Abstract: Gastric lipomas are rare tumors, accounting for 2%-3% of all benign gastric tumors. They are of submucosal or extremely rare subserosal origin. Although most gastric lipomas are usually detected incidentally, they can cause abdominal pain, dyspeptic disorders, obstruction, invagination, and hemorrhages. Subserosal gastric lipomas are rarely symptomatic. There is no report on treatment of subserosal gastric lipomas in the English literature. We present a case of a 50-year-old male with symptomatic subserosal gastric lipoma which was successfully managed with removal, enucleation of lipoma, explorative gastrotomy and edge resection for histology check of gastric wall. The incidence of gastric lipoma, advanced diagnostic possibilities and their role in treatment modalities are discussed.
Abstract: BACKGROUND: Abdominal surgical site infections (SSI) cause substantial morbidity and mortality for patients undergoing operative procedures. We determined the incidence of and risk factors for SSI after abdominal surgery in the Department of Abdominal Surgery at the University Clinical Centre of Kosovo (UCCK). METHODOLOGY: Prospective surveillance of patients undergoing abdominal surgery was performed between December 2005 and June 2006. CDC definitions were followed to detect SSI and study forms were based on Europe Link for Infection Control through Surveillance (HELICS) protocol. RESULTS: A total of 253 surgical interventions in 225 patients were evaluated. The median age of patients was 42 years and 55.1% of them were male. The overall incidence rate of SSI was 12%. Follow-up was achieved for 84.1% of the procedures. For patients with an SSI, the median duration of hospitalization was 9 days compared with 4 days for those without an SSI (p < 0.001). Surgical procedures were classified as emergent in 53.3% of cases. Superficial incisional SSI was most common (55%). Clinical infections were culture positive in 40.7% of cases. Duration of operation, duration of preoperative stay, wound class, ASA score > 2, use of antibiotic prophylaxis and NNIS class of > 2 were all significant at p < .001. The SSI rates for the NNIS System risk classes 0, 1 and 2-3 were 4.2%, 46.7% and 100%, respectively. CONCLUSIONS: SSI caused considerable morbidity among surgical patients in UCCK. Appropriate active surveillance and infection control measures should be introduced during preoperative, intra-operative, and postoperative care to reduce infection rates.
Abstract: Surgical site infections in an abdominal surgical ward at Kosovo Teaching Hospital
Lul Raka,1,3 Avdyl Krasniqi,2,3 Faton Hoxha,2,3 Ruustem Musa,2 Gjyle Mulliqi,1,3 Selvete Krasniqi,1,3 Arsim Kurti,1,3 Antigona Dervishaj,1,3 Beqir Nuhiu,2 Baton Kelmendi,2 Dalip Limani,2,3 Ilir Tolaj.3
1National Institute for Public Health of Kosova, Prishtina, Kosova; 2Department of Surgery, University Clinical Centre of Kosova, Prishtina, Kosova; 3School of Medicine, Prishtina University, Prishtina, Kosova.
Abstract
Background: Abdominal surgical site infections (SSI) cause substantial morbidity and mortality for patients undergoing operative procedures. We determined the incidence of and risk factors for SSI after abdominal surgery in the Department of Abdominal Surgery at the University Clinical Centre of Kosovo Æ’v(UCCK).
Methodology: Prospective surveillance of patients undergoing abdominal surgery was performed between December 2005 and June 2006. CDC definitions were followed to detect SSI and study forms were based on Europe Link for Infection Control through Surveillance (HELICS) protocol.
Results: A total of 253 surgical interventions in 225 patients were evaluated. The median age of patients was 42 years and 55.1% of them were male. The overall incidence rate of SSI was 12%. Follow-up was achieved for 84.1% of the procedures. For patients with an SSI, the median duration of hospitalization was 9 days compared with 4 days for those without an SSI (p<0.001). Surgical procedures were classified as emergent in 53.3% of cases. Superficial incisional SSI was most common (55%). Clinical infections were culture positive in 40.7% of cases. Duration of operation, duration of preoperative stay, wound class, ASA score
>2, use of antibiotic prophylaxis and NNIS class of >2 were all significant at p < .001. The SSI rates for the NNIS System risk classes 0, 1 and 2-3 were 4.2%, 46.7% and 100%, respectively.
Conclusions: SSI caused considerable morbidity among surgical patients in UCCK. Appropriate active surveillance and infection control measures should be introduced during preoperative, intra-operative, and postoperative care to reduce infection rates.
Key Words: Kosova, nosocomial infections, surgical site infections.
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Abstract: INTRODUCTION: Hepatic hydatidosis has been a common pathology for decades in our department. In the past were used different surgical methods to manage liver hydatidosis, but, a method of choice still is not found, especially for treatment of large liver hydatid cysts. OBJECTIVE: To analyze the outcome of different surgial methods used for treatment of large hepatic hydatid cysts in our department over a period of 12 years. MATERIAL AND MEDTHODS: A retrospective random chart review of patients with liver hydatid cysts treated surgically during 1981-1990 and 2000-2001. RESULTS: A total of 183 patients were studied: 110 (60.1% = female, 73 (39.9%) male; the medican age was 37 years (range 17 to 81); the mean preoperative ultrasonographic diameter of cysts was 13.05 cm (median 11.3 cm and maximal 22.3 cm). 72.7% of cysts were localized in the right hepatic lobe and 27.3% in the left hepatic lobe in 21 (11.5%) patients two different cysts in both hepatic lobes were found. Following surgical methods were performed; in 50 (27.3%) patients endocystectomy and capitonnage, in 10 (5.4%) patients external drainage, in 115 (62.8%) endocystectomy and partial pericystectomy with omentoplication according Papadimitris and in 8 (4.4%) opatients complete pericystectomy or atypical liver resection. In 31 (16.9%) choledochal T-tube was placed. Mean postoperative hospital stay was 15.7 days (minimum 5, maximum 71). Overall complication rate was 18.8%, there was no mortality. CONCLUSIONS: Enucleatin of endocysts and partial pericystectomy witzh omentoplication accroding Papadimitris was most often used last years. Endocystectomy with capitonnage as well as external drainage that were used in the past for treatment of large hydatid hepatic cysts, had a more postoperative complications and longer hospital stay compared to the method of Papadimitris.
Abstract: Expression of nicotinic subtypes acethyl choline receptors within airway related vagal preganglionic neurons in ferrets
Burim M Neziri1, Shaip Krasniqi1, Shqipe Devaja1, Muharrem Jakupaj1 and Avdyl Krasniqi2
1 Institut of Pathophysiology
2 Surgery Clinic, University Clinical Center of Kosova, Prishtina, Albania
ABSTRACT
Acetylcholine is the primary parasympathetic neurotransmitter in the airways, and is traditionally associated with inducing airway smooth muscle contraction and mucus secretion. Nicotine administred topically to the ventrolateral region of medulla oblongata where the airway related vagal preganglionic neurons (AVPNs) are located, elevates cholinergic outflow to the airways, inducing bronchoconstriction and airway submucosal gland secretion. These effects could be blocked by intracisternally administred hexamethonium (HXM), a general blocker of nicotinic acetylcholine receptors (nAChRs), suggesting the presence of nAChRs on AVPNs. Furthermore in the present study, we examined the role of three main functionally characterized subtypes of nAChRs in the CNS, the alpha7 homomeric and alpha4beta2 heteromeric receptors in cholinergic outflow to the airways, by microinjection into AVPNs of specific blocker of nicotinic acetylcholine receptors (nAChRs). Additionaly we characterized the expression of these subtypes of receptors at the message (mRNA) and protein levels in brain tissues taken from the rNA region, the site where AVPNs are located. These results indicate that in ferrets the majority of neurons from group of AVPNs express the alpha7 homomeric receptors, while the minority of them shows expression of alpha4beta2 heteromeric receptors.
