Impact of preoperative frailty on outcomes in patients subjected to emergency laparotomy: a prospective study.

Purpose: Emergency laparotomy (EL) is a high-risk procedure, especially in frail patients. This study investigates the prevalence of frailty in referral facilities, evaluates the impact of frailty on postoperative morbidity and mortality, and assesses the long-term effect of EL on patients' functional status.

Methods: This prospective multicentre cohort study included patients aged 50 years and older who underwent EL.

Digital Platform for Pediatric Mental Health Support During Armed Conflicts: Development and Usability Study.

Background: The prevalence of mental health disorders among children and adolescents presents a significant public health challenge. Children exposed to armed conflicts are at a particularly high risk of developing mental health problems, necessitating prompt and robust intervention. The acute need for early intervention in these situations is well recognized, as timely support can mitigate long-term negative outcomes.

Diagnostic Performance of Clinical and Routine Laboratory Data in Acute Mesenteric Arterial Occlusion-An International Multicenter Study.

Background: There are no clinical or laboratory markers that can diagnose acute mesenteric ischemia (AMI) accurately. This study aimed to find differences in clinical and laboratory markers between arterial occlusive AMI and other acute abdominal diseases where AMI was initially suspected.

Methods: This was a post hoc study of an international prospective multicenter study where data on patients with suspected AMI were collected.

Impact of frailty on outcomes following emergency laparotomy: a retrospective analysis across diverse clinical conditions.

Purpose: Emergency laparotomy (EL) encompasses procedures of varying complexity and urgency, undertaken in different clinical scenarios, leading to different risks of morbidity and mortality. We hypothesized that the increased mortality and longer postoperative length of stay (LoS) observed in frail patients are related to differences in indication for operation, a higher rate of sepsis, worse intraperitoneal soiling, and more advanced malignancy in this group.

Methods: This retrospective cohort study analysed patients entered into the National Emergency Laparotomy Audit database between January 1, 2018, and June 15, 2021, in Oxford.

Medical perspectives on Israeli children after their release from captivity - A retrospective study.

Aim: Following the Hamas terror attack on Israeli towns on October 2023, 250 individuals were taken into captivity. On November-December 2023, during the cease-fire deal, 26 women and children were released. This study is the first to describe the physical and behavioural findings in children and their mothers in the immediate phase of returning home from captivity.

Novel gas mixture combined with an auto-transfusion tourniquet enhances cerebral O transport and hemodynamic indices in CPR swine. Part B - A pilot experimental study.

Objectives: The cognitive outcome of CPR is poor. This study aims to evaluate if enhancing blood flow to the brain and oxygen dissociation from the hemoglobin improve cerebral O transport during CPR in cardiac arrest swine.

Methods: Standard swine-CPR model of induced VF and recovery was treated with an auto-transfusion tourniquet (A-TT®; HemaShock® (HS) Oneg HaKarmel Ltd.

Incidence, diagnosis, management and outcome of acute mesenteric ischaemia: a prospective, multicentre observational study (AMESI Study).

Background: The aim of this multicentre prospective observational study was to identify the incidence, patient characteristics, diagnostic pathway, management and outcome of acute mesenteric ischaemia (AMI).

Methods: All adult patients with clinical suspicion of AMI admitted or transferred to 32 participating hospitals from 06.06.

Clinical implications of extremely elevated C-reactive protein among febrile immunocompetent children.

Aim: To identify the various diagnoses associated with extremely elevated C-reactive protein (CRP) (>30 mg/dL) among immunocompetent children and to evaluate its clinical implications during emergency department (ED) workup and hospital management.

Methods: Children (3 months-18 years) with fever in ED were included, retrospectively. The cohort was divided into two groups-'extremely elevated CRP' (>30 mg/dL) and 'highly elevated CRP' (15-30 mg/dL).

Short Postoperative Intravenous Versus Oral Antibacterial Therapy in Complicated Acute Appendicitis: A Pilot Noninferiority Randomized Trial.

Objective: The purpose of this study is to investigate noninferiority of postoperative oral administration of antibiotics in complicated appendicitis.

Background: Recent investigations have used exclusively intravenous administration of antibiotics when comparing outcomes of postoperative antibacterial therapy in complicated appendicitis. We hypothesized that oral antibacterial treatment results in noninferior outcomes in terms of postoperative infectious complications as intravenous treatment.

Frailty Assessment Can Enhance Current Risk Prediction Tools in Emergency Laparotomy: A Retrospective Cohort Study.

Objective: We set out to assess the performance of the P-POSSUM and NELA risk prediction tool (NELA RPT), and hypothesized that combining them with the Clinical Frailty Scale (CFS) would significantly improve their performance. Emergency laparotomy (EL) is a high-risk surgical intervention, particularly for elderly patients with marked comorbidities and frailty. Accurate risk prediction is crucial for appropriate resource allocation, clinical decision making, and informed consent.

Outcomes of resuscitative and emergent thoracotomies following injury at the largest trauma center in Estonia.

Background: An emergency department thoracotomy (EDT) is performed in critically injured patients after a recent or in an imminent cardiac arrest following trauma. Emergent thoracotomy (ET) or operation room thoracotomy is reserved for more stable patients. However, the number of these interventions performed in an European settings is limited.

Open versus laparoscopic appendectomy for acute appendicitis in pregnancy: a population-based study.

Background: Laparoscopic appendectomy (LA) is the standard treatment for acute appendicitis (AA) in general population. However, the safety of LA during pregnancy has remained a matter of debate. The purpose of this study was to compare surgical and obstetrical outcomes in pregnant women who underwent LA vs.

Selective non-operative management of penetrating abdominal injuries at Northern European trauma centers: the NordiPen Study.

Purpose: A selective nonoperative management (SNOM) of penetrating abdominal injuries (PAI) is a standard of care in numerous established trauma centers. However, available evidence supporting SNOM of PAI in European settings remains scarce. Thus, we performed a multi-center study at selected Northern European trauma centers to investigate the management and outcomes of PAI.

Long-term survival, risk factors and causes of mortality in surgically treated chronic pancreatitis.

Background/objectives: Chronic pancreatitis (CP) is a complex disease with a high complications rate, poor quality of life and considerable mortality. Prospective investigations on long-term outcomes in chronic pancreatitis are scarce. Thus, we aimed to assess long-term survival, causes of death and impact of risk factors on survival in a cohort of surgically managed patients with chronic pancreatitis.

Development and characterization of chitosan nanoparticles loaded nanofiber hybrid system for vaginal controlled release of benzydamine.

Vaginal infections caused by various pathogens such as fungi, viruses and protozoa are frequently seen. Systemic and local treatments can be applied to eliminate these infections. Novel vaginal drug delivery systems can be used to provide local treatment.

A contemporary prospective review of 205 consecutive patients with penetrating colon injuries.

Background: Management of colon injuries has significantly evolved in the recent decades resulting in considerably decreased morbidity and mortality. We set out to investigate penetrating colon injuries in a high-volume urban academic trauma center in South Africa.

Methods: All patients with penetrating colon injuries admitted between 1/2015 and 1/2018 were prospectively enrolled.

Electrospun metronidazole-loaded nanofibers for vaginal drug delivery.

To develop and characterize innovative vaginal dosage forms for the treatment of bacterial vaginosis (BV). This study is the first comparative evaluation of the metronidazole (MET)-loaded polyvinylpyrrolidone (PVP) nanofiber formulations on BV treatment. Vaginal nanofibers are one of the potential innovative dosage forms for BV treatment because of their flexible, mucoadhesive, and easy application in vaginal application which can be applied by the mucosal route.

The role of elevated high-sensitivity cardiac troponin on outcomes following severe blunt chest trauma.

Background: Blunt cardiac injuries (BCI) result in poor outcomes following chest trauma. Admission ECG and troponin levels are frequently obtained in patients with suspected BCI, nevertheless, the prognostic value of cardiac troponins remains controversial. The purpose of the current study was to review the prognostic value of elevated high-sensitivity cardiac troponin T (hs-cTnT) in patients with severe blunt chest injuries.

Severe blunt trauma in Finland and Estonia: comparison of two regional trauma repositories.

Purpose: Evolving trauma system of Estonia has undergone several reforms; however, performance and outcome indicators have not been benchmarked previously. Thus, we initiated a baseline study to compare demographics, management and outcomes of severely injured patients between Southern Finland and Northern Estonia utilizing regional trauma repositories.

Methods: A comparison of data fields of the Helsinki University Hospital trauma registry (HTR) and trauma registry at the North Estonia Medical Centre in Tallinn (TTR) between 1/1/2015 and 31/12/2016 was performed.

Twenty-four hour versus extended antibiotic administration after surgery in complicated appendicitis: A randomized controlled trial.

Background: Recent investigations noted noninferiority in short-course antimicrobial treatments following source control in abdominal infections. We set out to investigate noninferiority of a short and fixed (24 hours) antibiotic administration compared to extended treatment after source control in complicated appendicitis in a prospective single-center open-label randomized controlled trial.

Methods: After Institutional Review Board (IRB) approval, all consecutive adult patients (age, ≥ 18 years) with complicated appendicitis including gangrenous appendicitis, perforated appendicitis, and appendicitis with periappendicular abscess between May 2016 and February 2018 were randomly allocated to antibacterial therapy limited to 24 hours (short) vs.

Cardiac Injuries at Estonian Major Trauma Facilities: A 23-year Perspective.

Background And Aims: Cardiac injuries are highly lethal lesions following trauma and most of the patients decease in pre-hospital settings. However, studies on cardiac trauma in Estonia are scarce. Thus, we set out to study cardiac injuries admitted to Estonian major trauma facilities during 23 years of Estonian independence.

Prospective Observational Study on acute Appendicitis Worldwide (POSAW).

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis.

Simultaneous common bile duct clearance and laparoscopic cholecystectomy: experience of a one-stage approach.

Introduction: The timing and optimal method for common bile duct (CBD) clearance and laparoscopic cholecystectomy remains controversial. Several different approaches are available in clinical practice. The current study presents the experience of two European hospitals of simultaneous laparoscopic cholecystectomy (LC) and intra-operative endoscopic retrograde cholangiopacreatography (IO-ERCP) done by surgeons.

Spatial heterogeneity in root litter and soil legacies differentially affect legume root traits.

Background And Aims: Plants affect the soil environment via litter inputs and changes in biotic communities, which feed back to subsequent plant growth. Here we investigated the individual contributions of litter and biotic communities to soil feedback effects, and plant ability to respond to spatial heterogeneity in soil legacy.

Methods: We tested for localised and systemic responses of to soil biotic and root litter legacy of seven grassland species by exposing half of a root system to control soil and the other half to specific inoculum or root litter.