty-five patients with intra-abdominal sepsis of various causes were evaluated retrospectively to assess the results of
semiopen management of the septic abdomen and reoperations on demand in severe peritonitis. All of the patients were in a
state of neglected peritonitis, and had at least one failing organ system. The Mannheim Peritonitis Index (MPI) scoring system
was used for stratification of abdominal sepsis.
Results. The mean MPI score of 25 patients was 24, ranging 10 to 33. Eight (32%) patients were reexplored (MPI=21). There were overall
9 (36%) complications in patients with mean MPI score of 23. Six (24%) mesh-related complications (infection and enterocutaneous
fistulas) developed (MPI=19). The mean MPI score of patients without complications was 24. Four (16%) patients died with index
MPI score of 26 due to fulminant hepatitis, myocardial infarction, and multiple organ failure. The admission period averaged
63 days.
Conclusions. In 25 critically ill patients with abdominal sepsis the mortality was lower than expected, relative to heterogeneous data
from the literature; also, major complications occurred less frequently although the mean MPI score was high. The authors
conclude that this approach is a reliable contribution to the complex treatment of these patients.
Electronic Publication 相似文献
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Detection and genotyping of oocysts of Cryptosporidium parvum by real-time PCR and melting curve analysis 总被引:5,自引:0,他引:5
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Tanriverdi S Tanyeli A Başlamişli F Köksal F Kilinç Y Feng X Batzer G Tzipori S Widmer G 《Journal of clinical microbiology》2002,40(9):3237-3244
Several real-time PCR procedures for the detection and genotyping of oocysts of Cryptosporidium parvum were evaluated. A 40-cycle amplification of a 157-bp fragment from the C. parvum beta-tubulin gene detected individual oocysts which were introduced into the reaction mixture by micromanipulation. SYBR Green I melting curve analysis was used to confirm the specificity of the method when DNA extracted from fecal samples spiked with oocysts was analyzed. Because C. parvum isolates infecting humans comprise two distinct genotypes, designated type 1 and type 2, real-time PCR methods for discriminating C. parvum genotypes were developed. The first method used the same beta-tubulin amplification primers and two fluorescently labeled antisense oligonucleotide probes spanning a 49-bp polymorphic sequence diagnostic for C. parvum type 1 and type 2. The second genotyping method used SYBR Green I fluorescence and targeted a polymorphic coding region within the GP900/poly(T) gene. Both methods discriminated between type 1 and type 2 C. parvum on the basis of melting curve analysis. To our knowledge, this is the first report describing the application of melting curve analysis for genotyping of C. parvum oocysts. 相似文献
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G. Kahraman T. Marur E. Tanyeli M. Yildirim 《Surgical and radiologic anatomy : SRA》2002,23(6):433-435
Abstract An hepatomesenteric trunk, formed by the common hepatic and superior mesenteric arteries, was found in a 50-year-old male cadaver. The left gastric and splenic arteries arose as a common trunk, the gastrosplenic trunk, from the abdominal aorta; no typical celiac trunk was present. In addition, the hepatomesenteric trunk passed posterior to the portal vein. A knowledge of variations of the common hepatic artery may be important in pancreaticoduodenectomy, as well as during hepatic artery infusion chemotherapy. 相似文献
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John Timothy Wright Mary Fete Holm Schneider Madelaine Zinser Maranke I. Koster Angus J. Clarke Smail Hadj‐Rabia Gianluca Tadini Nina Pagnan Atila F. Visinoni Birgitta Bergendal Becky Abbott Timothy Fete Clark Stanford Clayton Butcher Rena N. D'Souza Virginia P. Sybert Maria I. Morasso 《American journal of medical genetics. Part A》2019,179(3):442-447
An international advisory group met at the National Institutes of Health in Bethesda, Maryland in 2017, to discuss a new classification system for the ectodermal dysplasias (EDs) that would integrate both clinical and molecular information. We propose the following, a working definition of the EDs building on previous classification systems and incorporating current approaches to diagnosis: EDs are genetic conditions affecting the development and/or homeostasis of two or more ectodermal derivatives, including hair, teeth, nails, and certain glands. Genetic variations in genes known to be associated with EDs that affect only one derivative of the ectoderm (attenuated phenotype) will be grouped as non‐syndromic traits of the causative gene (e.g., non‐syndromic hypodontia or missing teeth associated with pathogenic variants of EDA “ectodysplasin”). Information for categorization and cataloging includes the phenotypic features, Online Mendelian Inheritance in Man number, mode of inheritance, genetic alteration, major developmental pathways involved (e.g., EDA, WNT “wingless‐type,” TP63 “tumor protein p63”) or the components of complex molecular structures (e.g., connexins, keratins, cadherins). 相似文献
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Atila Cihan Monnerat Sophie Urwyler Sandrine Andrea Refardt Julie Winzeler Bettina Christ-Crain Mirjam 《Pituitary》2022,25(4):636-644
Pituitary - Non-osmotic stimulation tests using glucagon, arginine, or macimorelin were recently evaluated for their ability to assess posterior pituitary function. Glucagon and arginine, but not... 相似文献
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