International journal of surgery
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The spleen has an abundance of lymphoid tissue, including splenic macrophages that attack encapsulated organisms. Overwhelming post-splenectomy infection (OPSI) is a serious disease that can progress from a mild flu-like illness to fulminant sepsis in a short time period. However, recognition and clinical management of OPSI is not well established. ⋯ Although the mortality rate from OPSI has been reduced by appropriate vaccination and education. The precise pathogenesis and a suitable therapeutic strategy remain to be elucidated. Overwhelming postsplenectomy infection (OPSI) is a serious fulminant process that carries a high mortality rate.
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Surgical procedures present an immense risk to patients, and adverse patient outcomes are frequently due to substandard non-technical skills amongst surgical staff. The implementation of a 19-item Surgical Safety Checklist, developed by the World Health Organization, is being enforced in operating theatres globally. The objective is to systematically analyze published literature to assess the use of the WHO Surgical Safety Checklist and their impact in on patient safety. ⋯ The recent use of checklists in surgery has shown improvements in patient outcomes post-operatively. A review was conducted to establish the impact of the checklist on different surgical specialities.
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Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. ⋯ For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research.
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The repair of peripheral nerve injuries is still one of the most challenging tasks and concerns in neurosurgery, plastic and orthopedic surgery. Effect of acetyl-L-carnitine (ALC) loaded chitosan conduit as an in situ delivery system of ALC in bridging the defects was studied using a rat sciatic nerve regeneration model. A 10-mm sciatic nerve defect was bridged using a chitosan conduit (CHIT/ALC) filled with 10 μL ALC (100 ng/mL). ⋯ Morphometric indices of regenerated fibers showed number and diameter of the myelinated fibers in CHIT/ALC were significantly higher than in control group. In immuohistochemistry, the location of reactions to S-100 in CHIT/ALC was clearly more positive than CHIT group. ALC when loaded in a chitosan conduit resulted in improvement of functional recovery and quantitative morphometric indices of sciatic nerve.
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Systematic reviews and meta-analyses are important in shaping clinical practice, but the underlying quality of these studies is critical. The PRISMA guidelines for the reporting of systematic reviews, published in 2009, aimed to improve the quality of reporting of these studies. We looked at whether the reporting of systematic reviews relevant to vascular surgery had improved since the introduction of these guidelines. ⋯ Since the publication of the PRISMA guidance, there has been a marginal improvement in the quality of reporting of systematic reviews and meta-analyses in the field of vascular surgery. However, given the importance of these studies, this needs to be improved, especially as poor reporting may reflect poor methodology in conduct. Journals' instructions to authors should insist on submissions following the published guidance, and this intervention would likely improve both the methodology and quality of reporting of published systematic reviews.