Tag Archives: Surgery

Canadian scientists and Swiss surgeons discovered the cause of excess postoperative scarring | Instant News


PICTURE: This is a view through a multi-photon microscope as macrophages (red) gather at the injury site (green).
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Credit: Provided by Kubes’ Lab, Snyder Institute for Chronic Disease, Cumming School of Medicine, University of Calgary

The body is extraordinary at healing itself. However, sometimes it can be overkill. Excess scar tissue after abdominal and pelvic surgery within the peritoneal cavity can lead to serious complications and sometimes death. The peritoneal cavity has a protective layer containing organs in our stomach. It also contains fluids to keep organs lubricated. When the lining is damaged, tissue and scar tissue can form, causing problems. Researchers at the University of Calgary and the University of Bern, Switzerland, have discovered what causes excess scarring and options for trying to prevent it.

“This is of global concern. This complication of peritoneal adhesions causes pain and can lead to life-threatening small bowel obstruction and infertility in women,” said Dr. Joel Zindel, MD, University of Bern, Switzerland, and first author of a researcher working on the study as a Swiss National Science Foundation researcher at the University of Calgary. “People sometimes need a second operation.”

Research published in Science, performed on mice and showed excess scar tissue caused by macrophages, a type of white blood cell that rushes to the surgical site to begin repairing the wound.

“Joel developed a new method using very specialized imaging equipment in my lab that gives scientists a first look at what these macrophages are doing in real time,” said Dr. Paul Kubes, PhD, lead investigator of the study and professor at the Cumming School of Medicine. “We’re still working to understand why macrophages do this repair work because they are known to attack pathogens. Whatever they respond to, it’s clear their involvement is causing the scar tissue problem.”

Researchers have also found two ways to inhibit this natural response. They remove macrophages, or they introduce drugs to block macrophage stiffness. Both processes are very effective in stopping adhesion.

“We believe the macrophage response does not make the evolutionary leap to understand that surgery is beneficial and not a threat to survival,” Kubes said. “It’s possible, the body reacts to surgery, that an organ exposed to the environment is interpreted as a threat, like a predator attack. The body doesn’t understand that a surgeon will do critical repair work.”

Macrophages are also present in humans, and the research team believes that the responses seen in mice likely translate to adults and children. They hope to turn to human cell trials, soon, and eventually clinical trials.

“Every surgeon does surgery for people who have these abdominal adhesions,” says Zindel. “It is tremendous to prevent these surgical complications. This not only benefits the individual, but also creates significant savings for the healthcare system, by reducing hospital admission and surgical costs.”

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Basic research is funded by the Natural Sciences and Engineering Research Council while clinical applications are funded by the Canadian Institutes of Health Research (CIHR). Kubes is supported by the Heart & Stroke and CIHR Canada Research Chairs Program and Zindel is supported by a scholarship from the Swiss National Science Foundation.

This research was made possible with support from the Nicole Perkins Microbial Communities Core Lab, the Live Cell Imaging Resource Laboratory at the Cumming School of Medicine, and the Microscopy Imaging Center (MIC) of the University of Bern.

Denial: AAAS and EurekAlert! is not responsible for the accuracy of news releases posted to EurekAlert! by contributing to or for the use of any information via the EurekAlert system.

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US skier Tommy Ford continues to recover from an accident at his home in Bend Sports | Instant News


Tommy Ford doesn’t remember the terrible accident that ended the World Cup ski season on January 9.

He remembers waking up in a Bern hospital, Switzerland, and studying injuries to his head, right knee and left wrist.

“I don’t remember the accident at all or the next hour,” Ford said in an interview with The Bulletin last week. “I don’t remember the helicopter ride I looked like going through.”

Ford, who can get around on crutches but can’t stand for long, has been returning home in Bend over the past few weeks, getting help and support from his parents and older brother.

“You learn what support systems are, or become more aware of them, when you are less capable,” Ford said.

31-year-old Ford – a two-time Olympic athlete born and raised in Bend – is in the middle of the 2020-21 season banner, posting four World Cup top 10 results in the giant slalom, including taking the podium in Santa Caterina, Italy.

He has qualified for the world alpine skiing championships, currently being performed in Cortina d’Ampezzo, Italy.

One of the top-ranked riders at the World Cup giant slalom race in Adelboden, Switzerland, Ford crashed three gates from the finish line after spreading into rough snow beside the track, according to the Associated Press.

His skin touched and he fell forward, sliding first down the hill on his neck and left shoulder.

Ford hit a worker on the side of the track before stopping by the safety net beside the finish.

He initially lay still with his face facing the snow despite immediately regaining his senses and talking to the medical staff, whom he doesn’t remember.

A helicopter lands in the field 20 minutes later to transport Ford to Bern.

Ford’s long-time girlfriend Laurenne Ross, also a World Cup skier and two-time Olympian from Bend, is watching Ford’s race on television as she prepares to race her first World Cup in two years after overcoming multiple knee injuries.

“It totally baffles me,” Ross wrote in an email last week from Cortina d’Ampezzo, where she finished 26th on Saturday in a world championship decline. “Obviously I am very concerned about his head injury, because obviously he is passed out. I’m usually pretty comfortable watching Tommy ski – he’s a solid, smooth skier – but he’s definitely over the top, and pushes the skis… and sometimes you crash when you’re skiing over the edge. Needless to say, I am very sad for him. “

After several days in Bern following the accident, Ford traveled to Vail, Colorado, where doctors at the Steadman Philippon Research Institute repaired torn ligaments in his knee and wrist. He is scheduled to return to Vail later this month for additional surgery on his knee. Ford said he tore two ligaments in his right knee and also fractured a plateau and tibial meniscus.

He also continues to recover from the concussion he suffered.

“I don’t have a headache or anything, but I have limited capacity for stimulation,” he said.

Ford said he was happy to be at his parents’ home in Bend, where he was getting plenty of sleep and rest, and was “starting to recover.” He wears a detachable splint on his left wrist and his right knee is in a brace, which he can remove as often as possible.

He added that it was too early to discuss a time frame for a possible return to ski racing or to bid for his third US Olympic Team. The 2022 Winter Olympics in Beijing are only one year away.

“There is no time frame that is overly detailed at the moment because I will have to have another operation,” Ford said. “I have to bear more weight in March. That’s all I really know. It’s still very early days. I haven’t gotten too far with the emotional side of things and all of that. “

Although Ross continues to race in Europe and Ford has returned home to Bend, the two are able to discuss Ford’s injury and his approach to rehabilitation. Ross, 32, has had 10 surgeries during his skiing career, three of which were major knee operations.

“Unfortunately Laurenne has a lot of experience with knee injuries, and she’s been very helpful with some advice,” said Ford. “I just don’t want to burden him because he also tries to perform at a high level and you don’t want to talk about injuries all the time. But he’s very helpful. He’s really entertaining. “

Ross said he was sure Ford would take the time and get back into the snow when he was “really ready.”

“Hopefully it will be race time next season, but we’ll just have to wait and see,” said Ross. “I’m here for him, every step of the way, whatever it is. I do have the insights I have shared, but everyone is very different when it comes to healing and processing. So I just try to support Tommy in whatever way he needs me to be there, in whatever way he wants to approach his recovery. It’s been the ride, and although I can offer advice, I know we are very different people, very different skiers, and often have different perspectives on injury and recovery. “

Ross added that the most important thing on which Ford is currently focused is “rest, recovery and reflection”.

“It’s important to consider if you want to get another injury (like the one he’s recovering from now), because that’s always the chance you take when you push out the starting gate in a ski race,” said Ross. “But first, he needs to focus on healing.”

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Black Children Face Higher Risk Than White Children During The Operation | Instant News


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While the risks to children is low, black children face higher risk than white children when undergoing surgery. Getty Images
  • A new study published this week in the journal “Pediatrics,” examined the records of more than 170,000 relatively healthy children.
  • The researchers found that black children are 3.43 times the odds of dying and 18 percent more likely to develop postoperative complications.
  • Parents and caregivers can protect children by acting as advocate in the medical system.

Black children in the USA is almost 3 1/2 times more likely to die as white children within 30 days after surgery, according to a new study.

The study, which was published this week in the journal Pediatricsexamined records of more than 170,000 relatively healthy children.

The study showed that compared with white children, black children are 3.43 times the odds of dying, 18 percent more likely to develop postoperative complications, and 7 percent more likely to develop serious complications during the 30-day period after surgery.

Dr. Olubukola Nafiu, Department of anesthesiology and pain medicine at nationwide children’s hospital and lead author of the study, noted that it is known that a higher comorbidity load often leads to higher probability of complications during or after surgery.

“[So] we decided to flip the argument and look at people who are relatively healthy population, are assigned a healthy condition before the operation,” said Nafiu, an assistant Professor of Pediatrics and anesthesiology at the Ohio state University College of medicine.

Although the mortality and incidence of adverse events was low, Nafiu and his colleagues were struck by data showing higher mortality rates among black children.

Nafiu said the paper leaves unanswered a few questions.

“This document does not solve” – he said. “It found a link between race and these outcomes.”

“Our next job, go in the database and see if we can find any specific complications most associated with mortality and other factors. Through this we can come up with other proposals,” he said.

He added that the database that was provided by the American College of surgeons do not include the names of the hospitals where assistance had been received.

He noted that a number of theories can help to explain the large disparity in results, including institutional, provider, or factors associated with the patient.

Patient factors can include what happened before the surgery, such as socio-economic factors, access to healthcare and the types of services that patients called.

“You could have two patients with the same disease but the way of operation is very different, for example, the time it took for them to see the doctor, how long it took to bring them to the surgeon, and how long it took to get them on the operating list. It is well known that African Americans generally receive assistance in low – performing hospitals,” he added.

Other factors may include home environment, said Dr. Jean Leclerc Raphael, Professor of Pediatrics at the medical College Baylor in Houston.

“Maybe they can’t do post-op care, as they should [or failed to adhere to the post-discharge instructions]” – he said.

“This is a difficult question. Therefore, we must do the work the understanding of the factors that brought us here,” said Rapheal.

Dr. Wayne A. I. Frederick, Professor of surgery at the Howard University, said that the study raises a number of issues, including the role of unconscious bias.

“Colored people are suffering from diseases of all kinds,” said Frederick, Charles R. drew vested in the Department of surgery at the University’s Howard College of medicine and President of the University.

To better answer these questions, he said, it is important to look at several factors including in hospitals, the capabilities of the surgeon, and the cultural level of the entire healthcare system.

“This is more multifactorial inequalities in health are multifactorial,” said Frederick.

Dr. Katherine Remick, associate Professor in the departments of Pediatrics and surgery at the University of Texas at Austin Dell Medical school, said the study should lead to a “call to action”.

“This level of inequality should not exist in the United States,” said REMIK. “More research needs to be done to understand why these differences exist, and to support efforts aimed at creating greater equity within our health system.”

Nafiu said there are two big takeaway messages from this study.

One operation is still very safe and mortality rates are still very low.

“If your child is sick don’t stay home”, he said.

Two: “this is a retrospective study, which has quite a few limitations. There are a lot of questions. We can only guess and not right answer,” he said.

“Research says that healthy African-American children dying in hospitals,” Nafiu said. “It would be the worst message stating that the parents or of the laity can go. Our task is to find what is behind the wheel. We want to find out what happens, so we can provide the best care for children of any racial status.”

At the same time, parents should be aware, ‘ said Frederick. Parents and caregivers can protect children by acting as advocate in the medical system.

“Taking care of the kids, you must be a strong defender, which means you have to be aware and to be aware of the procedures,” he said.

“If you don’t feel confident in some hospitals, there are patient navigators that can help,” he added. “I would urge parents to fully understand and ask the right questions. Make sure that the patient-Doctor relationship is established very early. There are many opportunities to obtain information.”

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