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Incidences and Risk Factors for Surgical Site Infections in Koutiala, Mali

Surgical Science 2024年第7期15卷 465-469页

作者： Mahamadou Coulibaly Moussa Diassana Issiaka Diarra Bréhima Bengaly Birama Togola Drissa Ouattara Souleymane Sanogo Samuel Kletigui dembélé Cheick Aka Waigalo Brehima Ballo Drissa Traoré Nouhoum Ongoiba Faculty of Medicine University of Science Technique and Technologies of Bamako Bamako Mali department of Surgery Koutiala Hospital Koutiala Mali department of Surgery Sikasso Hospital Sikasso Mali dpartement de chirurgie Hpital Commune I Bamako Mali department of Surgery University Hospital Center Point G Bamako Mali department of Surgery Tominian Hospital Tominian Mali

Purpose: This paper aims to assess the incidences and risk factors for surgical site (ISO) infections in the general surgery department of the Koutiala District Hospital. Patients and Methods: This was a prospective and descriptive study from August 1, 2017 to October 31, 2020 involving all patients who underwent laparotomy in the general surgery department of the Koutiala District Hospital. Patients who were not operated on and who did not have a laparotomy were not included. Age, sex, frequency, patient history, National Nosocomial Infections Surveillance (NNIS) index, time to occur, bacteriological test results and course of infection were analyzed. Results: Fifty patients were registered. The average age was 34.2 ± 21.2 years old. Eleven patients were 60 years old or older. The hospital incidence rate was 4.3% and the community incidence rate was 6.1 cases per 100,000 population. The concept of smoking was noted in 15 patients. Patients were operated on in emergency 84% of cases. Peritonitis was the most common initial lesion with 32% of cases. Our patients had an NNIS index greater than 0 in 84% of cases. The time to develop infection from the surgical site was less than 3 days in 8 patients (16% of cases). depending on the depth of the infection, it was superficial (cutaneous) in 39 patients (78%) and deep (subcutaneous and organic) in 11 patients (22%). Escherichia coli was the most common germ with 72% followed by staphylococcus aureus at 24%. We noted 22% morbidity. The median length of hospitalization was 9 ± 2.2 days. Conclusion: ISO is common in our service. Prevention and mastery require knowledge of risk factors.

关键词： Surgical Site Infection Incidence Risk Factors Surgery

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Long-term assessment of collagenase treatment for Dupuytren’s contracture:A 10-year follow-up study

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World Journal of Orthopedics 2024年第4期15卷 355-362页

作者： Marco Passiatore Vitale Cilli Adriano Cannella Ludovico Caruso Giulia Maria Sassara Giuseppe Taccardo Rocco de Vitis department of Bone and Joint Surgery ASST-Spedali CiviliBrescia 25123Italy department of chirurgie de la Main Centre Hospitalier Interregional Edith CavellBruxelles 1160Belgium department of Orthopedics Fondazione Policlinico Universitario Agostino Gemelli IRCSSRome 00168Italy

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).despite its benefits,the long-term outcomes remain *** study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with *** To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with *** A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic *** study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years *** Thirty-seven patients completed the 10-year *** 10 years,patients treated at the PIP joint exhibited a 100%***,patients treated at the MCP joint only showed a 50%*** satisfaction varied,with a lower satisfaction reported in PIP joint *** exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained *** differences were noted between outcomes at the 7-year and 10-year *** CCH demonstrated sustained efficacy when applied to the MCP ***,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient ***-intervention is needed within a decade of treatment.

关键词： Collagenase Xiapex Dupuytren disease Dupuytren recurrence Long term follow-up

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Epidemiologic, Diagnostic, and Therapeutic Features of Urinary Stone Disease in Northern Benin from 2018 to 2023

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Open Journal of Urology 2024年第2期14卷 128-137页

作者： Gandaho Isidore Sossa Jean Toré Sanni Rafiou Dènon Emmanuel Allodé Alexandre Avakoudjo Déjinnin Josué Georges Département de chirurgie et Spécialités Chirurgicales Université de Parakou Parakou Bénin Faculté des Sciences de la Santé Université d’Abomey-Calavi Abomey-Calavi Bénin

Objective: To determine the epidemiologic, diagnostic, and therapeutic features of urinary in northern Benin from 2018 to 2023. Patients and Method: The study was an observational and descriptive one. We exhaustively and retrospectively collected data from the medical records of the patients that were managed from February 1, 2018 to February 1, 2023 at the department of Surgery of “Centre Hospitalier Universitaire Départmental Borgou-Alibori or CHUD-BA”. Results: Among the 4522 patients managed, 75% or 1.7% had urinary stone disease. Their mean age was 41 years. The sex ratio was 2.75, the males being predominantly affected. Of the 75 cases of urinary stone disease, 30.7% (n = 23) were renal, 46.7% (n = 35) were ureteral, and 22.7% (n = 17) were vesical. The patients came from variable geographical areas, ethnic groups, and professional sectors. Their main complaints were pain (57.3%), hematuria (14.7%), dysuria (12%), and fever (5.3%). 15 (20%) patients, i.e., 7 renal stone and 8 ureteral stone patients, had an obstructive renal failure. The imaging tools available were ultrasonography, tomography and computed tomographic scan. 11 of the bladder stone cases (64.7%) were associated with a bladder outlet obstruction. Overall, 38.7% of the patients had either diabetes mellitus (6.7%), hypertension or high blood pressure (6.7%), benign prostate hyperplasia (8%), urinary schistosomiasis (6.7%), ureteral pelvic junction obstruction (2.7%), and prostate cancer (1.3%). Of the 19 patients whose dietary behavior was investigated 15 (79%), 11 (57.9%) et 11 (57.9%) demonstrated a diet which was respectively rich in milk, fromage and meat. 100% of bladder stones were removed through cystolithotomy. Renal stones were removed by pyelolithtomy (52.2%) and nephrolithotomy (21.7%). Ureteral stones were removed through ureterolithotomy (40%), expelled by means of alpha-blockers (40%) or managed with ureteral pigtail stent (20%). Conclusion: The hospital prevalence of urinary stone d

关键词： Urinary Stone Epidemiologic Diagnostic Therapeutic

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Advancing immunosuppression in liver transplantation: A narrative review

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 441-448页

作者： Samuele Iesari Francesca Laura Nava Ilaria Elena Zais Laurent Coubeau Mariano Ferraresso Evaldo Favi Jan Lerut General Surgery and Kidney Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico15 Via della Commenda20122 MilanItaly Institut de Recherche Expérimentale et Clinique Universitécatholique de Louvain10 Avenue Hippocrate1200 BrusselsBelgium Service de chirurgie et Transplantation Abdominale Cliniques Universitaires Saint-Luc55 Avenue Hippocrate1200 BrusselsBelgium department of Clinical Sciences and Community Health Universitàdegli Studi di Milano19 Via della Commenda20122 MilanItaly

Immunosuppression is essential to ensure recipient and graft survivals after liver transplantation(LT). However, our understanding and management of the immune system remain suboptimal. Current immunosuppressive therapy cannot selectively inhibit the graft-specific immune response and entails a significant risk of serious side effects, i.e., among others, de novo cancers, infections, cardiovascular events, renal failure, metabolic syndrome, and late graft fibrosis, with progressive loss of graft function. Pharmacological research, aimed to develop alternative immunosuppressive agents in LT, is behind other solidorgan transplantation subspecialties, and, therefore, the development of new compounds and strategies should get priority in LT. The research trajectories cover mechanisms to induce T-cell exhaustion, to inhibit co-stimulation, to mitigate non-antigen-specific inflammatory response, and, lastly, to minimize the development and action of donor-specific antibodies. Moreover, while cellular modulation techniques are complex, active research is underway to foster the action of T-regulatory cells, to induce tolerogenic dendritic cells, and to promote the function of B-regulatory cells. We herein discuss current lines of research in clinical immunosuppression, particularly focusing on possible applications in the LT setting.

关键词： Liver transplantation Immunosuppression Drug development Long-term results Clinical operational tolerance

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Visceral Leishmaniasis at the National Reference University Hospital Center of N’Djamena (Chad): Epidemiological, Clinical, Diagnostic, Therapeutic and Prognostic Aspects

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Advances in Infectious Diseases 2024年第2期14卷 478-486页

作者： Joseph Mad-Toïngué Mahamat Ali Ahmat Oumaïma Mahamat Djarma Alifa Adjibera Philippe Ali Mahamat Moussa Ngakoutou Rangar Choua Ouchemi Mahamat Ali Bolti Djiddi Ali Sougoudi Mamissou Didi Mahamat Doungous Atim Service des Maladies Infectieuses CHU de Référence Nationale N’Djamena Chad Service de Gastroentérologie et Médecine Interne CHU de Référence Nationale N’Djamena Chad Service de Pneumologie et Phtisiologie CHU de Référence Nationale N’Djamena Chad Service de chirurgie viscérale CHU de Référence Nationale N’Djamena Chad Service de Médecine CHU de la Renaissance N’Djamena Chad

Introduction: leishmaniasis is a group of parasitic diseases caused by a parasite of the genus Leishmania transmitted by the bite of an infected vector called a sandfly. There are four forms. Visceral leishmaniasis is the most severe form. The aim of our work is to study the epidemiological, clinical, diagnostic, therapeutic and prognostic aspects of the disease in the Infectious Diseases department of the Centre Hospitalier Universitaire de Référence Nationale in N'Djaména. Methodology: Patients were recruited on the basis of clinical signs suggestive of visceral leishmaniasis, i.e. prolonged fever, splenomegaly and altered general condition. Biological confirmation was performed with a rapid diagnostic test using recombinant K39 parasite antigen, which is known to have good specificity and sensitivity. Epidata version 3.1 software was used to process patient data. Results: From 05/04/21 to 15/12/23, 153 positive cases were managed. The mean age of patients was 18 years, with a sex ratio of 9.2. Of these patients, 103 (67.3%) had recently stayed at gold mining sites. Patients testing positive were treated with sodium stibogluconate combined with paromomycin for 17 days. The mortality rate was 13.2%. Conclusion: Leishmaniasis is a serious and little-known disease in Chad. In order to respond to the disease, it is necessary to reinforce the capacities of health structures and to carry out appropriate actions in the outbreaks.

关键词： Visceral Leishmaniasis Gold Mining Sites Chad

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Rib Osteosynthesis for Sub-Acute Management of a Flail Chest in a Tertiary Centre in a Low-Middle Income Country of Sub-Saharan Africa: Case Report at Douala Laquintinie Hospital

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Open Journal of Thoracic Surgery 2024年第1期14卷 1-16页

作者： Fabrice Stéphane Arroye Betou Nyankoue Mebouinz Ferdinand Guy Aristide Bang Kobe Folkabo Zephany Banga Nkomo Douglas Moussa Seck Diop Abdoul Lahad Mbeng Marcella derboise Christelle Biyouma Noel Essomba Souleyman Diatta Handy Eone Daniel Arthur Essomba Hassan Ndiaye Maurice Aurelien Sosso department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences (FMBS) University of Yaoundé (UYI) Yaoundé Cameroon department of Surgery and Affiliated Disciplines Douala Laquintinie Hospital Douala Cameroon department of Surgery and Specialties Yaoundé General Hospital Yaoundé Cameroon department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences (FMPS) University of Dschang Dschang Cameroon Service de chirurgie Thoracique et Cardiovasculaire Centre Hospitalier Universitaire de Fann Faculté de Médecine de Pharmacie et d’Odontologie Université de Cheikh Anta Diop Dakar Sénégal UFR des Sciences de la Santé Ziguinchor Sénégal

Background: Costal fracture surgical is still a debate, therefore we shall select between early and delay surgical management. Case Report: We are reporting two cases of post road traffic clash delay ribs fractures osteosynthesis involving a 63-year-old man with multistage fractures on the left and pulmonary pinning of one of the costal arches, complicated by a homolateral haemothorax and a 41-year-old man with a bilateral flail chest. Conclusion: The simple postoperative course and the immediate postoperative improvement in the patient’s clinical respiratory condition enabled us to discuss the time frame for management, in this case the indication for early or later surgery.

关键词： Flail Chest Fixation Plate Rib Fracture Osteosynthesis

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Evaluating pediatric ureteropelvic junction obstruction:Dynamic magnetic resonance urography vs renal scintigraphy 99mtechnetium mercaptoacetyltriglycine

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World Journal of Radiology 2024年第3期16卷 49-57页

作者： Yousuf Al-Shaqsi Matthieu Peycelon Annabel Paye-Jaouen Elisabeth Carricaburu Anca Tanase Christine Grapin-Dagorno Alaa El-Ghoneimi department of Pediatric Surgery Sultan Qaboos University HospitalMuscat 123Oman Service de chirurgie Viscérale et Urologie Pédiatrique Hôpital Universitaire Robert-DebréAssistance-Publique Hôpitaux de ParisParis 75019France Centre de Références Maladies Rares Malformations Rares des Voies Urinaires(MARVU)Paris 97019France Facultéde Médecine Universitéde ParisParis 75006France Service d’Imagerie Pédiatrique Hôpital Universitaire Robert-DebréAssistance-Publique Hôpitaux de ParisParis 75019France UniversitéParis 13 Sorbonne Paris CitéParis 75013France

BACKGROUND Ureteropelvic junction obstruction(UPJO)is a common congenital urinary tract disorder in *** can be diagnosed as early as in utero due to the presence of hydronephrosis or later in life due to symptomatic *** To evaluate the discrepancy between dynamic contrast-enhanced magnetic resonance urography(dMRU)and scintigraphy 99m-technetium mercaptoacetyltriglycine(MAG-3)for the functional evaluation of *** Between 2016 and 2020,126 patients with UPJO underwent surgery at Robert debré*** these,83 received a prenatal diagnosis,and 43 were diagnosed during *** of the 126 patients underwent surgery based on the clinical situation and postnatal ultrasound findings without undergoing functional imaging *** renal function was evaluated preoperatively using scintigraphy MAG-3(n=28),dMRU(n=53),or both(n=40).In this study,we included patients who underwent surgery for UPJO and scintigraphy MAG-3+dMRU but excluded those who underwent only scintigraphy MAG-3 or *** patients were divided into groups A(10%discrepancy).We examined the discrepancy in split renal function between the two modalities and investigated the possible risk *** The split renal function between the two kidneys was compared in 40 patients(28 boys and 12 girls)using scintigraphy MAG-3 and *** renal function,as determined using both modalities,showed a difference of10%in 9 *** of the relative renal function using dMRU revealed an excellent correlation coefficient with renal scintigraphy MAG-3 for both *** Our findings demonstrated that dMRU is equivalent to scintigraphy MAG-3 for evaluating split renal function in patients with UPJO.

关键词： Uteropelvic junction obstruction Scintigraphy 99m-technetium mercaptoacetyltriglycine Magnetic resonance imaging Dynamic contrast-enhanced magnetic resonance urography

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Advanced nonmetastatic hepatocellular carcinoma: curative surgery may be an option

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Hepatobiliary Surgery and Nutrition 2022年第6期11卷 870-872页

作者： Julie Leclerc Ahmet Ayav Service de chirurgie cancerologique digestive hepato-bilio-pancreatique et colo-rectaleCHRU NancyNancyFrance

In this multicentric retrospective study(1),the authors aimed to compare surgery versus Sorafenib(SOR)for the treatment of advanced nonmetastatic hepatocellular carcinoma(HCC).Data were collected from two Italian regi... 详细信息

关键词： surgery hepatocellular metastatic

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Meso-Rex bypass for the management of extrahepatic portal vein obstruction in adults(with video)

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 25-32页

作者： Martin Brichard Samuele Iesari Jan Lerut Raymond Reding Pierre Goffette Laurent Coubeau Service de chirurgie et Transplantation Abdominale Cliniques Universitaires Saint-LucUniversitéCatholique de Louvain10 Avenue HippocrateBrussels 1200Belgium Pôle de chirurgie Expérimentale et Transplantation Institut de Recherche Expérimentale et CliniqueUniversitéCatholique de LouvainBrusselsBelgium department of Clinical Sciences and Applied Biotechnology University of L’AquilaL’AquilaItaly department of General Surgery and Kidney Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilanItaly Service de Radiologie et Imagerie médicale Cliniques Universitaires Saint-LucUniversitéCatholique de LouvainBrusselsBelgium

Background:Extrahepatic portal vein obstruction(EHPVO)results in severe portal hypertension(PHT)leading to severely compromised quality of ***,pharmacological and endoscopic management is unable to solve this *** hepatic portal flow using meso-Rex bypass(MRB)may solve *** procedure,uncommon in adult patients,is considered the treatment of choice for EHPVO in ***:From 1997 to 2018,8 male and 6 female adults,with a median age of 51 years(range 22-66)underwent MRB procedure for EHPVO at the University Hospitals Saint-Luc in Brussels,***-toms of PHT were life altering in all but one patient and consisted of repetitive gastro-intestinal bleedings,sepsis due to portal biliopathy,and/or severe abdominal *** surgical technique consisted in interposition of a free venous graft or of a prosthetic graft between the superior mesenteric vein and the Rex recess of the left portal ***:Median operative time was 500 min(range 300-730).Median follow-up duration was 22 months(range 2-169).One patient died due to hemorrhagic shock following percutaneous transluminal interven-tion for early graft *** morbidity,defined as Clavien-Dindo score≥III,was 35.7%(5/14).Shunt patency at last follow-up was 64.3%(9/14):85.7%(6/7)of pure venous grafts and only 42.9%(3/7)of prosthetic *** relief was achieved in 85.7%(12/14)who became asymptomatic after ***:Adult EHPVO represents a difficult clinical condition that leads to severely compromised quality of life and possible life-threatening *** such patients,MRB represents the only and last resort to restore physiological portal vein *** successful in a majority of patients,this procedure is associated with major morbidity and mortality and should be done in tertiary centers expe-rienced with vascular liver surgery to get the best results.

关键词： Meso-Rex bypass Extrahepatic portal vein obstruction Extrahepatic portal hypertension Portal vein thrombosis Surgical procedure

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French Editorials from the Association de chirurgie Hépato-Bilio-Pancréatique et Transplantation-France(ACHBPT)

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Hepatobiliary Surgery and Nutrition 2021年第1期10卷 129-130页

作者： Fabrizio Panaro Karim Boudjema Editorial Office department of Surgery St-Eloi University HospitalMontpellierFrance Association de chirurgie Hépato-Bilio-Pancréatique et Transplantation-France RennesFrance Service de chirurgie Hépatobiliaire et Digestive CHU RennesUniv RennesRennesFrance Hepatobiliary Surgery and Nutrition AME Publishing Company

The international journal Hepatobiliary Surgery and Nutrition(HBSN)offers a great opportunity to the French Association of Hepato-Biliary Surgery and Liver Transplantation(ACHBPT).Indeed,each of the monthly“analyzed articles”written by our colleagues will be submitted for publication as an editorial in *** course,it has to be written in English and edited by one of our expert members(Video 1,Figures 1,2).

关键词： Surgery Transplantation Liver

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