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Predictive factors for anastomotic leakage after laparoscopic colorectal surgery

World Journal of Gastroenterology 2018年第21期24卷 2247-2260页

作者： Antonio Sciuto Giovanni Merola Giovanni D De Palma Maurizio Sodo Felice Pirozzi Umberto M Bracale Umberto Bracale Department of Abdominal Surgery Casa Sollievo della Sofferenza Research Hospital Department of General Surgery Casa di Cura Villa Berica Department of Gastroenterology Endocrinology and Endoscopic SurgeryUniversity Hospital of Naples Federico Ⅱ Department of Public Health University of Naples Federico Ⅱ

Every colorectal surgeon during his or her career is faced with anastomotic leakage(AL); one of the most dreaded complications following any type of gastrointestinal anastomosis due to increased risk of morbidity, mortality, overall impact on functional and oncologic outcome and drainage on hospital resources. In order to understand and give an overview of the AL risk factors in laparoscopic colorectal surgery, we carried out a careful review of the existing literature on this topic and found several different definitions of AL which leads us to believe that the lack of a consensual, standard definition can partly explain the considerable variations in reported rates of AL in clinical studies. Colorectal leak rates have been found to vary depending on the anatomic location of the anastomosis with reported incidence rates ranging from 0 to 20%, while the laparoscopic approach to colorectal resections has not yet been associated with a significant reduction in AL incidence. As well, numerous risk factors, though identified, lack unanimous recognition amongst researchers. For example, the majority of papers describe the risk factors for left-sided anastomosis, the principal risk being male sex and lower anastomosis, while little data exists defining AL risk factors in a right colectomy. Also, gut microbioma is gaining an emerging role as potential risk factor for leakage.

关键词： Laparoscopic colorectal surgery Colorectal surgery Anastomotic leakage Laparoscopy Risk factor Rectal cancer Diverting stoma

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Advantages of preoperative planning using computed tomography scan for treatment of malleolar ankle fractures

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World Journal of Orthopedics 2021年第3期12卷 129-139页

作者： Luigi Tarallo Gian Mario Micheloni Michele Mazzi Arturo Rebeccato Michele Novi Fabio Catani Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto University of Modena and Reggio EmiliaModena 41121Italy Dipartimento di Chirurgia AULSS8 Berica-Ospedale San Bortolo-VicenzaVicenza 36100Italy

Malleolar ankle fractures have been classified using plain radiographs,and there is no consensus regarding the role of computed tomography(CT)scans in preoperative *** analyzed critical aspects,such as limits of standard radiographs,types of injury,classification methods and cost/benefit *** scans allow a 3 D analysis of the fracture to be obtained and consequently assess the indication for surgical procedure,surgical access and the type of fixation devices *** exam is useful for detecting lesions that may go unnoticed on radiographs and will help surgeons to clarify the pathoanatomy of ankle *** to Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association(AO/OTA)classification,CT scan is recommended in medial malleolar fractures with vertical rim,type 44 B fractures with posterior malleolar involvement and all type 44 C fractures(according to AO/OTA).Also Tillaux-Chaput fractures(43-B1 according to AO/OTA),malleolar fractures in the presence of distal tibial fractures(43 according to AO/OTA)and distal tibia fractures in adolescents should be studied with CT scans.

关键词： Computed tomography scan Malleolar fractures Planning Trauma Imaging

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The role of acetazolamide in critical care and emergency medicine

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Journal of Geriatric Cardiology 2024年第11期21卷 1085-1095页

作者： Jacopo Davide Giamello Gabriele Savioli Yaroslava Longhitano Fiorenza Ferrari Salvatore D’Agnano Ciro Esposito Manfredi Tesauro Christian Zanza Department of Emergency Medicine Azienda Ospedaliera S.Croce e CarleCuneoItaly Emergency Medicine and Surgery IRCCS Fondazione Policlinico San MatteoPaviaItaly Department of Anesthesiology and Perioperative Medicine University of PittsburghPittsburghPA 15260USA Department of Emergency Medicine-Emergency Medicine Residency Program Humanitas University-Research Hospital20089 RozzanoItaly International Renal Research Institute of Vicenza(IRRIV) Department of NephrologyDialysis and TransplantationSan Bortolo HospitalAzienda ULSS berica VicenzaItaly Department of Anaesthesia Critical Care and EmergencyFoundation IRCCS Ca'Granda Ospedale Maggiore PoliclinicoMilanItaly Unit of Nephrology and Dialysis ICS MaugeriUniversity of PaviaPaviaItaly Department of Systems Medicine University of Rome"Tor Vergata"RomeItaly Geriatric Medicine Residency Program University of Rome"Tor Vergata"RomeItaly

Acetazolamide is the commonly prescribed oral and intravenous carbonic anhydrase inhibitor;over the years,its use in clinical practice has decreased in favor of more recent ***,it is a rather handy drug,which can be useful in several clinical settings when managing critically ill *** objective of this review is the evaluation of the most recent evidence on the use of acetazolamide in emergency medicine and critical care ***,the safety profile of this drug has been *** is a narrative review on the use of acetazolamide in the main contexts in which this drug can be useful in emergency situations for patients with potential critical *** the timeline 1999–2024,a search was conducted on the main scientific platforms;resources of greatest relevance for the use of acetazolamide in critical care and emergency medicine were *** most common emergency situations in which a critically ill patient could benefit from acetazolamide therapy are acute heart failure,acute mountain sickness,post hypercapnic metabolic alkalosis,idiopathic intracranial hypertension and acute angle-closure *** a few cases,however,randomized controlled clinical trials have been *** are also other less solid indications based mostly on experience or retrospective *** seems to be an overall safe drug;serious side effects are rare and can be avoided by carefully selecting the patients to be *** represents a precious resource for emergency physicians and intensivists;critical patients with different conditions can in fact benefit from it;furthermore,acetazolamide is a safe drug if administered to correctly selected patients.

关键词： critical prescribed furthermore

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