Integrative clinical medicine最新文献

{"title":"Intraabdominal abscess after cholecystectomy: Do not forget the stones","authors":"Nadshathra Varathan, G. Hess, F. Nocera, I. Lazaridis, A. Posabella","doi":"10.15761/icm.1000156","DOIUrl":"https://doi.org/10.15761/icm.1000156","url":null,"abstract":"Gallbladder perforation is one of the frequent complications in laparoscopic cholecystectomy, which can cause a loss of gallstones in the abdominal cavity. Usually these are removed. But in cases where they are not completely removed it can cause intraabdominal abscess even years after. Here we present a patient who was admitted with a sepsis due to an intraabdominal abscess. *Correspondence to: Nadshathra Varathan, Kleinriehenstrasse 304058 – Basel, Switzerland, E-mail: nadshathra.varathan@clarunis.ch Received: June 12, 2019; Accepted: June 25, 2019; Published: June 28, 2019 Introduction Acute cholecystitis is one of the most frequent encountered acute abdominal diseases worldwide. The prevalence of gallstones is reported in a range between 10% and 15% among adults [1]. Cholesterol gallstones account for 80-90% in western societies. Approximately 80% of gallstones remain asymptomatic [2,3], 1-2% of individuals with gallstones become symptomatic each year [2,4]. Of those with symptomatic gallstones, 10% will develop an acute cholecystitis [5]. In people younger than 50 years, women are three times more likely than men to develop an acute cholecystitis [6]. Laparoscopic cholecystectomy is the standard treatment for acute cholecystitis [7]. The timing of surgical intervention in acute cholecystitis is still a subject of ongoing studies. Initial studies concluded that early laparoscopic cholecystectomy for acute cholecystitis was associated with a higher conversion rate, more complications and longer surgery times [8]. However, with advances in laparoscopic techniques, early laparoscopic cholecystectomy became the standard practice for treatment of acute cholecystitis [7]. One of the common complications of laparoscopic cholecystectomy is a gallbladder perforation [9]. The incidence varies from 1.3 to 40% [10,11]. This can cause gallstone spillage, which in most cases remain clinically asymptomatic, however in 0.04 to 19% of the cases adverse events were reported [11]. The intra-abdominal abscesses formation is the most frequent complication [12]. The presence of pigment stones is correlated to development of complications [12]. We present the case of sepsis due to intraabdominal abscess years after laparoscopic cholecystectomy. Case presentation In July 2018, a 78-year-old male patient presented at the emergency room in an outside hospital with acute right upper quadrant pain and nausea for two days. In the prior weeks he suffered from intermitting fever, loss of appetite and loss of weight. His medical history was remarkable for status post laparoscopic cholecystectomy in 2000 where gallstones were lost and left in the peritoneal cavity. In cause of a sepsis with the need of surveillance in an intensive care unit the patient was moved to our hospital. Infection signs in the blood (white blood cells and CRP) were clearly elevated. The computer tomography (CT) of the abdomen confirmed an abdominal abscess in the right lower quadrant close to the col","PeriodicalId":91880,"journal":{"name":"Integrative clinical medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67469660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left bundle branch block-induced cardiomyopathy: A review and pooled analysis of pathophysiology, diagnosis and clinical management","authors":"Aref Albakri","doi":"10.15761/icm.1000163","DOIUrl":"https://doi.org/10.15761/icm.1000163","url":null,"abstract":"","PeriodicalId":91880,"journal":{"name":"Integrative clinical medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67469712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-dose dietary riboflavin and direct sunlight exposure in the treatment of keratoconus and post-refractive surgery ectasia of the cornea","authors":"J. Jarstad, L. McDaniel, Alan R. Schaeffer, Marwa A Taranissi","doi":"10.15761/icm.1000160","DOIUrl":"https://doi.org/10.15761/icm.1000160","url":null,"abstract":"","PeriodicalId":91880,"journal":{"name":"Integrative clinical medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67469878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of indocyanine green fluorescence imaging on blood flow evaluation of the reconstructed conduit after esophageal cancer surgery","authors":"K. Koyanagi, S. Ozawa","doi":"10.15761/icm.1000164","DOIUrl":"https://doi.org/10.15761/icm.1000164","url":null,"abstract":"Esophagectomy remains a standard curative treatment for localized thoracic esophageal cancer. However, morbidity is a major concern after surgery because of the surgical invasiveness and the complex operative procedures. The anastomosis between the cervical esophagus and the reconstructed conduit is more likely to leak than other gastrointestinal anastomosis and is consequently associated with higher postoperative mortality. Among several factors, such as patient factors, surgical techniques, and tissue factors, that is a high probability that ischemia at the tip of the reconstructed conduit can attribute to the anastomotic leakage. Traditional practice has been to check the pulsation of the marginal artery, the color of the conduit, and/or bleeding from the cutting edge of the bowel. These methods are all subjective and rarely provide a clear demarcation between good blood perfusion area and non-good blood perfusion area of the reconstructed conduit. Instead, to obtain the objective information of blood perfusion of the reconstructed conduit and to decide the appropriate anastomotic site after esophagectomy, laser Doppler flowmetry emerged as a tissue blood flow assessment system. However, it has not been widely accepted by surgeons due to the lack of reproducibility and no apparent correlation","PeriodicalId":91880,"journal":{"name":"Integrative clinical medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67470025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of obesity on the short-term efficacy of inter sphincteric resection for patients with ultra-low rectal or anal canal cancer","authors":"X. Wang, J. Liu, X. Lv, Z. Gan, L. Li","doi":"10.15761/icm.1000157","DOIUrl":"https://doi.org/10.15761/icm.1000157","url":null,"abstract":"Aim: To determine whether obesity has an impact on the short-term efficacy of inter sphincteric resection (ISR) for patients with ultra-low rectal or anal canal cancer. Methods: This retrospective study includes 276 patients with rectal or anal canal cancer who received treatment from the Rectal Surgery Group of the Gastrointestinal Surgery Center of West China Hospital. According to the WHO, the overweight has a BMI greater than 25. We compare the intraoperative related indicators, postoperative recovery indicators and the rate of occurrence of complications between Group A and Group B. Results: The time of operation in Group B is apparently longer than that in Group A (143.41 min VS. 130.91 min P < 0.05), the intraoperative blood loss, the anastomotic patterns and the reconstruction pattern are not statistically different. The rate of perianal infection of Group B is significantly higher than that of Group A (6.5% VS. 1.5% P < 0.05), and the rate of incision infection of Group B is significantly higher than that of Group A (5.6% VS. 0.6% P < 0.05). The rate of occurrence of other complications between two groups is not statistically different. Conclusion: Obesity increases the difficulty of performing ISR for ultra-low rectal or anal canal cancers, extends the time of operation, and increases the incidence rate of perianal infection post-operatively. There is no significant difference between the indications of postoperative recovery, and the incidence rate of complications in obese patients and that in normal weight patients. In terms of the short-term effects, the operations for obese patients are safe and effective. *Correspondence to: LI L, Way-nan Guo-Xue Xiang 37#, Chengdu, Sichuan, 610041, China, Tel: 86-18980601487; E-mail: drlili116@126.com","PeriodicalId":91880,"journal":{"name":"Integrative clinical medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67469746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk and physical therapy in primary prevention","authors":"Peres Paulo","doi":"10.15761/ICM.1000142","DOIUrl":"https://doi.org/10.15761/ICM.1000142","url":null,"abstract":"","PeriodicalId":91880,"journal":{"name":"Integrative clinical medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67469149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cell surface molecules TSCL1: Culprit behind chronic inflammation and cancers caused by oncogenic viruses","authors":"Richard Hunte, Noula Shembade","doi":"10.15761/icm.1000154","DOIUrl":"https://doi.org/10.15761/icm.1000154","url":null,"abstract":"Received: April 10, 2019; Accepted: June 24, 2019; Published: June 28, 2019 A vast number of cell surface molecules (CSMs), which are involved in the regulation of inflammation, innate and adaptive immune response, cell death, and the restoration of tissue homeostasis were recently identified. Whereas some of these CSMs serve the role of cell adhesive molecules, others function as costimulatory molecules to unlock distinct inflammatory and immune responses [1,2]. In addition, certain CSM heterophilic and homophilic interactions serve the role of either ligands or receptors, or both in this process [3]. CSMs also play a critical role in cell-to-cell communication [4]. The fate of the tissue is determined by the levels of CSMs expressed in a particular tissue. Certain levels of CSM expression are sufficient for their beneficial function; however, altering levels of CSM expression due to infection, injury, or substance abuse play a detrimental role in a particular tissue. Interestingly, the mechanisms of CSM-mediated distinct effects on regulation of inflammation, innate and adaptive immunity, and the optimal levels of CSM expression required for beneficial effects are poorly understood. This review will focus on recent findings on the mechanism of inflammation regulation mediated by a highly upregulated CSM, tumor suppressor in lung cancer-1 (TSLC1), in oncogenic virus infected cells.","PeriodicalId":91880,"journal":{"name":"Integrative clinical medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67469640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACT 2018 – Lessons to be learned from the past","authors":"F. Falter, E. Kemna","doi":"10.15761/ICM.1000141","DOIUrl":"https://doi.org/10.15761/ICM.1000141","url":null,"abstract":"In this review we summarize the current status of knowledge and outline future directions regarding the use of activated clotting time devices (ACT) for heparin monitoring. It is over 50 years ago that Paul Hattersley first described the ACT and 40 years ago it was first used as a simple method of heparin management during extracorporeal circulation. Today, ACT is the primary test for monitoring heparin activity in cardiac and vascular operating rooms, intensive care and hemodialysis units as well as in the catheter lab. Without appropriate anticoagulation clot will start to form during these procedures, with a high chance of a fatal event occurring. Currently, there are several POC methods available for ACT measurement, however results obtained with different devices can vary substantially. Furthermore, the target ACTs which are described in guidelines are mostly empiric or based on small-scale studies done with one or different POC ACT devices. Moreover, it is important to realize that there is no “gold standard” ACT method and therefore no “true” ACT. The ACT has gone unchallenged for a long time. Being mostly ‘clinician owned’ we have come to accept that, in the absence of a gold standard, there is no way to determine if any one of the commercially available devices measures a true ACT value. The lesson to be learned from the last 40 years is that clinicians’, laboratory staff ’s and manufacturers’ approach to the ACT needs to become more collaborative, open and truly multidisciplinary in order to stand up to the level of scrutiny that is increasingly demanded in modern healthcare. *Correspondence to: Florian Falter, Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, CB23 3RE, UK, Tel: +44 1480 364406; E-mail: florian.falter@gmail.com","PeriodicalId":91880,"journal":{"name":"Integrative clinical medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67469109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total neoadjuvant therapy of locally advanced rectal cancer: Neoadjuvant FOLFOXIRI chemotherapy followed by short-course radiation and consolidated XELOX chemotherapy prior to resection","authors":"Yuanhe Wang, Mingyi Zhou, Jingdong Zhang","doi":"10.15761/ICM.1000139","DOIUrl":"https://doi.org/10.15761/ICM.1000139","url":null,"abstract":"Locally advanced rectal cancer (LARC) consists of stage II (T3/4, node-negative, M0) and stage III (T3/4, node-positive, M0) rectal cancer. The rectal cancer located in the mid-low rectum (up to 12 cm from anal verge) was identified to penetrate through the muscle wall with or without nodal metastasis by imaging or pathological test (c/ pT3-4b, or c/pN1-2) but without distal metastases (M0). The risk of pelvic recurrence of rectal cancer (especially for LARC) is higher than colon cancer. And the local recurrence of rectal cancer could lead to a poor prognosis [2]. The high risk of locoregional recurrence is associated with the unique anatomy of rectum: close to pelvic organs and structures, absent a serosa surrounding the rectum, and difficult to obtain wide surgical margins at resection. The anatomy of rectum increases the technical difficulty, postoperative complication and local recurrence.","PeriodicalId":91880,"journal":{"name":"Integrative clinical medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67469436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of groups in preventing suicide: Is contagion a concern of the past?","authors":"A. Spears, Sarah R. Sullivan, M. Goodman","doi":"10.15761/icm.1000153","DOIUrl":"https://doi.org/10.15761/icm.1000153","url":null,"abstract":"Received: June 18, 2019; Accepted: June 24, 2019; Published: June 28, 2019 The efficacy and safety of including individuals at risk for suicide in groups is a polarizing topic that has been debated since the 1960s [1]. Often suicide has been viewed as a problematic factor in groups, specifically, researchers report suicidal individuals disturb the group process, and increase risk of harm [2,3]. Yalom wrote that suicidal patients do not benefit from groups because they, “do not receive the specialized attention they require” and the “threat of suicide is too taxing; too anxiety provoking for group members to manage” (p. 231). Additionally, some report that groups make it easier for suicidal individuals to conceal or evade [4]. However, one of the biggest concerns of suicide-focused groups is the effect of contagion (e.g., exposure to suicide leadings to one’s own suicide death) [5]. While some research regarding the development and efficacy of suicide groups was published in the 1960’s and 1970’s, there is a paucity of research in the past 50 years concerning the relationship between suicide risk and group therapy. Furthermore, the literature that does exist on this topic is contradictory with some fearing contagion related outcomes [6,7] and others noting the value of suicide prevention groups [8,9]. Therefore, this brief review aims to explore the use of groups in a population at risk for suicide and whether contagion is a concern within these groups.","PeriodicalId":91880,"journal":{"name":"Integrative clinical medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67469249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}