Evaluation of the Collaborative Use of an Evidence-Based Care Bundle in Emergency Laparotomy.

Importance: Patients undergoing emergency laparotomy have high mortality, but few studies exist to improve outcomes for these patients.

Objective: To assess whether a collaborative approach to implement a 6-point care bundle is associated with reduction in mortality and length of stay and improvement in the delivery of standards of care across a group of hospitals.

Design, Setting, And Participants: The Emergency Laparotomy Collaborative (ELC) was a UK-based prospective quality improvement study of the implementation of a care bundle provided to patients requiring emergency laparotomy between October 1, 2015, and September 30, 2017.

Emergency Abdominal Surgery in the Elderly: Can We Predict Mortality?

Background: The United Kingdom population is ageing. Half of patients requiring an emergency laparotomy are aged over 70, 20 % die within 30 days, and less than half receive good care. Frailty and delay in management are associated with poor surgical outcomes.

The Challenge of Antimicrobial Resistance in Managing Intra-Abdominal Infections.

Background: In recent years, there has been a worldwide increase in infections caused by microorganisms resistant to multiple antimicrobial agents.

Methods: In the past few decades, an increased prevalence of infections caused by antibiotic-resistant pathogens, including Enterococcus spp., carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii, extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp.

Current concept of abdominal sepsis: WSES position paper.

Although sepsis is a systemic process, the pathophysiological cascade of events may vary from region to region.Abdominal sepsis represents the host's systemic inflammatory response to bacterial peritonitis.It is associated with significant morbidity and mortality rates, and is the second most common cause of sepsis-related mortality in the intensive care unit.

Ectopic hormone-secreting pheochromocytoma: a francophone observational study.

Background: Ectopic hormone-secreting pheochromocytomas are rare; only case reports exist in the literature. This condition has been linked with increased malignancy, familial syndromes, and ACTH secretion. We wanted to test these hypotheses and shed light on the nature of ectopic hormone-secreting pheochromocytomas.

Preoperative vitamin D deficiency predicts postoperative hypocalcemia after total thyroidectomy.

Background: Transient postthyroidectomy hypocalcemia occurs in up to 30% of patients. We evaluated the effect of vitamin D deficiency on postthyroidectomy hypocalcemia.

Methods: Data were collected prospectively between January 2006 and March 2009.

25-hydroxy vitamin D deficiency causes parathyroid incidentalomas.

Purpose: 25-OH D3 (D3) deficiency causes secondary hyperparathyroidism. Asymmetric gland hypertrophy may also lead to unnecessary parathyroid gland resection by mistaking these glands for parathyroid incidentalomas. We tested the hypothesis that D3 deficiency causes parathyroid gland hypertrophy.

Report of 100 open inguinal hernia repairs using a 2-cm incision: a novel technique.

We report a novel open technique for the repair of inguinal hernias using a 2-cm incision. This allows bilateral cases to be performed safely as day case procedures, where laparoscopic repair is not possible. A 2-cm incision is made over the deep inguinal ring.