288 results on '"Surgical Injury"'
Search Results
2. Comparison of Standard Cystoscopy With Carbon Dioxide Cystoscopy
- Author
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Abdurrahman Hamdi İnan, Associate Professor
- Published
- 2024
3. fMRI and IVCM Cornea Microscopy of CXL in Keratoconus
- Author
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Eric Moulton, Assistant Professor of Anesthesia
- Published
- 2024
4. 論達文西輔助手術損害及其 預防和司法處理.
- Author
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黃清華
- Abstract
Copyright of Taiwan Law Review is the property of Angle Publishing Co., Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2024
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- View/download PDF
5. Surgical Force: Initial Study and Clinical Implications in the Assessment of Ureteral Access Sheath Induced Injury.
- Author
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Lavasani, Seyed Amiryaghoub M., Rojhani, Allen, Cumpanas, Andrei D., Osann, Kathryn, Morgan, Kalon L., Hernandez, Mariah C., McCormac, Amanda, Piedras, Paul, Vo, Kelvin, Gorgen, Antonio R. H., Sharifi, Seyed Hossein H., Gao, Bruce M., Tano, Zachary E., Patel, Roshan M., Landman, Jaime, and Clayman, Ralph V.
- Subjects
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MALE models , *WOUNDS & injuries , *CHI-squared test , *LOGISTIC regression analysis , *UROLOGISTS - Abstract
Purpose: Ureteral access sheaths (UAS) pose the risk of severe ureteral injury. Our prior studies revealed forces ≤6 Newtons (N) prevent ureteral injury. Accordingly, we sought to define the force urologists and residents in training typically use when placing a UAS. Materials and Methods: Among urologists and urology residents attending two annual urological conferences in 2022, 121 individuals were recruited for the study. Participants inserted 12F, 14F, and 16F UAS into a male genitourinary model containing a concealed force sensor; they also provided demographic information. Analysis was completed using t-tests and Chi-square tests to identify group differences when passing a 16F sheath UAS. Participant traits associated with surpassing or remaining below a minimal force threshold were also explored through polychotomous logistic regression. Results: Participant force distributions were as follows: ≤4N (29%), >6N (45%), and >8N (32%). More years of practice were significantly associated with exerting >6N relative to forces between 4N and 6N; results for >8N relative to 4N and 8N were similar. Compared to high-volume ureteroscopists (those performing >20 ureteroscopies/month), physicians performing ≤20 ureteroscopies/month were significantly less likely to exert forces ≤4N (p = 0.017 and p = 0.041). Of those surpassing 6N and 8N, 15% and 18%, respectively, were high-volume ureteroscopists. Conclusions: Despite years of practice or volume of monthly ureteroscopic cases performed, most urologists failed to pass 16F access sheaths within the ideal range of 4N to 6N (74% of participants) or within a predefined safe range of 4N to 8N (61% of participants). [ABSTRACT FROM AUTHOR]
- Published
- 2024
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6. Eye Surface Properties After Using Dexamethasone Drops With and Without Preservatives in Patients After Cataract Surgery (EyeSurface)
- Author
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Wrocław University of Science and Technology
- Published
- 2023
7. Effect of a Bundle of Non-pharmacological Interventions on the Stress Response to Surgery (SPACU-lab)
- Published
- 2023
8. Immune Phenotype and Postoperative Complications After Elective Surgery.
- Author
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Moris, Dimitrios, Barfield, Richard, Chan, Cliburn, Chasse, Scott, Stempora, Linda, Jichun Xie, Plichta, Jennifer K., Thacker, Julie, Harpole, David H., Purves, Todd, Lagoo-Deenadayalan, Sandhya, Hwang, Eun-Sil Shelley, and Kirk, Allan D.
- Abstract
Objectives: To characterize and quantify accumulating immunologic alterations, pre and postoperatively in patients undergoing elective surgical procedures. Background: Elective surgery is an anticipatable, controlled human injury. Although the human response to injury is generally stereotyped, individual variability exists. This makes surgical outcomes less predictable, even after standardized procedures, and may provoke complications in patients unable to compensate for their injury. One potential source of variation is found in immune cell maturation, with phenotypic changes dependent on an individual's unique, lifelong response to environmental antigens. Methods: We enrolled 248 patients in a prospective trial facilitating comprehensive biospecimen and clinical data collection in patients scheduled to undergo elective surgery. Peripheral blood was collected preoperatively, and immediately on return to the postanesthesia care unit. Postoperative complications that occurred within 30 days after surgery were captured. Results: As this was an elective surgical cohort, outcomes were generally favorable. With a median follow-up of 6 months, the overall survival at 30 days was 100%. However, 20.5% of the cohort experienced a postoperative complication (infection, readmission, or system dysfunction). We identified substantial heterogeneity of immune senescence and terminal differentiation phenotypes in surgical patients. More importantly, phenotypes indicating increased T-cell maturation and senescence were associated with postoperative complications and were evident preoperatively. Conclusions: The baseline immune repertoire may define an immune signature of resilience to surgical injury and help predict risk for surgical complications. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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9. Feasibility of Neostigmine for Intraoperative Neuromonitoring in Thyroid Surgery
- Author
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SMG-SNU Boramae Medical Center and Jung-Man Lee, Associate professor
- Published
- 2022
10. Magnetic Spiderman for Preparation of Liver Donation (MSPLD)
- Published
- 2021
11. Mini-invasive Approaches to Aortic Surgery (MSvsMT)
- Author
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Prof Sandro Gelsomino, Prof Edvin Prifti, Prof Guido Sani, Dr Aleksander Dokollari, and Massimo Bonacchi, Professor
- Published
- 2021
12. Supradiaphragmatic intrathoracic migration of ventriculoperitoneal shunt with 'double bending sign'
- Author
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Shunta Tsuchida, MD, Joji Tokugawa, MD, PhD, Takamitsu Banno, MD, PhD, Takashi Mitsuhashi, MD, PhD, and Makoto Hishii, MD, PhD
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Cerebrospinal shunt ,Complication ,Hydrocephalus ,Reoperation ,Surgical injury ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Ventriculoperitoneal shunt (VPS) is a common treatment for hydrocephalus. An 80-year-old woman presented with subarachnoid hemorrhage caused by rupture of an aneurysm of the right middle cerebral artery. Emergency clipping was performed. Hydrocephalus occurred shortly after and VPS placement was performed. She improved and was transferred to a rehabilitation hospital. She presented with dyspnea 5 months later. Chest computed tomography (CT) showed extensive pleural effusion and intrathoracic migration of the distal VPS catheter. Chest CT confirmed that the distal catheter had penetrated into the pleural cavity under the second rib, and the catheter tip was located at the bottom of the right thoracic cavity. Review of chest CT right after the shunt surgery found the distal catheter passing only under the second and third ribs and otherwise located in the subcutaneous layer to the abdominal cavity. Chest radiography showed that the distal shunt tube was distorted in a characteristic “double bending sign.” This rare case of supradiaphragmatic intrathoracic migration of VPS indicates a possible mechanism of this migration, based on the anatomical physiology, and that “double bending sign” indicates the need for further investigation.
- Published
- 2022
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13. Postoperative systemic inflammatory dysregulation and corticosteroids: a narrative review.
- Author
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Bain, C. R., Myles, P. S., Corcoran, T., and Dieleman, J. M.
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CORTICOSTEROIDS , *CLINICAL trials , *DIETARY supplements , *NARRATIVES - Abstract
Summary: In some patients, the inflammatory‐immune response to surgical injury progresses to a harmful, dysregulated state. We posit that postoperative systemic inflammatory dysregulation forms part of a pathophysiological response to surgical injury that places patients at increased risk of complications and subsequently prolongs hospital stay. In this narrative review, we have outlined the evolution, measurement and prediction of postoperative systemic inflammatory dysregulation, distinguishing it from a healthy and self‐limiting host response. We reviewed the actions of glucocorticoids and the potential for heterogeneous responses to peri‐operative corticosteroid supplementation. We have then appraised the evidence highlighting the safety of corticosteroid supplementation, and the potential benefits of high/repeated doses to reduce the risks of major complications and death. Finally, we addressed how clinical trials in the future should target patients at higher risk of peri‐operative inflammatory complications, whereby corticosteroid regimes should be tailored to modify not only the a priori risk, but also further adjusted in response to markers of an evolving pathophysiological response. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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14. Surgical Planning With Patient-specific Pancreaticobiliary Disease With 3D Models
- Author
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Figen GOVSA, Prof. Dr, Senior investigator
- Published
- 2020
15. The Influence of Peripheral Nerve Blocks in Patients Undergoing Limb Orthopedic Surgery
- Author
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Kaohsiung Municipal Hsiaokang Hospital and I-Cheng Lu, Visiting staff
- Published
- 2020
16. Spinal Approach for Lumbar Active Discopathy
- Author
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JM Remacle, MD, Head of Neurosurgery Department, CHR Citadelle, Vincent Bonhomme, MD, PhD, University Department of Anesthesia and Intensive Care Medicine, CHR Citadelle, and Remacle Thibault, MD, Resident in Neurosurgery Department, PhD Student University Of Liege, Belgium
- Published
- 2020
17. Effect of Preoperative Music on Sterile Inflammation Induced by Laparoscopic Surgery
- Author
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PROF. BRIJ B AGARWAL, Vice Chairman Department of General and Laparoscopic Surgery
- Published
- 2019
18. Surgical injury: comparing open surgery and laparoscopy by markers of tissue damage
- Author
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Máca J, Peteja M, Reimer P, Jor O, Šeděnková V, Panáčková L, Ihnát P, Burda M, and Ševčík P
- Subjects
open surgery ,laparoscopy ,gastrointestinal surgery ,alarmins ,surgical injury ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Jan Máca,1 Matúš Peteja,2 Petr Reimer,1 Ondřej Jor,1 Věra Šeděnková,1 Lucie Panáčková,1 Peter Ihnát,2 Michal Burda,3 Pavel Ševčík1 1Department of Anesthesiology and Intensive Care Medicine, University Hospital Ostrava, Ostrava, Czech Republic; 2The Clinic of Surgery, University Hospital Ostrava, Ostrava, Czech Republic; 3Institute for Research and Applications of Fuzzy Modeling, Centre of Excellence IT4Innovations, University of Ostrava, Ostrava, Czech Republic Background: Major abdominal surgery (MAS) is high-risk intervention usually accompanied by tissue injury leading to a release of signaling danger molecules called alarmins. This study evaluates the surgical injury caused by two fundamental types of gastrointestinal surgical procedures (open surgery and laparoscopy) in relation to the inflammation elicited by alarmins. Patients and methods: Patients undergoing MAS were divided into a mixed laparoscopy group (LPS) and an open surgery group (LPT). Serum levels of alarmins (S100A8, S100A12, HMGB1, and HSP70) and biomarkers (leukocytes, C-reactive protein [CRP], and interleukin-6 [IL-6]) were analyzed between the groups. The secondary objectives were to compare LPT and LPS cancer subgroups and to find the relationship between procedure and outcome (intensive care unit length of stay [ICU-LOS] and hospital length of stay [H-LOS]). Results: A total of 82 patients were analyzed. No significant difference was found in alarmin levels between the mixed LPS and LPT groups. IL-6 was higher in the LPS group on day 2 (p=0.03) and day 3 (p=0.04). Significantly higher S100A8 protein levels on day 1 (p=0.02) and day 2 (p=0.01) and higher S100A12 protein levels on day 2 (p=0.03) were obtained in the LPS cancer subgroup. ICU-LOS and H-LOS were longer in the LPS cancer subgroup. Conclusion: The degree of surgical injury elicited by open MAS as reflected by alarmins is similar to that of laparoscopic procedures. Nevertheless, an early biomarker of inflammation (IL-6) was higher in the laparoscopy group, suggesting a greater inflammatory response. Moreover, the levels of S100A8 and S100A12 were higher with a longer ICU-LOS and H-LOS in the LPS cancer subgroup. Keywords: open surgery, laparoscopy, gastrointestinal surgery, alarmins, surgical injury, major surgery
- Published
- 2018
19. Anatomical study of the ventral neurovascular structures and hypoglossal canal for the surgery of the upper cervical spine.
- Author
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Hong, Jae Taek, Espinoza Orías, Alejandro A., and An, Howard S.
- Abstract
• The prevalence of the ICA located in front of the lateral mass was not uncommon. • The HN can be located more medial side in the cases with medially displaced ICA. • There could be neurovascular injury during posterior instrumentation and transoral surgery. • Height of occipital condyle is large enough to place posterior condyle screw if not directed too cranially. • This study can be useful for posterior CVJ instrumentation and ventral decompressive surgery. The aim of this study is to evaluate the anatomical relationship between the bony structures and ventral neurovascular structures around craniovertebral junction (CVJ). Eleven fresh-frozen cadaveric specimens were dissected around CVJ. The anatomical relationships were evaluated between C1 bony structures (midline, lateral margin of the C1 lateral mass (LM) and C1 transverse process (TP)) and ventral neurovascular structure such as ICA and HN. Morphometric evaluation of occipital condyle was also performed. The diameter of the HN and the ICA was 2.4 ± 0.5 mm and 5.1 ± 0.2 mm. The ICA was located lateral to the C1 LM in 44.4% (ICA Group 1) and in front of lateral half of the C1 LM in 55.6% (ICA Group 2). The HN was located lateral to the C1 LM in 85% (HN Group 1) and in front of lateral half of the C1 LM in 15% (HN Group 2). HN Group 2 was significantly more common in ICA Group 2 (p < 0.05, OR = 2.00, 95% CI: 1.07–3.71). There was significant correlation between ICA and HN in terms of the distance from the midline, C1 LM and TP (r = 0.67, 0.87 and 0.76 respectively, P < 0.01). In conclusion, the HN location is related with ICA location and the medially located ICA is a risk factor of the HN located ventral to the C1 LM. These results demonstrate the vulnerability of the neurovascular structures during CVJ surgery and suggest that preoperative 3D-CTA or enhanced CT scan can be useful in guiding surgical technique. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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20. Alarmins and Clinical Outcomes After Major Abdominal Surgery—A Prospective Study
- Author
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Jan Máca, Filip Burša, Pavel Ševčík, Peter Sklienka, Michal Burda, and Michal Holub
- Subjects
alarmins ,major abdominal surgery ,surgical injury ,outcome ,damage-associated molecular patterns ,gastrointestinal resection ,Surgery ,RD1-811 - Abstract
Purpose: Tissue injury causing immune response is an integral part of surgical procedure. Evaluation of the degree of surgical trauma could help to improve postoperative management and determine the clinical outcomes. Materials and Methods: We analyzed serum levels of alarmins, including S100A5, S100A6, S100A8, S100A9, S100A11, and S100A12; high-mobility group box 1; and heat-shock protein 70, after elective major abdominal surgery (n = 82). Blood samples were collected for three consecutive days after surgery. The goals were to evaluate the relationships among the serum levels of alarmins and selected surgical characteristics and to test potential of alarmins to predict the clinical outcomes. Results: Significant, positive correlations were found for high-mobility group box 1 with the length of surgery, blood loss, and intraoperative fluid intake for all three days of blood sampling. The protein S100A8 serum levels showed positive correlations with intensive care unit length of stay, 28-day and in-hospital mortality. The protein S100A12 serum levels had significant, positive correlations with intensive care unit length of stay, 28-day mortality, and in-hospital mortality. We did not find significant differences in alarmin levels between cancer and noncancer subjects. Conclusion: The high-mobility group box 1 serum levels reflect the degree of surgical injury, whereas proteins S100A8 and S100A12 might be considered good predictors of major abdominal surgery morbidity and mortality.
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- 2017
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21. Application of the Rotterdam postoperative cerebellar mutism syndrome prediction model in patients undergoing surgery for medulloblastoma in a single institution.
- Author
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Bush S, Klimo P, Onar-Thomas A, Huang J, Boop FA, Gajjar A, Robinson GW, and Khan RB
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- Child, Male, Female, Humans, Child, Preschool, Adolescent, Retrospective Studies, Postoperative Complications diagnostic imaging, Postoperative Complications etiology, Postoperative Complications epidemiology, Medulloblastoma diagnostic imaging, Medulloblastoma surgery, Medulloblastoma epidemiology, Mutism etiology, Mutism diagnosis, Mutism epidemiology, Cerebellar Diseases diagnosis, Cerebellar Diseases etiology, Cerebellar Neoplasms diagnostic imaging, Cerebellar Neoplasms surgery
- Abstract
Objective: Postoperative cerebellar mutism syndrome (CMS) develops in up to 40% of children with medulloblastoma. The Rotterdam model (RM) has been reported to predict a 66% risk of CMS in patients with a score of ≥ 100. The aim of this study was to retrospectively apply the RM to an independent cohort of patients with newly diagnosed medulloblastoma and study the applicability of the RM in predicting postoperative CMS., Methods: Participants had to have their first tumor resection at the authors' institution and be enrolled in the SJMB12 protocol (NCT01878617). All participants underwent structured serial neurological evaluations before and then periodically after completing radiation therapy. Imaging was reviewed by the study neurologist who was blinded to CMS status when reviewing the scans and retrospectively applied RM score to each participant., Results: Forty participants were included (14 females and 26 males). Four (10%) patients had CMS. The median age at tumor resection was 11.7 years (range 3.5-17.8 years). Tumor location was midline in 30 (75%), right lateral in 6 (15%), and left lateral in 4 (10%). The median Evans index was 0.3 (range 0.2-0.4), and 34 (85%) patients had an Evans index ≥ 0.3. Five participants required a ventricular shunt. The median tumor volume was 51.97 cm3 (range 20.13-180.58 cm3). Gross-total resection was achieved in 35 (87.5%) patients, near-total resection in 4 (10%), and subtotal in 1. The median RM score was 90 (range 25-145). Eighteen participants had an RM score of ≥ 100, and of these 16.7% (n = 3) had CMS. Of the 22 patients with an RM score < 100, 1 child developed CMS (4.5%, CI 0.1%-22.8%); 3 of the 18 patients with an RM score ≥ 100 developed CMS (16.7%, CI 3.6%-41.4%). The observed rate of CMS in the cohort of children with an RM score ≥ 100 was significantly lower than the observed rate in the original RM cohort (66.7%, CI 51%-80.0%, p < 0.001). A greater risk of CMS in patients with an RM score ≥ 100 could not be confirmed (p = 0.31)., Conclusions: At the authors' institution, the incidence of CMS in patients who had an RM ≥ 100 was significantly lower than the RM cohort. These findings raise questions regarding generalizability of RM; however, fewer cases of CMS and a relatively small cohort limit this conclusion.
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- 2023
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22. Short Term Comparison of Incontinence Rate of Open Vs Closed Internal Sphincterotomy.
- Author
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Ayub, Shamaila, Ali, Aun, Saeed, Summaya, Shaikh, Muhammad Rauf, and Memon, Amjad Siraj
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STATISTICAL sampling , *OPERATIVE surgery , *FECAL incontinence - Abstract
Objectives: To compare incidence of incontinence in patients with chronic anal fissure undergoing lateral sphincterotomy through open and closed method. Methodology: A total number of 154 patients with chronic anal fissure were included in the study after meeting the criteria. Patients were divided into Group A (closed lateral sphincerotomy with von-graefe knife) and Group B (open lateral sphincterotomy or Parks procedure) through simple random sampling. Post operatively incontinence was assessed at day 7, at one month follow up, 3 months and then 6 months follow up using the Wexner score. Results: Out of 154 patients enrolled in the study, only 138 patients were available for analysis and interpretation. Patients in group B had more incidence of incontinence on day 7 when compared to group A (P=0.052). At 1 month follow up this difference of incontinence reduced even further and later there was no significant difference noted at 3 months and 6 months follow up. Conclusion: There is no significant difference in rate of incontinence between open and closed lateral internal sphincterotomy. Surgeons should choose to perform the type of surgical procedure on the basis of one's expertise, and other pros and cons of individual techniques rather than continence safety only. [ABSTRACT FROM AUTHOR]
- Published
- 2019
23. Clinical and Epidemiological analysis of the structure of combat surgical injury during Antiterrorist operation / Joint Forces Operation
- Author
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S. V. Tertyshnyі, R. V. Yenin, S. O. Korol, S. V. Khalik, I. P. Khomenko, O. S. Нerasimenko, and V. Yu. Shapovalov
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,Armed conflict ,Abdominal cavity ,Pelvic cavity ,clinical and epidemiological research, combat surgical trauma, structure of casualties ,Surgical Injury ,Medical care ,medicine.anatomical_structure ,Epidemiology ,medicine ,Medicine ,Abdomen ,business ,Pelvis - Abstract
I Introduction. In generalizing the experience of providing medical care to the wounded in armed conflicts, a special place belongs to the analysis of the magnitude and structure of casualties, which depend on the conditions, forms and methods of hostilities. The purpose. Conduct a clinical and epidemiological analysis of the proportion of gunshot and mine injuries in the structure of combat surgical trauma during the Anti-terrorist operation / Joint Forces operation. Materials and methods. The total number of wounded as a result of the armed conflict in eastern Ukraine in the period from 2014 to 2019 was more than 41 thousand people, from them killed among the civilian population – 3350 people and 4100 – servicemen. Results. It was proved that the wounded with non-severe combat surgical trauma are 36.5%, severe – 48.9%, extremely severe – 14.6%. Shrapnel wounds were received by 35.3%, bullet wounds – 48.3%, mine injuries – 16.6%. Isolated combat surgical trauma was found in 16.8%, multiple – in 34.3%, combined – in 48.9% of the wounded. Impenetrable combat surgical trauma was diagnosed in 63.7% of the wounded, penetrating into the pleural cavity – in 17.2%, in the abdominal cavity – in 16.0%, in the pelvic cavity – in 3.1%. Conclusions. In the structure of sanitary losses of the surgical profile during the ATO / OOS, the wounded with injuries of the extremities are 56.7%, with injuries of the chest – 10.1%, abdomen – 5.1%, pelvis – 3.0%.
- Published
- 2021
24. Prospects for improving pre-hospital care for wounded with gunshot penetrating wounds to the chest
- Author
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T. Yu. Suprun, V.Yu. Markevich, N. A Zhirnova, S. E Komyagin, K. P. Golovko, Igor M Samokhvalov, and A. B. Vertiy
- Subjects
medicine.medical_specialty ,business.industry ,Penetrating wounds ,030208 emergency & critical care medicine ,030204 cardiovascular system & hematology ,medicine.disease ,Hemothorax ,Surgical Injury ,Hospital care ,Pleural drainage ,03 medical and health sciences ,0302 clinical medicine ,Pneumothorax ,Blood loss ,Medicine ,business ,Intensive care medicine ,Cause of death - Abstract
The analysis of injuries, life-threatening consequences and outcomes of treatment of wounded with penetrating chest wounds and the results of approbation of a prototype (medical) disposable set UD-02v for the elimination of strained and open pneumothorax, hemothorax, pleural drainage and collection of spilled blood with the possibility of subsequent reinfusion at the pre-hospital stage is presented. The prototype of the UD-02v set was created as part of the implementation of the state defense order in 2018. Its creation is due to the fact that despite the improvement of medical care at the stages of medical evacuation and the widespread use of individual armor protection, chest injuries currently remain a frequent type of combat surgical injury, accounting for 6 to 12% of all injuries. The main cause of death of injured and injured with chest injuries remains blood loss caused by continuing intrapleural bleeding and concomitant damage to other anatomical areas. Stressful pneumothorax, together with intrapleural bleeding, account for 93% of preventable causes of fatal chest injuries at the pre-hospital stage. Untimely elimination of the consequences of severe breast injuries should be considered as a negative factor affecting the outcome of treatment, and significant improvement in treatment results should be expected only in the case of early elimination of the most severe consequences of breast injuries. The developed set of UD-02v exceeds foreign medical devices in its medical and technical characteristics, and is the most promising for acceptance for the supply of the Armed forces of the Russian Federation as part of the samples of complete and service equipment.
- Published
- 2020
25. The case of the multistage treatment of acute pancreatitis using a variety of minimally invasive techniques
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Dmitriy P. Shershen, Sergey Y. Ivanusa, Anton Viktorovich Chebotar, and M V Lazutkin
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medicine.medical_specialty ,Rehabilitation ,business.industry ,medicine.medical_treatment ,medicine ,Acute pancreatitis ,Disease ,Surgical procedures ,Stage (cooking) ,Intensive care medicine ,medicine.disease ,Surgical Injury ,business - Abstract
Treatment of acute pancreatitis and infectious complications is a complex multidisciplinary task. The use of traditional surgical procedures for the rehabilitation of foci of pancreatogenic infection often aggravates the course of the disease, leads to the development of postoperative complications, does not improve the results of treatment. On the contrary, the use of minimally invasive techniques avoids additional surgical injury. The case of stage treatment of acute pancreatitis and its purulent-septic complications with the use of minimally invasive technologies is presented to the readers.
- Published
- 2020
26. Macrophage Response to Allogeneic Adipose Tissue-Derived Stromal Cells in Hyaluronan-Based Hydrogel in a Porcine Vocal Fold Injury Model.
- Author
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King, Suzanne N., Woo, Joo Hyun, Tang, Sharon, and Thibeault, Susan L.
- Subjects
- *
VOCAL cord injuries , *ANIMAL experimentation , *COLLAGEN , *FAT cells , *FLOW cytometry , *GENE expression , *HOMOGRAFTS , *IMMUNOHISTOCHEMISTRY , *INTERLEUKINS , *POLYMERASE chain reaction , *POSTOPERATIVE care , *SWINE , *TRANSFORMING growth factors-beta , *WOUND healing , *TREATMENT effectiveness , *SURGICAL site - Abstract
Objective: Adipose tissue-derived stromal cells (ASC) embedded in hyaluronan scaffold is a beneficial prophylactic treatment for vocal fold (VF) surgical scar. Here, we investigated the macrophage inflammatory response to allogeneic ASC-constructs and identified changes in lamina propria extracellular matrix. Method: Pig ASC were characterized and transfected with GFP+ lentivirus. Thirty-three pigs underwent VF biopsies, and after 3 days, gel alone, gel+pASC, placebo, or pASC alone was injected into wound bed. Animals were sacrificed 3, 7, or 26 days post-injection. Flow cytometry; qPCR for NF-α, TGFβ, IL-10, IL-4, IFNγ, IL-12, FGF2, Col1A1, and HGF; and immunohistochemistry for collagen, elastin, HA, and fibronectin were performed to characterize macrophage phenotype, quantify cytokine transcription, analyze extracellular matrix remodeling, and track GFP+ cells. Results: No significant differences were found in SWC3+/SWC9+ phenotype or mRNA expression between cells+gel, gel, or placebo. The ASC alone exhibited significantly greater collagen, gel alone resulted in significantly less hyaluronan, and gel+pASC significantly more fibronectin (all P < .05). The pASC-GFP+ were detected 26 days post-injection. Conclusions: The ASC-constructs were biocompatible; they did not influence the macrophage inflammatory response or provoke increases in collagen expression. Long-term engraftment was confirmed. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
27. Alarmins and Clinical Outcomes After Major Abdominal Surgery—A Prospective Study.
- Author
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Máca, Jan, Burša, Filip, Ševčík, Pavel, Sklienka, Peter, Burda, Michal, and Holub, Michal
- Subjects
- *
TISSUE wounds , *IMMUNE response , *TRAUMATOLOGY , *INTENSIVE care units , *MORTALITY - Abstract
Purpose: Tissue injury causing immune response is an integral part of surgical procedure. Evaluation of the degree of surgical trauma could help to improve postoperative management and determine the clinical outcomes.Materials and Methods: We analyzed serum levels of alarmins, including S100A5, S100A6, S100A8, S100A9, S100A11, and S100A12; high-mobility group box 1; and heat-shock protein 70, after elective major abdominal surgery (n= 82). Blood samples were collected for three consecutive days after surgery. The goals were to evaluate the relationships among the serum levels of alarmins and selected surgical characteristics and to test potential of alarmins to predict the clinical outcomes.Results: Significant, positive correlations were found for high-mobility group box 1 with the length of surgery, blood loss, and intraoperative fluid intake for all three days of blood sampling. The protein S100A8 serum levels showed positive correlations with intensive care unit length of stay, 28-day and in-hospital mortality. The protein S100A12 serum levels had significant, positive correlations with intensive care unit length of stay, 28-day mortality, and in-hospital mortality. We did not find significant differences in alarmin levels between cancer and noncancer subjects.Conclusion: The high-mobility group box 1 serum levels reflect the degree of surgical injury, whereas proteins S100A8 and S100A12 might be considered good predictors of major abdominal surgery morbidity and mortality. [ABSTRACT FROM PUBLISHER]
- Published
- 2017
- Full Text
- View/download PDF
28. Does Early Ureteroneocystostomy After Iatrogenic Ureteral Injury Jeopardize Outcome?
- Author
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Bahaa S. Malaeb, John T. Stoffel, Paholo Barboglio-Romo, Sapan N. Ambani, and Peyton Skupin
- Subjects
Adult ,Male ,medicine.medical_specialty ,Reconstructive surgery ,Urology ,Iatrogenic Disease ,030232 urology & nephrology ,Ureteral reconstruction ,03 medical and health sciences ,0302 clinical medicine ,Early Medical Intervention ,Ureteral injury ,medicine ,Humans ,Intraoperative Complications ,Ureterostomy ,Retrospective Studies ,business.industry ,Significant difference ,Retrospective cohort study ,Middle Aged ,Surgical Injury ,Surgery ,Cystostomy ,Delayed repair ,Treatment Outcome ,030220 oncology & carcinogenesis ,Cohort ,Female ,Ureter ,business - Abstract
Objective To compare the outcomes of patients who underwent early repair (≤7 days) of iatrogenic ureteral injury with ureteroneocystostomy and compare them to those repaired in a delayed fashion (>7 days). Methods A retrospective review of billing data between 2012 and 2018 identified patients who underwent ureteroneocystostomy for a benign ureteral disease. Inclusion criteria included all ureteral injuries related to a laparoscopic, robotic, or open surgical injury. Patients with ureteral injury related to radiation, stones, or reconstructive surgery were excluded. Patients undergoing reconstruction during the initial injury or within ≤7 days were designated as having undergone early repair, while the remaining were considered delayed repair. Demographics, as well as inpatient and postdischarge data were acquired, and statistical analysis was performed comparing the 2 groups. Results Sixty-seven patients met inclusion criteria. Early repair was performed on 12 patients, while 55 underwent delayed repair. No significant difference in age, gender, Charlson Comorbidity Score, laterality, stricture location, or history of pelvic/abdominal radiation was noted. Inpatient complications were significantly higher in the immediate group (58 vs 18%, P =.004). Thirty- and 90-day complications were similar. Two patients in the delayed group and none in the immediate group demonstrated stricture recurrence (P =.710). A higher rate of Boari flap ureteral reconstruction was performed in the delayed cohort (P =.001). Conclusion In this cohort, there was no detectable difference in outcomes when comparing early and delayed ureteroneocystostomy for iatrogenic ureteral injuries.
- Published
- 2020
29. Preoperative cone beam computed tomography evaluation of mandibular second and third molars in relation to the inferior alveolar canal
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Rawan N Alsaedi, Ebtihal H Zain-Alabdeen, Rahaf A Alhazmi, Omar A Alahmady, and Abdulrahman A Aloufi
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Microbiology (medical) ,Molar ,Orthodontics ,Cone beam computed tomography ,business.industry ,Immunology ,lcsh:R ,lcsh:Medicine ,inferior alveolar canal ,Inferior alveolar nerve ,cone beam computed tomography ,Surgical Injury ,Clinical knowledge ,Mandibular second molar ,stomatognathic system ,second molar ,Immunology and Allergy ,Medicine ,third molar ,business ,Inferior alveolar canal - Abstract
Objective: The aim is to evaluate the location and proximity of second and third molars roots to the inferior alveolar canal (IAC) and demographic factors associated with these proximities. Materials and Methods: Cone beam computed tomography scans were evaluated for 292 roots of 146 teeth from 40 patients. A radiologist read, measured, and evaluated the vertical and horizontal positions of the roots of the second and third molars in relation to the IAC. Results: No significant differences were found between the third molar roots and neighboring second molar roots in the closeness to the IAC. The most common horizontal relation was “roots above IAC” (54%) followed by “roots lingual to IAC” (41.78%), “roots buccal to IAC” (3.42%), and “IAC between the roots” (0.68%). No significant differences in second and third molar roots and their contrasting teeth in the proximity to IAC. The older age group had significantly higher vertical measurements between third molar roots and IAC. There were significantly larger vertical measurements in the right third molar roots to IAC in males than females. Conclusions: These anatomical relationships are important clinical knowledge to avoid potential surgical injury to the inferior alveolar nerve.
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- 2020
30. Accelerated Canine Retraction by Corticotomy Assisted or Periodontal Distraction
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Neveen F. Abo-Taha, Atia Abd Elwareth Abd Elrazik Yousif, and Emad F. Essa
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Orthodontics ,business.industry ,medicine.medical_treatment ,digestive, oral, and skin physiology ,030206 dentistry ,Surgical Injury ,humanities ,Canine retraction ,Bone remodeling ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Distraction ,Premolar ,Medicine ,business ,030217 neurology & neurosurgery ,Dental alveolus ,Reduction (orthopedic surgery) ,Corticotomy - Abstract
Objectives: Canine retraction was accelerated by periodontal distraction or several surgical techniques depending on the concept that the greater surgical injury to alveolar bone, the greater biological response in the form of localized inflammatory reaction and bone remodeling, hence tooth movement acceleration. The present study aimed to compare between certain surgical techniques and periodontal distraction combined with interseptal bone reduction to accelerate canine distalization.Patients and Methods: A randomized split mouth clinical multi-operator study was performed on 30 orthodontic patients aged 15 years and above whose treatment procedures were planned for first premolar extractions and subsequent retraction of canines. Canines were distalized by surgery or distraction on one side and by conventional mechanics on the other side (the control side). Subjects were randomized equally into three canine retraction groups: Group I (multiple-osteoperforation MOPs); Group II (MOPs+corticotomy) and Group III (periodontal distraction). Canine retraction was carried out by power chain applying 150 g of force per side. Total time for complete canine retraction was determined and change in canine angulation was assessed using panoramic radiographs.Results: Regarding the time needed for complete canine retraction for all groups, the experimental side(surgical or distraction) showed a statistically significant lower mean value as compared with the non-surgical side. In other words, less than three months in Group I, about two months in Group II and less than one month in Group III, while more than four months in the conventional retraction side was taken for complete canine retraction. the mean canine angulation changes by degree was (11-15.2-23.2-8.1) degree for group I, II III and conventional group respectively.Conclusion: Canine retraction movement was accelerated effectively by MOPs, corticotomy and periodontal distraction techniques; the fastest of them was the periodontal distraction mechanics. However, it showed more distal tipping and more buccal inclination of the canine than MOPs, corticotomy or conventional canine retraction.
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- 2019
31. [Comparative analysis of the effectiveness of SF-MPQ-2 and VAS for assessing the severity of pain syndrome in dental patients in the postoperative period].
- Author
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Brailovskaya TV, Kibitov AO, Gadzhikulieva AK, Chuprova NA, Nikolishin AE, and Sherstobitov VA
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- Humans, Pain Measurement, Visual Analog Scale, Postoperative Period, Pain
- Abstract
Objective: Conducting a comparative analysis of the effectiveness of the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2) and the Visual Analogue Scale (VAS) for assessing the severity of pain syndrome in dental patients in the postoperative period in dynamics., Material and Methods: The study included 51 patients who received dental surgical treatment. Two groups of patients were formed, depending on the type of surgery and the degree of trauma of the operation. Group 1 - low degree of injury - 28 patients; group 2 - high degree of injury - 23 patients. Patients independently filled out questionnaires at four stages of the study: before surgery, on the 1st, 3rd, and 5th days after surgery as part of scheduled visits., Results and Discussion: In patients of group 2, the severity of pain symptoms was higher than in patients of group 1 in terms of pain symptoms on SF-MPQ-2 at all stages of the study, except the day before surgery. At the same time, there were no differences with the indicators of the VAS scale at any of the stages of the study. The most informative indicators of SF-MPQ-2 are the total indicator MPQ-Sum and the constant pain indicator MPQ-Const, which were significantly higher in group 2 on the 1st day after surgery, taking into account the correction for gender and age. The highest level of coincidence of indicators on VAS and the total score on MPQ-Sum was revealed on the 5th day of the operation, regardless of the degree of trauma of the operation., Conclusion: The use of SF-MPQ-2 with a detailed description of pain sensations is the most acceptable way to assess the degree of pain syndrome in operative surgery, especially during the period when the severity of pain symptoms is maximum (in the first days of the postoperative period).
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- 2023
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- View/download PDF
32. A New Surgical Model of Skeletal Muscle Injuries in Rats Reproduces Human Sports Lesions.
- Author
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Contreras-Muñoz, P., Fernández-Martín, A., Torrella, R., Serres, X., De la Varga, M., Viscor, G., Järvinen, T. A. H., Martínez-Ibáñez, V., Peiró, J. L., Rodas, G., and Marotta, M.
- Subjects
- *
TRAUMA surgery , *SKELETAL muscle , *ATHLETES , *BIOLOGICAL models , *FLUORESCENT antibody technique , *HISTOLOGY , *MAGNETIC resonance imaging , *NEEDLE biopsy , *RATS , *REGENERATION (Biology) , *TENDONS , *SURGERY - Abstract
Skeletal muscle injuries are the most common sports-related injuries in sports medicine. In this work, we have generated a new surgicallyinduced skeletal muscle injury in rats, by using a biopsy needle, which could be easily reproduced and highly mimics skeletal muscle lesions detected in human athletes. By means of histology, immunofluorescence and MRI imaging, we corroborated that our model reproduced the necrosis, inflammation and regeneration processes observed in dystrophic mdx-mice, a model of spontaneous muscle injury, and realistically mimicked the muscle lesions observed in professional athletes. Surgically-injured rat skeletal muscles demonstrated the longitudinal process of muscle regeneration and fibrogenesis as stated by Myosin Heavy Chain developmental (MHCd) and collagen-I protein expression. MRI imaging analysis demonstrated that our muscle injury model reproduces the grade I-II type lesions detected in professional soccer players, including edema around the central tendon and the typically high signal feather shape along muscle fibers. A significant reduction of 30 % in maximum tetanus force was also registered after 2 weeks of muscle injury. This new model represents an excellent approach to the study of the mechanisms of muscle injury and repair, and could open new avenues for developing innovative therapeutic approaches to skeletal muscle regeneration in sports medicine. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
33. The Effect of Posterior Lumbar Spinal Surgery on Biomechanical Properties of Rat Paraspinal Muscles 13 Weeks After Surgery
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Shun Yamamoto, Thomas R. Oxland, Stephen H.M. Brown, Fabio M.V. Rossi, Mitsuru Saito, Masoud Malakoutian, Marine Theret, and John Street
- Subjects
Lumbar Vertebrae ,medicine.diagnostic_test ,business.industry ,Lumbosacral Region ,Paraspinal Muscles ,Histology ,Thoracolumbar fascia ,Anatomy ,Surgical Injury ,Spinal surgery ,Spine ,Rats ,Rats, Sprague-Dawley ,medicine.anatomical_structure ,Lumbar ,Longissimus ,Elastic Modulus ,Biopsy ,medicine ,Animals ,Orthopedics and Sports Medicine ,Neurology (clinical) ,business ,Paraspinal Muscle - Abstract
STUDY DESIGN Preclinical study in rodents. OBJECTIVE To investigate changes in biomechanical properties of paraspinal muscles following a posterior spinal surgery in an animal model. SUMMARY OF BACKGROUND DATA Posterior spine surgery damages paraspinal musculature per histological and imaging studies. The biomechanical effects of these changes are unknown. METHODS 12 Sprague-Dawley rats were divided equally into sham and surgical injury (SI) groups. For sham, the skin and lumbodorsal fascia were incised at midline. For SI, the paraspinal muscles were detached from the vertebrae, per normal procedure. Thirteen weeks postsurgery, multifidus and longissimus biopsies at L1, L3, and L5 levels were harvested on the right. From each biopsy, three fibers and three to six bundles of fibers (∼10-20 fibers ensheathed in their extracellular matrix) were tested mechanically to measure their passive elastic modulus. The collagen content and fatty infiltration of each biopsy were also examined histologically by immunofluorescence staining. Nonparametric statistical methods were used with a 1.25% level of significance. RESULTS A total of 220 fibers and 279 bundles of fibers were tested. The elastic moduli of the multifidus and longissimus fibers and longissimus fiber bundles were not significantly different between the SI and sham groups. However, the elastic modulus of multifidus fiber bundles was significantly greater in the SI group compared to sham (SI median 82 kPa, range 23-284; sham median 38 kPa, range 23-50, P = 0.0004). The elastic modulus of multifidus fiber bundles in the SI group was not statistically different between spinal levels (P = 0.023). For histology, only collagen I deposition in multifidus was significantly greater in the SI group (median 20.8% vs. 5.8% for sham, P
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- 2021
34. Large Animal Models for Investigating Cell Therapies of Stress Urinary Incontinence
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Arnulf Stenzl, Jasmin Knoll, Niklas Harland, Bastian Amend, and Wilhelm K. Aicher
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Swine ,QH301-705.5 ,Urinary Incontinence, Stress ,Cell- and Tissue-Based Therapy ,030232 urology & nephrology ,Urinary incontinence ,Review ,Bioinformatics ,Catalysis ,Inorganic Chemistry ,03 medical and health sciences ,Dogs ,0302 clinical medicine ,Urethra ,Quality of life ,medicine ,Animals ,Humans ,animal ,Physical and Theoretical Chemistry ,Biology (General) ,Molecular Biology ,QD1-999 ,Spectroscopy ,urinary incontinence ,disease models ,business.industry ,Organic Chemistry ,General Medicine ,Severe obesity ,Surgical Injury ,Human situation ,3. Good health ,Computer Science Applications ,Disease Models, Animal ,Chemistry ,030220 oncology & carcinogenesis ,Rabbits ,Animal studies ,medicine.symptom ,cell therapy ,business ,Transgenic Rats ,Large animal - Abstract
Stress urinary incontinence (SUI) is a significant health concern for patients affected, impacting their quality of life severely. To investigate mechanisms contributing to SUI different animal models were developed. Incontinence was induced under defined conditions to explore the pathomechanisms involved, spontaneous recovery, or efficacy of therapies over time. The animal models were coined to mimic known SUI risk factors such as childbirth or surgical injury. However, animal models neither reflect the human situation completely nor the multiple mechanisms that ultimately contribute to the pathogenesis of SUI. In the past, most SUI animal studies took advantage of rodents or rabbits. Recent models present for instance transgenic rats developing severe obesity, to investigate metabolic interrelations between the disorder and incontinence. Using recombinant gene technologies, such as transgenic, gene knock-out or CRISPR-Cas animals may narrow the gap between the model and the clinical situation of patients. However, to investigate surgical regimens or cell therapies to improve or even cure SUI, large animal models such as pig, goat, dog and others provide several advantages. Among them, standard surgical instruments can be employed for minimally invasive transurethral diagnoses and therapies. We, therefore, focus in this review on large animal models of SUI.
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- 2021
35. Risk for and temporal trends in cesarean surgical complications
- Author
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Timothy Wen, Mary E. D'Alton, Cynthia Gyamfi-Bannerman, Adina R. Kern-Goldberger, Jason D. Wright, Alexander M. Friedman, Jean Guglielminotti, and Lillian Liao
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,Maternal morbidity ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Pregnancy ,Risk Factors ,medicine ,Humans ,030212 general & internal medicine ,Obesity ,Intensive care medicine ,Intraoperative Complications ,030219 obstetrics & reproductive medicine ,business.industry ,Cesarean Section ,Racial Groups ,Obstetrics and Gynecology ,Middle Aged ,Surgical Injury ,medicine.disease ,Comorbidity ,Cross-Sectional Studies ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
It is possible that in the setting of increasing patient comorbidity and obesity, risk for surgical injury and need for reoperation is increasing. It is also possible that with differential uptake of evidence-based recommendations and increasing prevalence of risk factors such as obesity, risk for surgical site complications is increasing. The objective of this study was to evaluate trends in, risk factors for, and racial disparities related to cesarean complications. This repeated cross-sectional study evaluated cesarean deliveries in the 2002–2014 National Inpatient Sample for women age 15–54. The primary outcome was a cesarean surgical complication composite including (i) surgical injuries, (ii) reoperation, and (iii) surgical site complications. Surgical injuries, reoperation, and surgical site complications were additionally evaluated individually as outcomes. Univariable and multivariable log linear regression models including demographic, clinical, and hospital factors were performed to assess risk for outcomes with unadjusted and adjusted risk ratios (aRR) with 95% confidence intervals (CI) as measures of association. Temporal trends were estimated using average annual percentage change from a joinpoint regression model. A stratified analysis was performed restricted to non-Hispanic black women. Data was weighted to provide national estimates. A total of 16.2 million estimated cesarean deliveries (3.2 million unweighted cesarean deliveries) from 2002 to 2014 were included in this analysis. The prevalence of the cesarean surgical complication composite was 1.14%, surgical site complications occurred in 0.60%, surgical injuries in 0.49%, and reoperations in 0.10%. Comparing the end of the study (2012–2014) to the beginning of the study (2002–2003), adjusted risk for the composite was similar (aRR 0.93, 95% CI 0.92, 0.95). In comparison, surgical site complication risk was lower at the end of the study (aRR 0.77, 95% CI 0.75, 0.79) while risks for surgical injury (aRR 1.18, 95% CI 1.15, 1.22) and reoperation (1.18, 95% CI 1.10, 1.26) were higher. Non-Hispanic black women were at increased risk for surgical site complications (aRR 1.83, 95% CI 1.80, 1.87) and reoperation (aRR 1.44, 95% CI 1.37, 1.51), but not surgical injury (aRR 0.99, 95% CI 0.97, 1.02). In analyses stratified for non-Hispanic black women, there was a reduction in risk for surgical site complications at the end of the study period compared to the beginning similar to the primary analysis (aRR 0.76, 95% 0.72, 0.81) with a modest decrease in overall risk for the composite outcome (aRR 0.85, 95% CI 0.81, 0.89). A decrease in risk for surgical site complications was offset by slightly increased risk for surgical injury and reoperation in adjusted analyses. Among non-Hispanic black women, surgical site complication risk decreased proportionately with this group still at significantly higher overall risk.
- Published
- 2021
36. Multi-laminate annulus fibrosus repair scaffold with an interlamellar matrix enhances impact resistance, prevents herniation and assists in restoring spinal kinematics
- Author
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Ricardo Vela, Jeremy Mercuri, Ryan Borem, Sanjitpal Gill, and Allison Madeline
- Subjects
musculoskeletal diseases ,Scaffold ,Materials science ,Spinal kinematics ,Biomedical Engineering ,Mechanical integrity ,Biocompatible Materials ,02 engineering and technology ,Matrix (biology) ,Article ,Biomaterials ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Animals ,Mechanical Phenomena ,Annulus (mycology) ,Tissue Scaffolds ,Annulus (oil well) ,Annulus Fibrosus ,Biomaterial ,Intervertebral disc ,030206 dentistry ,Surgical Injury ,musculoskeletal system ,021001 nanoscience & nanotechnology ,Biomechanical Phenomena ,Impact resistance ,medicine.anatomical_structure ,Mechanics of Materials ,Impact loading ,Cattle ,0210 nano-technology ,Intervertebral Disc Displacement ,Biomedical engineering - Abstract
Focal defects in the annulus fibrosus (AF) of the intervertebral disc (IVD) arising from herniation have detrimental impacts on the IVD's mechanical function. Thus, biomimetic-based repair strategies must restore the mechanical integrity of the AF to help support and restore native spinal loading and motion. Accordingly, an annulus fibrosus repair patch (AFRP); a collagen-based multi-laminate scaffold with an angle-ply architecture has been previously developed, which demonstrates similar mechanical properties to native outer AF (oAF). To further enhance the mimetic nature of the AFRP, interlamellar (ILM) glycosaminoglycan (GAG) was incorporated into the scaffolds. The ability of the scaffolds to withstand simulated impact loading and resist herniation of native IVD tissue while contributing to the restoration of spinal kinematics were assessed separately. The results demonstrate that incorporation of a GAG-based ILM significantly increased (p 0.001) the impact strength of the AFRP (2.57 ± 0.04 MPa) compared to scaffolds without (1.51 ± 0.13 MPa). Additionally, repair of injured functional spinal units (FSUs) with an AFRP in combination with sequestering native NP tissue and a full-thickness AF tissue plug enabled the restoration of creep displacement (p = 0.134), short-term viscous damping coefficient (p = 0.538), the long-term viscous (p = 0.058) and elastic (p = 0.751) damping coefficients, axial neutral zone (p = 0.908), and axial range of motion (p = 0.476) to an intact state. Lastly, the AFRP scaffolds were able to prevent native IVD tissue herniation upon application of supraphysiologic loads (5.28 ± 1.24 MPa). Together, these results suggest that the AFRP has the strength to sequester native NP and AF tissue and/or implants, and thus, can be used in a composite repair strategy for IVDs with focal annular defects thereby assisting in the restoration of spinal kinematics.
- Published
- 2019
37. The Effects of Round Window Membrane Injury and the Use of a Model Electrode Application on Hearing in Rats
- Author
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Abdullah Dalgic, Mehmet Ziya Özüer, and Murat Koc
- Subjects
Male ,medicine.medical_specialty ,Hearing loss ,medicine.medical_treatment ,Anti-Inflammatory Agents ,Audiology ,Dexamethasone ,Electrode insertion ,03 medical and health sciences ,0302 clinical medicine ,Cochlear implant ,otorhinolaryngologic diseases ,medicine ,Animals ,Vicryl ,Rats, Wistar ,030223 otorhinolaryngology ,Hearing Loss ,Cochlea ,Round window ,Injection, Intratympanic ,business.industry ,Surgical Injury ,Scala Tympani ,Cochlear Implantation ,Electrodes, Implanted ,Rats ,medicine.anatomical_structure ,Otorhinolaryngology ,Round Window, Ear ,030220 oncology & carcinogenesis ,Anesthesia ,medicine.symptom ,business ,medicine.drug - Abstract
Objective: To investigate the effects of the mechanical trauma to the round window, a model electrode inserted into the scala tympani on the cochlear reserve, and the efficacy of topical steroids in preventing hearing loss. Materials and Methods: 21 male Wistar Albino rats were equally categorized into three groups. In all groups an initial mechanical injury to round window was created. Only subsequent dexamethasone injection was administrated into the cochlea in the subjects of group 2 while a multichannel cochlear implant guide inserted into the cochlea prior to dexamethasone administration for group 3. Distortion product otoacoustic emissions (DPOAEs) were obtained prior to and immediately after the surgical injury, eventually on postoperative seventh day (d 7). Mean signal/noise ratios (S/Ns) obtained at 2000, 3000, and 4000 Hz were calculated. Data sets were compared with non-parametric statistical tests. Results: The early intraoperative mean S/Ns were significantly less than preoperative measurements for group 1 and 2; however, preoperative and postoperative d 7 average S/Ns did not differ. There was statistically significant difference between preoperative, intraoperative and postoperative d 7 average S/Ns for group 3. Conclusion: We observed that hearing was restored approximately to the preoperative levels following early postoperative repair. However, an electrode insertion into the cochlea via round window subsequent to mechanical trauma seems to cause a progressive hearing loss. Therefore, a special care must be taken to avoid the injury to the round window membrane in the course of the placement of a cochlear implant electrode and surgery for the chronic otitis media.
- Published
- 2021
38. Opioid-Sparring and Multimodal Analgesia as Parts of Enhanced Recovery After Surgery (ERAS) Applied In The Ksatria Airlangga Floating Hospital
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Christrijogo Sumartono Waloejo, Arie Utariani, Pratama Ananda, and Bambang Pujo Semedi
- Subjects
Protocol (science) ,Enhanced Recovery After Surgery (ERAS) ,business.industry ,Perioperative ,Surgical Injury ,medicine.disease ,Fight-or-flight response ,Surgical recovery ,Health facility ,Perioperative protocol ,Medicine ,Medical emergency ,Ksatria Airlangga Floating Hospital ,business ,Hospital service ,Enhanced recovery after surgery - Abstract
Introduction: Enhanced Recovery After Surgery (ERAS) protocol is a perioperative multimodal service program designed to achieve a faster surgical recovery period and a better outcome, the key in reducing morbidity in surgery is by reducing the “surgical injury” and reducing the body’s stress response caused by the surgery. The success of the ERAS protocol depends on the interpretation and collaboration of the multidisciplinary team, therefore though the protocol is carried out in a hospital that has sufficient facilities and resources, the obstacle in the implementation of ERAS can still happen. The implementation of ERAS protocol in the non-permanent hospital service facility becomes a challenge in itself. Case Reports: From the two case reports of the implementation of ERAS protocol in the Ksatria Airlangga Floating Hospital (RST-KA) it is obtained that the key success of the anesthesia in ERAS protocol above lies on the administration of opioid-sparring therapy where it will reduce the use of opioid. Although there are many obstacles obtained in the RST-KA, the use of ERAS protocol can be conducted by making effective use of opioid-sparring combined with the administration of multimodal analgesia. Conclusion: Therefore, it can be concluded that the ERAS protocol can be applied in the social service concept in the non-permanent health facility.
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- 2021
39. Hyperactivation of dormant primordial follicles in ovarian endometrioma patients
- Author
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Michael W. Pankhurst, Sachiko Matsuzaki, Institut Pascal (IP), and Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
0301 basic medicine ,endocrine system ,Embryology ,endocrine system diseases ,medicine.medical_treatment ,Endometriosis ,Physiology ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Ovarian Follicle ,Humans ,Medicine ,Ovarian Reserve ,Ovarian reserve ,ComputingMilieux_MISCELLANEOUS ,Ovarian Endometrioma ,030219 obstetrics & reproductive medicine ,In vitro fertilisation ,Hyperactivation ,business.industry ,Ovary ,Obstetrics and Gynecology ,[SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology ,Cell Biology ,Surgical Injury ,medicine.disease ,female genital diseases and pregnancy complications ,3. Good health ,030104 developmental biology ,Reproductive Medicine ,Female ,Folliculogenesis ,business ,Infertility, Female ,Hormone - Abstract
Serum anti-Müllerian hormone (AMH) levels decrease after surgical treatment of ovarian endometrioma. This is the main reason that surgery for ovarian endometrioma endometriosis is not recommended before in vitro fertilization, unless the patient has severe pain or suspected malignant cysts. Furthermore, it has been suggested that ovarian endometrioma itself damages ovarian reserve. This raises two important challenges: (1) determining how to prevent surgical damage to the ovarian reserve in women with ovarian endometrioma and severe pain requiring surgical treatment and (2) deciding the best treatment for women with ovarian endometrioma without pain, who do not wish to conceive immediately. The mechanisms underlying the decline in ovarian reserve are potentially induced by both ovarian endometrioma and surgical injury but the relative contribution of each process has not been determined. Data obtained from various animal models and human studies suggest that hyperactivation of dormant primordial follicles caused by the local microenvironment of ovarian endometrioma (mechanical and/or chemical cues) is the main factor responsible for the decreased primordial follicle numbers in women with ovarian endometrioma. However, surgical injury also induces hyperactivation of dormant primordial follicles, which may further reduce ovarian reserve after removal of the endometriosis. Although further studies are required to elucidate the mechanisms underlying diminished ovarian reserve in women with ovarian endometrioma, the available data strongly suggests the need to prevent/minimize hyperactivation of dormant primordial follicles, regardless of whether surgery is performed, for better clinical management of ovarian endometrioma.
- Published
- 2020
40. Labour Management in Trial of Labour After Cesarean Delivery (TOLAC): A Gap Analysis and Quality Improvement Initiative
- Author
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Emily Delpero, Jacqueline Thomas, and Evan Tannenbaum
- Subjects
medicine.medical_specialty ,Quality management ,Vaginal birth ,Chorioamnionitis ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Pregnancy ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Cesarean delivery ,Prospective cohort study ,reproductive and urinary physiology ,030219 obstetrics & reproductive medicine ,Labor, Obstetric ,business.industry ,Obstetrics ,Cesarean Section ,Trial of labour ,Obstetrics and Gynecology ,Surgical Injury ,medicine.disease ,Quality Improvement ,Vaginal Birth after Cesarean ,Trial of Labor ,Female ,business - Abstract
Objective This quality improvement (QI) initiative was designed to identify gaps between evidence-based or hospital recommendations for trial of labour after cesarean delivery (TOLAC) labour management and clinical practice. Methods Viable, singleton pregnancies from January 1, 2016, to December 31, 2018, undergoing TOLAC were extracted from the electronic medical record. Sixty randomly selected charts were reviewed for (1) consent, (2) induction methods, (3) oxytocin use, (4) continuous fetal monitoring, (5) admission indication, (6) examination regularity, (7) duration of dystocia before decision to perform cesarean delivery (CD), and (8) maternal complications. Results The institutional vaginal birth after cesarean rate was 71%. Documented consent to TOLAC on admission was present in 50% of cases. Oxytocin augmentation was used in 38% of cases, and the median maximum dose was 4 mU/min (interquartile range [IQR] 3–7.5 mU/min). Delays in initiating oxytocin were identified in 47% of those patients. Decisions to deliver by cesarean were made after a median time of 5 hours and 40 minutes (IQR 3 hours and 30 minutes to 6 hours and 35 minutes) of failure to progress despite adequate contractions. After this decision, median time to delivery was 1 hour and 11 minutes (IQR 57 minutes to 2 hours and 16 minutes). Complications included postpartum hemorrhage (5%) and chorioamnionitis (6.7%). Surgical injury occurred in 10% of intrapartum CD. Peripartum complications were associated with delay in oxytocin implementation (χ2 (1) = 9.80; P Conclusion Areas for QI were identified in (1) consent, (2) duration of dystocia before decision to proceed with CD and delay to CD, and (3) peripartum complications. We recognize the potential use of this as a tool to identify areas for QI and prospective study.
- Published
- 2020
41. Understanding the Impact of Muscle and Bony Injury in the Lumbar Spine - How Multifidus Muscle and Facet Joint Damage Impact Muscle Architecture and Joint Degeneration in the Rat
- Author
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Olena Klahsen and Brown, Stephen
- Subjects
musculoskeletal diseases ,Multifidus muscle ,Rodent Model ,Collagen Content ,Osteoarthritis ,Muscle histology ,Cartilage histology ,Facet Joint ,Fibrosis ,Spine ,Zygapophyseal Joint ,Surgical Injury - Abstract
Rodent models that experience a mechanical injury to the facet joint have had contradicting results regarding the degree of osteoarthritis that the injured joint experiences. This thesis sought to answer if this disagreement was caused by surgical injury to the paraspinal multifidus muscle. It was expected that muscle and joint injury would drive changes in the muscle architecture, collagen content, facet joint transverse plane angle and characteristics of osteoarthritis. No consistent changes in any muscle measures were seen outside of the injured multifidus muscle, which had a decrease in mass and fascicle length while the collagen content increased. No changes in the facet joint angles or osteoarthritis statuses were seen. It is suspected that the degree of fibrosis for the injured muscle may have inhibited osteoarthritis processes. Future work should explore the role of paraspinal muscles in facet joint osteoarthritis using nonsurgical models. Ontario Government via the Ontario Graduate Scholarship, The National Science and Engineering Research Committee 2021-12-14
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- 2020
42. Case of bilateral Mooren's ulcers following filtering surgery using EX-PRESS glaucoma filtering devices
- Author
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Noriko Toyokawa, Shinichiro Kuroda, Hideya Kimura, and Kaoru Araki-Sasaki
- Subjects
medicine.medical_specialty ,Open angle glaucoma ,genetic structures ,Glaucoma implant surgery ,medicine.medical_treatment ,Glaucoma ,Case Report ,Autoimmune reaction ,03 medical and health sciences ,0302 clinical medicine ,Filtering surgery ,lcsh:Ophthalmology ,Metallic materials ,medicine ,EX-PRESS glaucoma filtering device ,business.industry ,Surgical injury ,Cataract surgery ,Mooren's ulcer ,corneal ulcer ,medicine.disease ,Trabeculotomy ,eye diseases ,Surgery ,Ophthalmology ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,Betamethasone ,sense organs ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Purpose: To report our findings in a case of bilateral Mooren's ulcer that developed after filtering surgeries using the EX-PRESS glaucoma filtering device (EX-PRESS surgery). Patients and methods: A 71-year-old Japanese man with primary open angle glaucoma underwent EX-PRESS surgery first in his left eye and 1 month later in his right eye. He developed Mooren's ulcer in his right eye at 7 months and in his left eye at 10 months after the initial EX-PRESS surgery. Systemic examinations showed no collagen vascular disease, and he did not have a history of bacterial or viral infections. He was not allergic to metallic materials. Before the EX-PRESS surgery, he had underdone cataract surgery combined with trabeculotomy in both eyes, and a reoperation of trabeculotomy in his left eye. He had not developed Mooren's ulcer after these surgeries. The Mooren's ulcer after the EX-PRESS surgery was treated with oral prednisolone (30 mg tapering) in combination with topical 0.1% betamethasone sodium. The ulcers were responsive and healed well in three months. Conclusions: The EX-PRESS devices were most likely the cause of the Mooren's ulcers considering that they were located close to the site of EX-PRESS insertion and no peripheral corneal ulcer developed after prior intraocular surgeries. Keywords: Mooren's ulcer, Glaucoma implant surgery, EX-PRESS glaucoma filtering device, Autoimmune reaction, Surgical injury
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- 2020
43. The effect of alveolar decortication on orthodontically induced root resorption
- Author
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Eliane H Dutra, Ahmad Ahmida, Ravindra Nanda, Po-Jung Chen, Joy H Chang, and Sumit Yadav
- Subjects
Male ,Tooth Movement Techniques ,medicine.medical_treatment ,Root Resorption ,Dentistry ,Osteoclasts ,Orthodontics ,Root resorption ,Mandibular first molar ,03 medical and health sciences ,0302 clinical medicine ,Osteoclast ,medicine ,Animals ,Root volume ,Rats, Wistar ,Tooth Root ,Tartrate-resistant acid phosphatase ,Buccal root ,business.industry ,030206 dentistry ,X-Ray Microtomography ,Original Articles ,Decortication ,medicine.disease ,Surgical Injury ,Rats ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,business - Abstract
Objective To determine the effect of alveolar decortication on orthodontically induced root resorption. Materials and Methods A total of 24 male Wistar rats (14 week old) were used. The rats were randomly divided into one of the following three groups: group 1 (control group), orthodontic tooth movement (OTM) for 2 weeks; group 2, OTM for 2 weeks + two alveolar decortications (2AD); group 3, OTM for 2 weeks + four alveolar decortications (4AD). The first molar was moved mesially for 2 weeks. Micro computed tomography was used to analyze root volume. In addition, histological sections were stained with Tartrate Resistant Acid Phosphatase (TRAP) to quantify the osteoclast number. Results The buccal root volume in OTM + 4AD group was decreased by 8.92% and 6.11% when compared with the OTM-only group and OTM + 2AD group, respectively. Similarly, the other four root volumes in the OTM + 4AD group was decreased by 8.99% and 5.24% when compared with the OTM-only group and OTM + 2AD group, respectively. There was a decrease in buccal root density in the OTM + 4AD group by 4.66% and 3.56% when compared with the OTM-only group and the OTM + 2AD group, respectively. In addition, there was an increase in the number of osteoclasts by 195.73% and 98.74% in OTM + 4AD group in comparison with the OTM and OTM + 2AD group. Conclusions The amount of orthodontically induced root resorption was positively correlated with the extent of surgical injury used to accelerate orthodontic tooth movement.
- Published
- 2019
44. [VESICOVAGINAL FISTULA CAUSED BY CYSTOCELE: A CASE REPORT]
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Yohei Matsuda, Kosuke Shibamori, Shuichi Kato, Fumiyasu Takei, and Masahiro Yanase
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Physical examination ,medicine.disease ,Surgical Injury ,Vesicovaginal fistula ,Vaginal wall ,Surgery ,Pelvic irradiation ,Total incontinence ,Catheter drainage ,medicine ,Obstructed labor ,business - Abstract
Typical etiologies of vesicovaginal fistula (VVF) include obstructed labor, iatrogenic surgical injury, pelvic irradiation and cancer invasion. VVF caused by cystocele are very rare. To date, there are no documented cases in Japanese literature.A 74-year-old woman presented with near total incontinence. On physical examination, she was found to have severe cystocele and pressure necrosis of anterior vaginal wall, which caused partial breakdown of vaginal mucosa and VVF. She underwent vesicovaginal fistula repair using transvaginal and transabdominal approaches. Catheter drainage was performed for 10 days and postoperative cystogram showed no sign of leakage. She is currently symptom-free at 55 months.
- Published
- 2019
45. Gynecomastia as paraneoplastic syndrome
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Natalia S Vorotyntseva, Ivan Petrovich Moshurov, and Mikhail S Ganzya
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Prostate adenocarcinoma ,medicine.medical_specialty ,business.industry ,Chest ct ,Male breast ,Cancer ,Disease ,medicine.disease ,Surgical Injury ,Gynecomastia ,Renal cell carcinoma ,medicine ,Radiology ,skin and connective tissue diseases ,business - Abstract
Background. Gynecomastia is one of the most famous and common paraneoplastic syndromes. With the growth of equipment clinics with modern diagnostic equipment, including the CT, increases the detection of breast pathology in men. There is the need for a correct interpretation of the data about the state of male breast by radiologists, and the attending physician, oncologist, mammologist, urologist, endocrinologist. The purpose of the study to identify possible differences in frequency and radiation pattern of gynecomastia in patients with cancer and without it and also to follow the dynamics of the development of gynecomastia in patients with cancer, to identify the probable causes of the progression of gynecomastia in patients with cancer. Materials and methods. It's data of 400 chest CT of men who were screened and treated for the different oncological pathology in Voronezh regional clinical oncological hospital in 2013-2015. And also data of 150 chest CT of men who were screened and treated for the various diseases (excluding oncological diseases) in the Voronezh regional clinical diagnostic center and Kursk regional clinical hospital in 2013-2015 was used. Results. The data of the frequency of occurrence various types of gynecomastia in patients with cancer pathology and without it was obtained. The frequency of occurrence of gynecomastia in patients with cancer depending on the localization and morphology of tumor was analyzed. The dynamics of the gynecomastia in patients with cancer was tracked and possible causes of its progression in patients in this group were identified. Conclusions 1. Gynecomastia is a frequent pathology revealed by chest CT in men as suffering from oncological disease and without it. Gynecomastia significantly more often found in patients suffering from prostate adenocarcinoma and renal cell carcinoma. Surgical injury may be one of the reasons for the development of gynecomastia. Feature of gynecomastia in patients with cancer is its asymmetry. When the detection of asymmetrical gynecomastia by chest CT is recommend the further examination of patient to exclude him cancer pathology, special attention should be paid to the prostate gland and the kidneys. Upon detection of the progression of gynecomastia in a patient with a history of cancer need further examination to exclude cancer pathology progression.
- Published
- 2018
46. DECOMPRESSION AND STABILIZATION SURGERY USING CUSTOM-MADE 3D PRINTED CAGES
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Aleksey V. Peleganchuk, Vyacheslav A. Bazlov, and Aleksandr V. Krutko
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RD1-811 ,business.industry ,interbody fusion ,Intervertebral disc ,Surgical Injury ,custom-made cage ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Medicine ,Orthopedics and Sports Medicine ,Surgery ,Implant ,Registration procedure ,business ,Surgical treatment ,bone-metal block ,Biomedical engineering - Abstract
The paper describes a method for three-dimensional printing of сustom-made interbody cages accounting for biomechanical parameters of the intervertebral disc (anteroposterior size, anterior and posterior disc heights), which provides the implant with unique characteristics. An example of using custom-made cages providing optimal conditions for the formation of interbody bone-metal block due to the extra tight fit of the combined implant is given. It is shown that custom-made cages have a beneficial effect on the spine support recovery time, significantly reduce the surgical injury, and shorten the time of surgery. The manufacturing of each developed implant which has its own form and architecture is not a serial but a piece production not requiring additional registration procedure. The use of custom-made spinal cages allows optimizing the process of surgical treatment and improving short- and medium-term results.
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- 2018
47. Supradiaphragmatic intrathoracic migration of ventriculoperitoneal shunt with "double bending sign".
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Tsuchida S, Tokugawa J, Banno T, Mitsuhashi T, and Hishii M
- Abstract
Ventriculoperitoneal shunt (VPS) is a common treatment for hydrocephalus. An 80-year-old woman presented with subarachnoid hemorrhage caused by rupture of an aneurysm of the right middle cerebral artery. Emergency clipping was performed. Hydrocephalus occurred shortly after and VPS placement was performed. She improved and was transferred to a rehabilitation hospital. She presented with dyspnea 5 months later. Chest computed tomography (CT) showed extensive pleural effusion and intrathoracic migration of the distal VPS catheter. Chest CT confirmed that the distal catheter had penetrated into the pleural cavity under the second rib, and the catheter tip was located at the bottom of the right thoracic cavity. Review of chest CT right after the shunt surgery found the distal catheter passing only under the second and third ribs and otherwise located in the subcutaneous layer to the abdominal cavity. Chest radiography showed that the distal shunt tube was distorted in a characteristic "double bending sign." This rare case of supradiaphragmatic intrathoracic migration of VPS indicates a possible mechanism of this migration, based on the anatomical physiology, and that "double bending sign" indicates the need for further investigation., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
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- 2022
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- View/download PDF
48. Labour management in trial of labour after C-section (TOLAC): A gap analysis and quality improvement initiative
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Emily Delpero, Evan Tannenbaum, and Jacqueline Thomas
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medicine.medical_specialty ,Quality management ,Obstetrics ,business.industry ,Electronic medical record ,Trial of labour ,Obstetrics and Gynecology ,Surgical Injury ,Chorioamnionitis ,medicine.disease ,Fetal monitoring ,medicine ,Failure to progress ,business ,Prospective cohort study - Abstract
Objectives This quality improvement (QI) initiative was designed to identify gaps between evidence-based and/or hospital recommendations for TOLAC labour management, and clinical practice. Methods Viable, singleton pregnancies from January 1, 2016 to December 31, 2018 undergoing TOLAC were extracted from the electronic medical record. Sixty (60) randomly selected charts were reviewed for 1) consent 2) induction methods 3) oxytocin use 4) continuous fetal monitoring 5) admission indication 6) exam regularity 7) duration of dystocia prior to decision for cesarean section (CS) 8) maternal complications. Results Institutional VBAC rate was 71%. Documented consent to TOLAC on admission was present in 50% of cases. Oxytocin augmentation was used in 38% of cases and the median max dose was 4 [IQR 3-7.5] mU/min. Delays in initiating oxytocin were identified in 47% of those patients. Decisions to deliver by CS were made after a median time of 5h 40 min [IQR 3h 30m – 6h35m] of failure to progress despite adequate contractions. After this decision, median time to delivery was 1h 11m [IQR 57m–2h 16m]. Complications included post-partum hemorrhage (5%) and chorioamnionitis (6.7%). Surgical injury occurred in 10% of intrapartum CS. Peri-partum complications were associated with delay in oxytocin implementation ((1) = 9.80, p Conclusions Areas for QI were identified in 1) consent, 2) duration of dystocia prior to decision for CS and delay to CS delivery, 3) peri-partum complications. We recognize the potential use of this as a tool to identify areas for QI and prospective study.
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- 2021
49. Timing of intraoperative parecoxib analgesia in colorectal surgery
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Lee, L.H., Irwin, M.G., Yao, T.J., Yuen, M.K., and Cheung, C.W.
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COLON surgery , *ANALGESIA , *ANTI-inflammatory agents , *PREOPERATIVE care , *SURGICAL complications , *ANESTHESIOLOGY - Abstract
Summary: Objective: The aim of this study was to determine the analgesic effect of parecoxib when administered either before or at the end of surgery in patients undergoing colorectal laparotomy. Methods: Sixty patients were randomised to three groups of 20. The PS group received intravenous parecoxib 40mg before skin incision and normal saline at skin closure. The SP group received saline before skin incision and intravenous parecoxib 40mg at skin closure. A control group (SS) received saline at both time points. Results: In both SP and PS groups, morphine consumption was smaller. There was a 40–55% reduction in cumulative morphine consumption in both treatment groups at all time points up to 48h after anaesthesia finished. The greatest reduction was from 12h to 24h which showed a 66% reduction for the SP group and a 55% reduction for the PS group compared to control (p =0.0003 and 0.0049, respectively, with an adjusted significance value=0.0167). For SP and PS groups, the time to first post-operative analgesic request tended to be longer and the number of patients requesting morphine in the recovery room was less. Conclusion: Parecoxib administration at the end of surgery is as effective as at the beginning with regard to analgesic and opioid-sparing effects. [Copyright &y& Elsevier]
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- 2008
- Full Text
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50. Surgical Wound Infection
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Tahani Saeed Almohayya, Sarah Saeed Alshahrani, Amal Nasser Alqahtani, Reem Ali Almanie, Roaa Fahad Alshabanah, Norah Ibraheem Almanie, Amjaad Saleh Saad AlJelban, and Ebtesam Mohammed Alahmari
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medicine.medical_specialty ,business.industry ,medicine ,Surgical debridement ,Surgical wound ,Disease ,Surgical wound infections ,Intensive care medicine ,business ,Surgical Injury ,Antimicrobial ,Wound infection ,Bacterial pollution - Abstract
Surgical wound infections prompt antagonistic patient results, including delayed hospitalization and demise. Wound infection happens with every entry point, however demonstrated procedures exist to diminish the hazard of surgical injury diseases. Specifically, enhanced adherence to prove that based deterrent measures identified with fitting antimicrobial prophylaxis can diminish the rate of surgical wound infection. Various patient-related and technique related components impact the danger of surgical injury disease, and henceforth counteractive action requires a package approach, with deliberate consideration regarding numerous hazard factors, to diminish the hazard of bacterial pollution and enhance the patient's defences. Forceful surgical debridement and successful antimicrobial treatment are expected to enhance the treatment of surgical wound infections.
- Published
- 2017
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