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Kim SS, Kycia I, Karski M, Ma RK, Bordt EA, Kwan J, Karki A, Winter E, Aktas RG, Wu Y, Emili A, Bauer DE, Sethupathy P, Vakili K. DNAJB1-PRKACA in HEK293T cells induces LINC00473 overexpression that depends on PKA signaling. PLoS One 2022; 17:e0263829. [PMID: 35167623 PMCID: PMC8846505 DOI: 10.1371/journal.pone.0263829] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/28/2022] [Indexed: 11/19/2022] Open
Abstract
Fibrolamellar carcinoma (FLC) is a primary liver cancer that most commonly arises in adolescents and young adults in a background of normal liver tissue and has a poor prognosis due to lack of effective chemotherapeutic agents. The DNAJB1-PRKACA gene fusion (DP) has been reported in the majority of FLC tumors; however, its oncogenic mechanisms remain unclear. Given the paucity of cellular models, in particular FLC tumor cell lines, we hypothesized that engineering the DP fusion gene in HEK293T cells would provide insight into the cellular effects of the fusion gene. We used CRISPR/Cas9 to engineer HEK293T clones expressing DP fusion gene (HEK-DP) and performed transcriptomic, proteomic, and mitochondrial studies to characterize this cellular model. Proteomic analysis of DP interacting partners identified mitochondrial proteins as well as proteins in other subcellular compartments. HEK-DP cells demonstrated significantly elevated mitochondrial fission, which suggests a role for DP in altering mitochondrial dynamics. Transcriptomic analysis of HEK-DP cells revealed a significant increase in LINC00473 expression, similar to what has been observed in primary FLC samples. LINC00473 overexpression was reversible with siRNA targeting of PRKACA as well as pharmacologic targeting of PKA and Hsp40 in HEK-DP cells. Therefore, our model suggests that LINC00473 is a candidate marker for DP activity.
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Affiliation(s)
- Stephanie S. Kim
- Department of Surgery, Boston Children’s Hospital, Boston, MA, United States of America
| | - Ina Kycia
- Department of Surgery, Boston Children’s Hospital, Boston, MA, United States of America
| | - Michael Karski
- Department of Surgery, Boston Children’s Hospital, Boston, MA, United States of America
| | - Rosanna K. Ma
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Evan A. Bordt
- Department of Pediatrics, Lurie Center for Autism, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Julian Kwan
- Department of Biochemistry, Center for Networks Systems Biology, Boston University School of Medicine, Boston, MA, United States of America
| | - Anju Karki
- Department of Surgery, Boston Children’s Hospital, Boston, MA, United States of America
| | - Elle Winter
- Department of Surgery, Boston Children’s Hospital, Boston, MA, United States of America
| | - Ranan G. Aktas
- Department of Surgery, Boston Children’s Hospital, Boston, MA, United States of America
| | - Yuxuan Wu
- Division of Hematology/Oncology, Boston Children’s Hospital, Boston, MA, United States of America
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Stem Cell Institute, Broad Institute, Boston, MA, United States of America
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States of America
| | - Andrew Emili
- Department of Biochemistry, Center for Networks Systems Biology, Boston University School of Medicine, Boston, MA, United States of America
| | - Daniel E. Bauer
- Division of Hematology/Oncology, Boston Children’s Hospital, Boston, MA, United States of America
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Stem Cell Institute, Broad Institute, Boston, MA, United States of America
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States of America
| | - Praveen Sethupathy
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Khashayar Vakili
- Department of Surgery, Boston Children’s Hospital, Boston, MA, United States of America
- * E-mail:
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Realpe AX, Blackstone J, Griffin DR, Bing AJF, Karski M, Milner SA, Siddique M, Goldberg A. Barriers to recruitment to an orthopaedic randomized controlled trial comparing two surgical procedures for ankle arthritis : a qualitative study. Bone Jt Open 2021; 2:631-637. [PMID: 34378406 PMCID: PMC8384444 DOI: 10.1302/2633-1462.28.bjo-2021-0074.r1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aims A multicentre, randomized, clinician-led, pragmatic, parallel-group orthopaedic trial of two surgical procedures was set up to obtain high-quality evidence of effectiveness. However, the trial faced recruitment challenges and struggled to maintain recruitment rates over 30%, although this is not unusual for surgical trials. We conducted a qualitative study with the aim of gathering information about recruitment practices to identify barriers to patient consent and participation to an orthopaedic trial. Methods We collected 11 audio recordings of recruitment appointments and interviews of research team members (principal investigators and research nurses) from five hospitals involved in recruitment to an orthopaedic trial. We analyzed the qualitative data sets thematically with the aim of identifying aspects of informed consent and information provision that was either unclear, disrupted, or hindered trial recruitment. Results Recruiters faced four common obstacles when recruiting to a surgical orthopaedic trial: patient preferences for an intervention; a complex recruitment pathway; various logistical issues; and conflicting views on equipoise. Clinicians expressed concerns that the trial may not show significant differences in the treatments, validating their equipoise. However, they experienced role conflicts due to their own preference and perceived patient preference for an intervention arm. Conclusion This study provided initial information about barriers to recruitment to an orthopaedic randomized controlled trial. We shared these findings in an all-site investigators’ meeting and encouraged researchers to find solutions to identified barriers; this led to the successful completion of recruitment. Complex trials may benefit for using of a mixed-methods approach to mitigate against recruitment failure, and to improve patient participation and informed consent. Cite this article: Bone Jt Open 2021;2(8):631–637.
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Affiliation(s)
- Alba X Realpe
- Bristol Medical School, University of Bristol, Bristol, UK
| | - James Blackstone
- Comprehensive Clinical Trials Unit, University College London, London, UK
| | | | - Andrew J F Bing
- Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Oswestry, Shropshire, UK
| | - Michael Karski
- Foot and Ankle Surgery, Wrightington Hospital, Wigan, UK
| | - Stephen A Milner
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Malik Siddique
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, Newcastle upon Tyne, UK
| | - Andrew Goldberg
- The Wellington Hospital, London, UK.,Imperial College London, London, UK.,UCL Institute of Orthopaedics and Musculoskeletal Science, Stanmore, UK
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Majeed H, Karim T, Davenport J, Karski M, Smith R, Clough TM. Clinical and patient-reported outcomes following Low Intensity Pulsed Ultrasound (LIPUS, Exogen) for established post-traumatic and post-surgical nonunion in the foot and ankle. Foot Ankle Surg 2020; 26:405-411. [PMID: 31142440 DOI: 10.1016/j.fas.2019.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/19/2019] [Accepted: 05/10/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Biophysical methods including Low Intensity Pulsed Ultrasound (LIPUS) are emerging as potential alternatives to revision surgery for treating established nonunions. We aim to prospectively review the clinical and patient-reported outcomes of patients treated with LIPUS following post-traumatic and post-surgical nonunions in the foot and ankle. METHODS Forty-seven consecutive patients underwent Exogen treatment. Patient-reported outcome scores included MOXFQ, EQ-5D and VAS. Patients were divided in to 3 groups: fractures (A), hindfoot procedures (B) and midfoot/forefoot procedures (C). RESULTS Thirty-seven patients (78.7%) clinically united, 4 patients (8.5%) noticed no significant improvement but did not want further intervention and 6 patients (12.8%) underwent revision surgery. The mean duration of Exogen treatment was 6 months. Union rates of 93%, 67% and 78% were noted in the three groups. Significant improvement in functional outcomes and potential cost savings were observed. CONCLUSIONS Exogen for established nonunion in the foot and ankle is a safe, valuable and economically viable clinical option as an alternative to revision surgery. We observed better results in the fracture and midfoot/forefoot groups and relatively poorer results in the hindfoot fusion group.
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Affiliation(s)
- Haroon Majeed
- Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL England, United Kingdom.
| | - Tariq Karim
- Wrightington Hospital, Hall Lane, Wigan, WN6 9EP England, United Kingdom
| | - James Davenport
- Wrightington Hospital, Hall Lane, Wigan, WN6 9EP England, United Kingdom
| | - Michael Karski
- Wrightington Hospital, Hall Lane, Wigan, WN6 9EP England, United Kingdom
| | - Robert Smith
- Wrightington Hospital, Hall Lane, Wigan, WN6 9EP England, United Kingdom
| | - Timothy M Clough
- Wrightington Hospital, Hall Lane, Wigan, WN6 9EP England, United Kingdom.
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Abstract
AIMS We report the long-term clinical and radiological outcomes of a consecutive series of 200 total ankle arthroplasties (TAAs, 184 patients) at a single centre using the Scandinavian Total Ankle Replacement (STAR) implants. PATIENTS AND METHODS Between November 1993 and February 2000, 200 consecutive STAR prostheses were implanted in 184 patients by a single surgeon. Demographic and clinical data were collected prospectively and the last available status was recorded for further survival analysis. All surviving patients underwent regular clinical and radiological review. Pain and function were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scoring system. The principal endpoint of the study was failure of the implant requiring revision of one or all of the components. Kaplan-Meier survival curves were generated with 95% confidence intervals and the rate of failure calculated for each year. RESULTS A total of 84 patients (87 ankles) were alive by the end of this study. Of the surviving 84 patients (87 ankles; rheumatoid arthritis (RA), n = 40; OA, n = 47), 45 were women and 39 were men, with a mean age of 54 years (18 to 72 years) at the time of surgery. A total of 32 implants failed (16%), requiring revision surgery. The mean time to revision was 80 months (2 to 257). The implant survival at 15.8 years, using revision as an endpoint, was 76.16% (95% confidence interval (CI) 64.41 to 87.91). We found a steady but low decrease in survival over the study period. The mean AOFAS score improved from 28 (10 to 52) preoperatively to 61 (20 to 90) at long-term follow-up. CONCLUSION STAR prostheses in the United Kingdom have now been largely superseded by newer design TAAs, potentially with improved characteristics and surgical techniques. The long-term survivorship for the STAR prosthesis can provide a benchmark for these later designs of ankle arthroplasty.
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Affiliation(s)
- T Clough
- Wrightington Hospital, Wigan, UK
| | - K Bodo
- Locum Consultant Foot and Ankle Surgeon, North Tees and Hartlepool NHS Foundation Trust, Hartlepool, UK
| | - H Majeed
- Wrightington Hospital, Wigan, UK
| | | | - M Karski
- Wrightington Hospital, Wigan, UK
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Alonso-Rasgado T, Jimenez-Cruz D, Karski M. 3-D computer modelling of malunited posterior malleolar fractures: effect of fragment size and offset on ankle stability, contact pressure and pattern. J Foot Ankle Res 2017; 10:13. [PMID: 28293302 PMCID: PMC5346225 DOI: 10.1186/s13047-017-0194-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 03/01/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The positioning of the fracture fragment of a posterior malleolus fracture is critical to healing and a successful outcome as malunion of a posterior malleolar fracture, a condition seen in clinical practice, can affect the dynamics of the ankle joint, cause posterolateral rotational subluxation of the talus and ultimately lead to destruction of the joint. Current consensus is to employ anatomic reduction with internal fixation when the fragment size is larger than 25 to 33% of the tibial plafond. METHODS A 3-dimensional finite element (FE) model of ankle was developed in order to investigate the effect of fragment size (6-15 mm) and offset (1-4 mm) of a malunited posterior malleolus on tibiotalar joint contact area, pressure, motion of joint and ligament forces. Three positions of the joint were simulated; neutral position, 20° dorsiflexion and 30° plantarflexion. RESULTS Compared to the intact joint our model predicted that contact area was greater in all malunion scenarios considered. In general, the joint contact area was affected more by section length than section offset. In addition fibula contact area played a role in all the malunion cases. CONCLUSIONS We found no evidence to support the current consensus of fixing posterior malleolus fractures of greater than 25% of the tibial plafond. Our model predicted joint instability only with the highest level of fracture in a loaded limb at an extreme position of dorsiflexion. No increase of peak contact pressure as a result of malunion was predicted but contact pattern was modified. The results of our study support the view that in cases of posterior malleolar fracture, posttraumatic osteoarthritis occurs as a result of load on areas of cartilage not used to loading rather than an increase in contact pressure. Ankle repositioning resulted in increased force in two ankle ligaments. Our finding could explain commonly reported clinical observations.
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Affiliation(s)
- Teresa Alonso-Rasgado
- Bioengineering Research Group, School of Materials, The University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - David Jimenez-Cruz
- Bioengineering Research Group, School of Materials, The University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - Michael Karski
- Wrightington Hospital, Wigan and Leigh NHS Foundation Trust, Lancashire, UK
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Goldberg AJ, Zaidi R, Thomson C, Doré CJ, Skene SS, Cro S, Round J, Molloy A, Davies M, Karski M, Kim L, Cooke P. Total ankle replacement versus arthrodesis (TARVA): protocol for a multicentre randomised controlled trial. BMJ Open 2016; 6:e012716. [PMID: 27601503 PMCID: PMC5020669 DOI: 10.1136/bmjopen-2016-012716] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Total ankle replacement (TAR) or ankle arthrodesis (fusion) is the main surgical treatments for end-stage ankle osteoarthritis (OA). The popularity of ankle replacement is increasing while ankle fusion rates remain static. Both treatments have efficacy but to date all studies comparing the 2 have been observational without randomisation, and there are no published guidelines as to the most appropriate management. The TAR versus arthrodesis (TARVA) trial aims to compare the clinical and cost-effectiveness of TAR against ankle arthrodesis in the treatment of end-stage ankle OA in patients aged 50-85 years. METHODS AND ANALYSIS TARVA is a multicentre randomised controlled trial that will randomise 328 patients aged 50-85 years with end-stage ankle arthritis. The 2 arms of the study will be TAR or ankle arthrodesis with 164 patients in each group. Up to 16 UK centres will participate. Patients will have clinical assessments and complete questionnaires before their operation and at 6, 12, 26 and 52 weeks after surgery. The primary clinical outcome of the study is a validated patient-reported outcome measure, the Manchester Oxford foot questionnaire, captured preoperatively and 12 months after surgery. Secondary outcomes include quality-of-life scores, complications, revision, reoperation and a health economic analysis. ETHICS AND DISSEMINATION The protocol has been approved by the National Research Ethics Service Committee (London, Bloomsbury 14/LO/0807). This manuscript is based on V.5.0 of the protocol. The trial findings will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER NCT02128555.
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Affiliation(s)
- Andrew J Goldberg
- UCL Institute of Orthopaedics and Musculoskeletal Science (IOMS), Royal National Orthopaedic Hospital (RNOH), London, UK
| | - Razi Zaidi
- UCL Institute of Orthopaedics and Musculoskeletal Science (IOMS), Royal National Orthopaedic Hospital (RNOH), London, UK
| | - Claire Thomson
- Surgical Intervention Trials Unit, University of Oxford, Botnar Research Centre, Oxford, UK
| | - Caroline J Doré
- Comprehensive Clinical Trials Unit, University College London, London, UK
| | - Simon S Skene
- Comprehensive Clinical Trials Unit, University College London, London, UK
| | - Suzie Cro
- MRC Clinical Trials Unit, University College London, London, UK
| | - Jeff Round
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Andrew Molloy
- Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | | | - Louise Kim
- Joint Research and Enterprise Office, St George's University of London and St George's University Hospitals NHS Foundation Trust, London, UK
| | - Paul Cooke
- Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Oxford, UK
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Gilbert J, Karski M, Smith TD, Burrows AM, Norbutt C, Siegel MI, Costello BJ, Cray JJ, Losee JE, Moursi AM, Cooper GM, Mooney MP. Transforming Growth Factor-β3 Therapy Delays Postoperative Reossification and Improves Craniofacial Growth in Craniosynostotic Rabbits. Cleft Palate Craniofac J 2015; 53:210-21. [PMID: 26090789 DOI: 10.1597/14-298] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Postoperative reossification is a common clinical correlate following surgery. It has been suggested that an underexpression of transforming growth factor-β3 (TGF-β3) may be related to craniosynostosis and postoperative reossification. Adding TGF-β3 may delay reossification and improve postoperative growth. The present study was designed to test this hypothesis. Thirty 10-day-old New Zealand white rabbits with hereditary coronal suture synostosis were divided into three groups: (1) suturectomy controls (n = 14), (2) suturectomy treated with bovine serum albumin (n = 8), and (3) suturectomy treated with TGF-β3 protein (n = 8). At 10 days of age, a 3-mm × 15-mm coronal suturectomy was performed, and serial three-dimensional (3D) computed tomography (CT) scans and cephalographs were taken at 10, 25, 42, and 84 days of age. Calvaria were harvested at 84 days of age for histomorphometric analysis. Mean differences were analyzed using a group by age analysis of variance. Analysis of the 3D CT scan data revealed that sites treated with TGF-β3 had significantly (P < .05) greater defect areas and significantly (P < .05) greater intracranial volumes through 84 days of age compared with controls. Histomorphometry showed that sites treated with TGF-β3 had patent suturectomy sites and significantly (P < .001) less new bone in the suturectomy site compared with controls. Serial radiograph data revealed significant (P < .05) differences in craniofacial growth from 25 to 84 days in TGF-β3-treated rabbits compared with controls. Data show that TGF-β3 administration delayed reossification and improved craniofacial growth in this rabbit model. These findings also suggest that this molecular-based therapy may have potential clinical use.
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Karski M, Förster L, Choi JM, Alt W, Widera A, Meschede D. Nearest-neighbor detection of atoms in a 1D optical lattice by fluorescence imaging. Phys Rev Lett 2009; 102:053001. [PMID: 19257509 DOI: 10.1103/physrevlett.102.053001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Indexed: 05/27/2023]
Abstract
We overcome the diffraction limit in fluorescence imaging of neutral atoms in a sparsely filled one-dimensional optical lattice. At a periodicity of 433 nm, we reliably infer the separation of two atoms down to nearest neighbors. We observe light induced losses of atoms occupying the same lattice site, while for atoms in adjacent lattice sites, no losses due to light induced interactions occur. Our method points towards characterization of correlated quantum states in optical lattice systems with filling factors of up to one atom per lattice site.
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Affiliation(s)
- M Karski
- Institut für Angewandte Physik der Universität Bonn, Wegelerstrasse 8, 53115 Bonn, Germany.
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Paluszkiewicz P, Karski M. [Extended small bowel resection with right hemicolectomy after massive superior mesenteric artery embolism, management in early postoperative period]. Wiad Lek 1999; 52:347-54. [PMID: 10540580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Intensive care management in recent postoperative period in nine patients with superior mesenteric artery embolism was provided. In all patients during surgical treatment an extensive resection of small bowel and right colectomy were performed. On the basis of physiopathological mechanisms of occlusional bowel ischemia and septic shock development the appropriate therapeutic procedure during pre and postoperative period was submitted. The authors suggest usefulness of the antibiotic prophylaxis in patients with high risk of measenteric embolism in order to decrease the dynamics of septic complications in the cases with bowel necrosis.
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Paluszkiewicz P, Karski M, Misztal M, Karski J. [Antibacterial treatment in patients after extended bowel resection with ileo-cecal valve removal--personal experience]. Pol Arch Med Wewn 1998; 100:437-41. [PMID: 10410578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Small bowel infection in patients that underwent extensional bowel resection is one of causal mechanisms of massive diarrhoea in postoperative period. The aim of this study was to investigate clinical importance of ciprofloxacin efficacy in treatment of massive diarrhoea in patients after extensional bowel resection with removing of ileo-coecal valve (EBR + ICVR). From group of 21 patients that underwent EBR + ICVR the postoperative period survived only 11. In 9 cases massive diarrhoea and sepsis was observed. Routinely applied three-drugs antibacterial therapy based on penicillin or first-generation cephalosporin, aminoglycoside and metronidazole was efficient in 18% of patients only. The ciprofloxacin was used as a second-shot therapy in patients which did not realt on routine three-drugs antibacterial management. In all cases the clinical efficacy was observed as recessing of diarrhoea and septic symptoms. On the basis of our experience we suggest that in patients with massive diarrhea due to ascending contamination of small bowel after extensive resection with removal of ileo-coecal valve, ciprofloxacine is the treatment of choice.
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Affiliation(s)
- P Paluszkiewicz
- Oddział Chirurgii Ogólnej Wojewódzkiego, Jana Bozego w Lublinie
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Karski J, Wolski T, Skublewski K, Wolski J, Karski M. The use of vegetable proteolytic enzymes in the treatment of surgical diseases. Ann Univ Mariae Curie Sklodowska Med 1994; 49:125-128. [PMID: 8771841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- J Karski
- Oddział Chirurgii, Wojewódzki Szpital Zespolony im. Jana Bozego w Lublinie
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