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Van Ravenswaay L, Parnes A, Nisly SA. Clicks for credit: an analysis of healthcare professionals' social media use and potential for continuing professional development activities. Med Educ Online 2024; 29:2316489. [PMID: 38359156 PMCID: PMC10877644 DOI: 10.1080/10872981.2024.2316489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Previous studies have examined social media habits and utilization patterns among various groups of healthcare professionals. However, very few studies have evaluated the use of social media to support continuing professional development activities. The goal of the 2023 Clinical Education Alliance social media survey was to explore how HCPs interact professionally with social media, describe utilization trends, and identify barriers to using social media to disseminate CPD content. METHODS We conducted an online anonymous, voluntary survey of healthcare professionals contained in the Clinical Education Alliance learner database from January to March 2023. The survey was distributed via email and all learners were invited to participate regardless of profession or specialty. This survey consisted of 16 questions and collected demographic information and social media utilization and habits of healthcare professionals. RESULTS Of the 2,615 healthcare professionals who completed the survey, 71.2% use social media. Most respondents were physicians (50.6%) practicing in an urban setting (59.6%) and have been practicing for more than 15 years (70.5%). The most widely used platform was Facebook (70.7%), but there were no significant differences among the different professions. Of the respondents who use social media, 44.5% used social media to access continuing professional development-certified activities. Surveyed learners preferred passive participation with social media content. Participant-reported concerns include issues with legitimacy of the information, privacy, time constraints, and institutional barriers. DISCUSSION As the continuing professional development community continues to evolve and seek new innovative strategies to reach healthcare professionals, the findings of this survey highlight the need to identify and enact social media-based strategies aimed to engage healthcare professionals and provide them with unbiased evidence-based education.
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Affiliation(s)
- Logan Van Ravenswaay
- Healthcare Education and Outcomes Postdoctoral Fellow, Clinical Education Alliance, Reston, VA, USA
| | - Alex Parnes
- Marketing and Engagement, Clinical Education Alliance, Reston, VA, USA
| | - Sarah A. Nisly
- Outcomes and Clinical Impact, Clinical Education Alliance, Reston, VA, USA
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Faraji N, Goli R, Mohsennezhad P, Mohammadpour Y, Parizad N, Salamat E, Pourbahram R, Bazbandi S. NSAID (nonsteroidal anti-inflammatory drugs) Induced Stevens Johnson Syndrome in a 50-year-old woman: A case study. Toxicol Rep 2024; 12:289-291. [PMID: 38469333 PMCID: PMC10925921 DOI: 10.1016/j.toxrep.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
Stevens-Johnson Syndrome (SJS) is a severe and rare adverse drug reaction associated with significant morbidity and mortality. Although SJS is commonly triggered by multiple drugs, non-steroidal anti-inflammatory drugs (NSAIDs), including diclofenac, have been frequently implicated. A middle-aged woman, who is 50 years old, has a prior medical record of high blood pressure, type 2 diabetes, and has recently suffered from a pulmonary embolism. She was later admitted to the intensive care unit (ICU), where she was ultimately diagnosed with Steven Johnson syndrome. Careful drug selection, close monitoring of patients with predisposing factors, and prompt identification of adverse events are crucial to prevent severe drug reactions.
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Affiliation(s)
- Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Pariya Mohsennezhad
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Islamic Azad University, Urmia, Iran
| | - Yousef Mohammadpour
- Department of Medical Education, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Parizad
- Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Elaheh Salamat
- Department of Anesthesia and Surgical Technology, School of Allied Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Raheleh Pourbahram
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University Chalus, Iran
| | - Samaneh Bazbandi
- Department of Anesthesiology, School of Nursing and Midwifery, Islamic Azad University Tehran Medical sciences, Tehran, Iran
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Mishra S, Taneja S. Algorithmic Approach to Deranged Liver Functions After Transplantation. J Clin Exp Hepatol 2024; 14:101317. [PMID: 38264576 PMCID: PMC10801315 DOI: 10.1016/j.jceh.2023.101317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/06/2023] [Indexed: 01/25/2024] Open
Abstract
Liver transplant (LT) recipients require close follow-up with regular monitoring of the liver function tests (LFTs). Evaluation of deranged LFT should be individualized depending upon the time since LT, peri-operative events, clinical course, and any complications. These derangements can range from mild and asymptomatic to severe and symptomatic elevations requiring expedited personalized assessment and management. Pattern of LFT derangement (hepatocellular, cholestatic, or mixed), donor-recipient risk factors, timing after LT (post-operative, 1-12 months, and >12 months since LT) along with clinical context and symptomatology are important considerations before proceeding with the initial evaluation. Compliance to immunosuppression and drug interactions should be ascertained along with local epidemiology of infections. Essential initial evaluation must include an ultrasound abdomen with Doppler to rule out any structural causes such as biliary or vascular complications apart from focussed laboratory evaluation. Early allograft dysfunction, ischemia reperfusion injury, small-for-size syndrome, biliary leaks, hepatic artery, and portal vein thrombosis are usual culprits in the early post-operative period whereas viral hepatitis (acute or reactivation), opportunistic infections, and recurrence of the primary disease are more frequent in the later period. Graft rejection, biliary strictures, sepsis, and drug induced liver injury remain possible etiologies at all times points after LT. Initial evaluation algorithm must be customized based on history, clinical examination, risk factors, and pattern and severity of deranged LFT. Allograft rejection is a diagnosis of exclusion and requires liver biopsy to confirm and assess severity. Empirical treatment of rejection sans liver biopsy is discouraged.
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Affiliation(s)
- Saurabh Mishra
- Department of Gastroenterology and Hepatology, Paras Health, Sector 22, Panchkula, Haryana 134109, India
| | - Sunil Taneja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India
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Buonpane A, De Innocentiis C, Bernardi M, Borgi M, Spadafora L, Gaudio C, Burzotta F, Trani C, Zoccai GB. Mechanical Cardiopulmonary Resuscitation Devices: Evidence Synthesis with an Umbrella Review. Curr Probl Cardiol 2024; 49:102485. [PMID: 38428555 DOI: 10.1016/j.cpcardiol.2024.102485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024]
Abstract
AIM Sudden cardiac arrest is a significant cause of death worldwide. Good quality cardiopulmonary resuscitation increases patients' survival. Manual cardiopulmonary resuscitation is often ineffective as rescuers may experience physical and mental fatigue. Mechanical cardiopulmonary resuscitation devices are designed to address this issue, providing an automated approach for high-quality resuscitation. In the present comprehensive umbrella review we summarize current evidence on mechanical devices. METHODS We searched systematic reviews on mechanical devices in MEDLINE/PubMed. Effect estimates were obtained from original reports, including 95% confidence intervals and p values, when applicable and available, focusing on return of spontaneous circulation, survival to discharge or 30 days, survival with good neurological outcome, and resuscitation-related injuries. RESULTS From 21 potentially pertinent publications, we shortlisted 10 reviews, each including between 5 and 22 studies. AutoPulse, LUCAS, and LUCAS-2 were among the investigated devices. Most reviews concluded toward mechanical devices being similar or better than manual resuscitation for return of spontaneous circulation and 30-days survival. Regarding survival with good neurological function, some reviews lacked data, while the remaining ones reported similar results or worse outcomes in patients undergoing mechanical resuscitation. Focusing on resuscitation-related injuries, data were limited or conflicting with one review reporting higher rates of injuries with mechanical devices, and two others suggesting similar outcomes. CONCLUSIONS Manual and mechanical cardiopulmonary resuscitation appear to be similar in terms of return of spontaneous circulation and short-term survival. Mechanical devices appear to be associated with higher resuscitation-related injuries, while there are conflicting data in terms of survival with good neurological outcomes. A comprehensive and large dedicated randomized trial is urgently needed.
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Affiliation(s)
- Angela Buonpane
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Largo Agostino Gemelli, 1, 00168, Roma (RM), Italy.
| | - Carlo De Innocentiis
- Responsible Research Hospital, Largo Agostino Gemelli, 1, 86100, Campobasso (CB), Italy
| | - Marco Bernardi
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185, Roma (RM) Italy
| | - Marco Borgi
- Department of Clinical and Experimental Medicine, Policlinico 'G. Martino,' University of Messina, Via Consolare Valeria, 1, 98124, Messina (ME), Italy
| | - Luigi Spadafora
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185, Roma (RM) Italy
| | - Carlo Gaudio
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185, Roma (RM) Italy
| | - Francesco Burzotta
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Largo Agostino Gemelli, 1, 00168, Roma (RM), Italy
| | - Carlo Trani
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Largo Agostino Gemelli, 1, 00168, Roma (RM), Italy
| | - Giuseppe Biondi Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, C.so della Repubblica, 79, 04100, Latina (LT), Italy; Mediterranea Cardiocentro, Via Orazio, 2, 80122, Napoli (NA), Italy
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Patel A, Wilson CA, Davidson J, Lam JY, Seemann NM. A Social Media Blueprint - Understanding What Makes the Optimal Social Media Account for Paediatric Surgical Families. J Pediatr Surg 2024; 59:768-773. [PMID: 38368196 DOI: 10.1016/j.jpedsurg.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/18/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Social media is one of the most common sources of information for parents seeking information on their child's health. The purpose of this study was to better understand the social media habits of parents of paediatric surgery patients through surveys and focus groups. METHODS An online survey was distributed to parents visiting paediatric surgery clinics at a tertiary care hospital. Surveys were distributed via QR code and social media. Two virtual focus groups were conducted with parents of paediatric patients. Descriptive statistics were used for survey analysis and focus group transcripts were thematically analyzed. RESULTS A total of 107 respondents completed the online survey. Median age of respondents was 36 (interquartile range: 32-41). 81.3% of the respondents were female. Facebook was the preferred social media platform (47.2%), followed by Instagram (41.5%) then other platforms (4.7%). Respondents indicated that their preferred length of video was 30 s (41.2%). When asked which type of video content they prefer, participants indicated animated video as most popular (66.0%) followed by a physician speaking (60.0%), and slides with voiceover (45.0%). The focus groups revealed themes of: (1) functionality and content; (2) branding, aesthetic and legitimacy; (3) unmasking of physicians; (4) peer and community support. CONCLUSION Creating a successful social media account for parents must take into consideration their social media habits. A Facebook account that features brief videos may be most likely to engage parents. Additionally, physicians need to establish credibility and legitimacy of their content to attract their target audience. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Ashaka Patel
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Claire A Wilson
- Division of Paediatric Surgery, London Health Sciences Centre, London, ON, Canada
| | - Jacob Davidson
- Division of Paediatric Surgery, London Health Sciences Centre, London, ON, Canada
| | - Jennifer Y Lam
- Division of Paediatric Surgery, London Health Sciences Centre, London, ON, Canada; Department of Surgery, Western University, London, ON, Canada
| | - Natashia M Seemann
- Division of Paediatric Surgery, London Health Sciences Centre, London, ON, Canada; Department of Surgery, Western University, London, ON, Canada.
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Yepez CE, Anderson CE, Frost E, Whaley SE, Koleilat M. Sleep Duration Is Associated with Household Food Insecurity and Sugar-Sweetened Beverage Intake Among Women, Infants and Children Participating Children Ages 0-5. Am J Health Promot 2024; 38:492-502. [PMID: 38155440 DOI: 10.1177/08901171231225289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
PURPOSE To determine associations between child and household characteristics and sleep duration among low-income children in Los Angeles County. DESIGN Cross-sectional study. SETTING Survey data collected in 2017 and 2020 in Los Angeles County, California. SAMPLE Special Supplemental Nutrition Program for Women, Infants and Children (WIC) households with children ages 4-60 months. MEASURES Sleep duration for children 4-60 months old (less than recommended (LTR), recommended range, more than recommended (MTR)), household food insecurity (HFI), sociodemographics, and daily servings of sugar-sweetened beverages (SSB). ANALYSIS Multinomial logistic regression, stratified by child age, was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for associations between household/child characteristics and LTR or MTR sleep compared to recommended duration among WIC participating children 4-60 months old. RESULTS The final sample included 3512 children ages 4-23 months and 6035 children ages 24-60 months. In the study population, 32% (3-5 years old) to 44% (4-11months) of children under 5 did not meet the recommended hours of sleep per night. HFI was associated with higher odds of LTR (OR 1.27, CI 1.12-1.45) and MTR (OR 1.46, CI 1.15-1.87) sleep among 24-60 month-old children. Each additional daily SSB serving was associated with higher odds of LTR sleep (4-23 months: OR 1.10, CI 1.02-1.19; 24-59 months: OR 1.12, CI 1.08-1.17). CONCLUSIONS HFI and SSB intake are associated with not getting the recommended amount of sleep among low-income WIC participating children. Nutrition assistance program participants may benefit from receiving information about recommended sleep duration for young children and how to establish sleep routines to optimize sleep duration.
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Affiliation(s)
- Catherine E Yepez
- Public Health Foundation Enterprises (PHFE) WIC, a Program of Heluna Health, City of Industry, CA, USA
| | - Christopher E Anderson
- Public Health Foundation Enterprises (PHFE) WIC, a Program of Heluna Health, City of Industry, CA, USA
| | - Erin Frost
- Department of Public Health, College of Health and Human Development, California State University, Fullerton, CA, USA
| | - Shannon E Whaley
- Public Health Foundation Enterprises (PHFE) WIC, a Program of Heluna Health, City of Industry, CA, USA
| | - Maria Koleilat
- Department of Public Health, College of Health and Human Development, California State University, Fullerton, CA, USA
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De Meyer GRY, Zurek M, Puylaert P, Martinet W. Programmed death of macrophages in atherosclerosis: mechanisms and therapeutic targets. Nat Rev Cardiol 2024; 21:312-325. [PMID: 38163815 DOI: 10.1038/s41569-023-00957-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 01/03/2024]
Abstract
Atherosclerosis is a progressive inflammatory disorder of the arterial vessel wall characterized by substantial infiltration of macrophages, which exert both favourable and detrimental functions. Early in atherogenesis, macrophages can clear cytotoxic lipoproteins and dead cells, preventing cytotoxicity. Efferocytosis - the efficient clearance of dead cells by macrophages - is crucial for preventing secondary necrosis and stimulating the release of anti-inflammatory cytokines. In addition, macrophages can promote tissue repair and proliferation of vascular smooth muscle cells, thereby increasing plaque stability. However, advanced atherosclerotic plaques contain large numbers of pro-inflammatory macrophages that secrete matrix-degrading enzymes, induce death in surrounding cells and contribute to plaque destabilization and rupture. Importantly, macrophages in the plaque can undergo apoptosis and several forms of regulated necrosis, including necroptosis, pyroptosis and ferroptosis. Regulated necrosis has an important role in the formation and expansion of the necrotic core during plaque progression, and several triggers for necrosis are present within atherosclerotic plaques. This Review focuses on the various forms of programmed macrophage death in atherosclerosis and the pharmacological interventions that target them as a potential means of stabilizing vulnerable plaques and improving the efficacy of currently available anti-atherosclerotic therapies.
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Affiliation(s)
- Guido R Y De Meyer
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium.
| | - Michelle Zurek
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Pauline Puylaert
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Wim Martinet
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
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Babu D, Marotti S, Rowett D, Lim R, Wisdom A, Kalisch Ellett L. What is impacting clinical pharmacists' participation in an interprofessional ward round: a thematic analysis of a national survey. J Interprof Care 2024; 38:444-452. [PMID: 38151971 DOI: 10.1080/13561820.2023.2289506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/25/2023] [Indexed: 12/29/2023]
Abstract
The ward round (WR) is an important opportunity for interprofessional interaction and communication enabling optimal patient care. Pharmacists' participation in the interprofessional WR can reduce adverse drug events and improve medication appropriateness and communication. WR participation by clinical pharmacists in Australia is currently limited. This study aims to explore what is impacting clinical pharmacists' participation in WRs in Australian hospitals. A self-administered, anonymous national survey of Australian clinical pharmacists was conducted. This study describes the outcomes from qualitative questions which were analyzed thematically in NVivo-2020 according to Braun and Clarke's techniques. Five themes were constructed: "Clinical pharmacy service structure", "Ward round structure", "Pharmacist's capabilities", "Culture" and "Value". A culture supportive of pharmacist's contribution with a consistent WR structure and flexible delivery of clinical pharmacy services enabled pharmacists' participation in WR. Being physically "absent" from the WR due to workload, workflow, and self-perception of the need for extensive clinical knowledge can limit opportunities for pharmacists to proactively contribute to medicines decision-making with physicians to improve patient care outcomes. Bidirectional communication between the interprofessional team and the pharmacist, where there is a co-construction of each individual's role in the WR facilitates consistent and inter-dependent collaborations for effective medication management.
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Affiliation(s)
- Dona Babu
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Sally Marotti
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Debra Rowett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Renly Lim
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Alice Wisdom
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Lisa Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Anderson AB, Rivera JA, McGlone PJ, Saberski ER, Tintle SM, Potter BK. Technical Trick: Cryoneurolysis for Subacute Pain Mitigation in Patients With Limb Loss. J Orthop Trauma 2024; 38:e191-e194. [PMID: 38252476 DOI: 10.1097/bot.0000000000002777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 01/23/2024]
Abstract
SUMMARY Pain after amputation is often managed by target muscle reinnervation (TMR) with the added benefit that TMR also provides improved myoelectric terminal device control. However, as TMR takes several months for the recipient muscles to reliably reinnervate, this technique does not address pain within the subacute postoperative period during which pain chronification, sensitization, and opioid dependence and misuse may occur. Cryoneurolysis, described herein, uses focused, extreme temperatures to essentially "freeze" the nerve, blocking nociception, and improving pain in treated nerves potentially reducing the chances of pain chronification, sensitization, and substance dependence or abuse.
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Affiliation(s)
- Ashley B Anderson
- Uniformed Services University of the Health Sciences, Bethesda, MD
- Division of Orthopaedics, Department of Surgery, Walter Reed National Military Center, Bethesda, MD
| | - Julio A Rivera
- Uniformed Services University of the Health Sciences, Bethesda, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD; and
| | - Patrick J McGlone
- Division of Orthopaedics, Department of Surgery, Walter Reed National Military Center, Bethesda, MD
| | - Ean R Saberski
- Uniformed Services University of the Health Sciences, Bethesda, MD
- Division of Plastics and Reconstructive Surgery, Department of Surgery, Walter Reed National Military Center, Bethesda, MD
| | - Scott M Tintle
- Uniformed Services University of the Health Sciences, Bethesda, MD
- Division of Orthopaedics, Department of Surgery, Walter Reed National Military Center, Bethesda, MD
| | - Benjamin K Potter
- Uniformed Services University of the Health Sciences, Bethesda, MD
- Division of Orthopaedics, Department of Surgery, Walter Reed National Military Center, Bethesda, MD
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Gédor M, Bourgkard È, Dziurla M, Ribet C, Goldberg M, Grzebyk M, Hédelin G, Boini S. Relationship between night work and health-related quality of life: an analysis based on profiles and cumulative duration of exposure to night work among French workers in the CONSTANCES cohort. Int Arch Occup Environ Health 2024; 97:377-386. [PMID: 38466419 DOI: 10.1007/s00420-024-02053-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/29/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE The aim of this study is to estimate the association between night work and health-related quality of life (HRQoL) among French workers. The association between cumulative duration of night work and HRQoL was also investigated. METHODS Three career-long night work exposure groups were defined at inclusion in the CONSTANCES cohort: permanent night workers, rotating night workers and former night workers. Day workers with no experience of night work were the reference group. HRQoL was assessed using the Short Form Health Survey (SF-12), in particular the physical component summary (PCS) and mental component summary (MCS) scores, with a higher score indicating better HRQoL. Several linear regression models were built to test the association between night work exposure and HRQoL. The relationship between cumulative duration of night work and HRQoL scores was analyzed using generalised additive models. RESULTS The sample consisted of 10,372 participants. Former night workers had a significantly lower PCS score than day workers (β [95% CI]: - 1.09 [- 1.73; - 0.45], p = 0.001), whereas permanent night workers had a significantly higher MCS score (β [95% CI]: 1.19 [0.009; 2.36], p = 0.048). A significant decrease in PCS score from 5 to 20 years of cumulative night work was observed among former night workers. CONCLUSIONS Former night workers had poorer physical HRQoL in contrast to permanent and rotating night workers who had similar or even better HRQoL than day workers, suggesting the well-known healthy worker survivor effect. Consequently, both current and former night workers require regular and specific follow-up focused on the physical components of their health.
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Affiliation(s)
- Maud Gédor
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France.
| | - Ève Bourgkard
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France
| | - Mathieu Dziurla
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France
| | - Céline Ribet
- Population-Based Epidemiological Cohorts Unit, Inserm UMS 11, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), Villejuif, France
| | - Marcel Goldberg
- Population-Based Epidemiological Cohorts Unit, Inserm UMS 11, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), Villejuif, France
| | - Michel Grzebyk
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France
| | - Guy Hédelin
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France
| | - Stéphanie Boini
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France
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11
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Nguyen M, Goel S, Tran L, Khan M, Jersmann H, Nguyen P, Krishnan S, Hodge JC, Foreman A. Management of complex adult airway pathology through a multidisciplinary approach: An 8-year case series. Clin Otolaryngol 2024. [PMID: 38634330 DOI: 10.1111/coa.14163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 03/10/2024] [Accepted: 03/24/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Marie Nguyen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Sahil Goel
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Liem Tran
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Maryam Khan
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Hubertus Jersmann
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - Phan Nguyen
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - Suren Krishnan
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - John-Charles Hodge
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Andrew Foreman
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
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Cheema HA, Jafar U, Shahid A, Masood W, Usman M, Hermis AH, Naseem MA, Sahra S, Sah R, Lee KY. Colchicine for the treatment of patients with COVID-19: an updated systematic review and meta-analysis of randomised controlled trials. BMJ Open 2024; 14:e074373. [PMID: 38631824 DOI: 10.1136/bmjopen-2023-074373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVES We conducted an updated systematic review and meta-analysis to investigate the effect of colchicine treatment on clinical outcomes in patients with COVID-19. DESIGN Systematic review and meta-analysis. DATA SOURCES We searched PubMed, Embase, the Cochrane Library, medRxiv and ClinicalTrials.gov from inception to January 2023. ELIGIBILITY CRITERIA All randomised controlled trials (RCTs) that investigated the efficacy of colchicine treatment in patients with COVID-19 as compared with placebo or standard of care were included. There were no language restrictions. Studies that used colchicine prophylactically were excluded. DATA EXTRACTION AND SYNTHESIS We extracted all information relating to the study characteristics, such as author names, location, study population, details of intervention and comparator groups, and our outcomes of interest. We conducted our meta-analysis by using RevMan V.5.4 with risk ratio (RR) and mean difference as the effect measures. RESULTS We included 23 RCTs (28 249 participants) in this systematic review. Colchicine did not decrease the risk of mortality (RR 0.99; 95% CI 0.93 to 1.05; I2=0%; 20 RCTs, 25 824 participants), with the results being consistent among both hospitalised and non-hospitalised patients. There were no significant differences between the colchicine and control groups in other relevant clinical outcomes, including the incidence of mechanical ventilation (RR 0.75; 95% CI 0.48 to 1.18; p=0.22; I2=40%; 8 RCTs, 13 262 participants), intensive care unit admission (RR 0.77; 95% CI 0.49 to 1.22; p=0.27; I2=0%; 6 RCTs, 961 participants) and hospital admission (RR 0.74; 95% CI 0.48 to 1.16; p=0.19; I2=70%; 3 RCTs, 8572 participants). CONCLUSIONS The results of this meta-analysis do not support the use of colchicine as a treatment for reducing the risk of mortality or improving other relevant clinical outcomes in patients with COVID-19. However, RCTs investigating early treatment with colchicine (within 5 days of symptom onset or in patients with early-stage disease) are needed to fully elucidate the potential benefits of colchicine in this patient population. PROSPERO REGISTRATION NUMBER CRD42022369850.
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Affiliation(s)
| | - Uzair Jafar
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Abia Shahid
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Waniyah Masood
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Usman
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Alaa Hamza Hermis
- Nursing College, Al-Mustaqbal University, 51001 Hillah, Babylon, Iraq
| | | | - Syeda Sahra
- Department of Infectious Diseases, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Ranjit Sah
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
| | - Ka Yiu Lee
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
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J RG, K D. Apnoea detection using ECG signal based on machine learning classifiers and its performances. J Med Eng Technol 2024:1-11. [PMID: 38625408 DOI: 10.1080/03091902.2024.2336500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 03/23/2024] [Indexed: 04/17/2024]
Abstract
Sleep apnoea is a common disorder affecting sleep quality by obstructing the respiratory airway. This disorder can also be correlated to certain diseases like stroke, depression, neurocognitive disorder, non-communicable disease, etc. We implemented machine learning techniques for detecting sleep apnoea to make the diagnosis easier, feasible, convenient, and cost-effective. Electrocardiography signals are the main input used here to detect sleep apnoea. The considered ECG signal undergoes pre-processing to remove noise and other artefacts. Next to pre-processing, extraction of time and frequency domain features is carried out after finding out the R-R intervals from the pre-processed signal. The power spectral density is calculated by using the Welch method for extracting the frequency-domain features. The extracted features are fed to different machine learning classifiers like Support Vector Machine, Decision Tree, k-nearest Neighbour, and Random Forest, for detecting sleep apnoea and performances are analysed. The result shows that the K-NN classifier obtains the highest accuracy of 92.85% compared to other classifiers based on 10 extracted features. The result shows that the proposed method of signal processing and machine learning techniques can be reliable and a promising method for detecting sleep apnoea with a reduced number of features.
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Affiliation(s)
- Rolant Gini J
- Department of Electronics and Communication Engineering, Amrita School of Engineering, Coimbatore, Amrita Vishwa Vidyapeetham, India
| | - Dhanalakshmi K
- Department of Electronics and Communication Engineering, Amrita School of Engineering, Coimbatore, Amrita Vishwa Vidyapeetham, India
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14
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Zhang S, Wang J, Zhang Q, Pan Y, Zhang Z, Geng Y, Jia B, Li Y, Xiong Y, Yan X, Li J, Wang H, Wu C, Huang R. Association of liver function and prognosis in patients with severe fever with thrombocytopenia syndrome. PLoS Negl Trop Dis 2024; 18:e0012068. [PMID: 38626222 DOI: 10.1371/journal.pntd.0012068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/12/2024] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVES Severe fever with thrombocytopenia syndrome (SFTS) is an epidemic emerging infectious disease with high mortality rate. We investigated the association between liver injury and clinical outcomes in patients with SFTS. METHODS A total of 291 hospitalized SFTS patients were retrospectively included. Cox proportional hazards model was adopted to identify risk factors of fatal outcome and Kaplan-Meier curves were used to estimate cumulative risks. RESULTS 60.1% of patients had liver injury at admission, and the median alanine transaminase, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBil) levels were 76.4 U/L, 152.3 U/L, 69.8 U/L and 9.9 μmol/L, respectively. Compared to survivors, non-survivors had higher levels of AST (253.0 U/L vs. 131.1 U/L, P < 0.001) and ALP (86.2 U/L vs. 67.9 U/L, P = 0.006), higher proportion of elevated ALP (20.0% vs. 4.4%, P < 0.001) and liver injury (78.5% vs. 54.9%, P = 0.001) at admission. The presence of liver injury (HR 2.049, P = 0.033) at admission was an independent risk factor of fatal outcome. CONCLUSIONS Liver injury was a common complication and was strongly associated with poor prognosis in SFTS patients. Liver function indicators should be closely monitored for SFTS patients.
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Affiliation(s)
- Shaoqiu Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Jian Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Qun Zhang
- Department of Infectious Diseases, Affiliated Zhongda Hospital of Southeast University, Nanjing, Jiangsu, China
| | - Yifan Pan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhiyi Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yu Geng
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Bei Jia
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Yuanyuan Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yali Xiong
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Xiaomin Yan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Huali Wang
- Department of General Practice, Nanjing Second Hospital, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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15
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Liu Y, Peng L, Li Y, Lu X, Wang F, Chen D, Lin N. Effect of liver cancer on the accumulation and hepatobiliary transport of per- and polyfluoroalkyl substances. J Hazard Mater 2024; 468:133743. [PMID: 38377901 DOI: 10.1016/j.jhazmat.2024.133743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
In this study, we examined the distribution of per- and polyfluoroalkyl substances (PFASs) in liver and bile tissues from the patients with liver cancer (n = 202) and healthy controls (n = 30), and calculated the hepatobiliary transport efficiency (TB-L) of PFASs. Among 21 PFASs, 13 PFASs were frequently detected in the liver (median: 8.80-16.3 ng/g) and bile (median: 11.03-14.26 ng/mL) samples. PFAS concentrations in liver were positively correlated with age, with higher levels of PFASs in the older. Variance analysis showed that gender and BMI (Body Mass Index) have an important impact on the distribution of PFASs. A U-shaped trend in TB-L of PFASs with the increasing of carbon chain length was found for the first time, and the TB-L of most PFASs in the control was higher than that of those in cases (p < 0.05), suggesting that hepatic injury would affect their transport. PFASs were positively associated with liver injury biomarkers, including γ-glutamyl transferase (GGT), alanine aminotransferase (ALT), and total bilirubin (TB) levels (p < 0.05). This is the first study on examining the hepatobiliary transport characteristics of PFASs, which may help understand the connection between PFAS accumulation and liver cancer risk.
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Affiliation(s)
- Ying Liu
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China; School of Environmental Studies, China University of Geosciences, Wuhan 430074, China
| | - Lin Peng
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China; State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, the Hong Kong Special Administrative Region of China
| | - Yanjie Li
- Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Xingwen Lu
- School of Environmental Science and Engineering, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China
| | - Fei Wang
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China.
| | - Da Chen
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Nan Lin
- Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
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Bertolini G, Belli L, Mazza S, Ugolotti PT, Tadonio I, Ceccarelli P, Rossi S, Ippolito S. Feasibility and Safety of Bridging Antiplatelet Therapy with Cangrelor in Neuro-Oncology: A Preliminary Experience. J Neurol Surg A Cent Eur Neurosurg 2024. [PMID: 38621711 DOI: 10.1055/s-0044-1785649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Antiplatelet therapy is mandatory for prevention of thrombotic events in patients with a recent history of acute coronary syndromes and/or percutaneous coronary interventions. However, if an urgent surgery is required during antiplatelet therapy, a compromise between the ischemic/thrombotic and hemorrhagic risk has to be reached. Different bridging schemes are reported in the literature, but there is no clear consensus on the optimal treatment strategy in terms of efficacy and safety. Although some indications about the perioperative management of antiplatelet therapy regarding specific surgical specializations are available, balancing the thrombotic and hemorrhagic risk on an individual basis, no evidence referring to neurosurgical or neuro-oncologic procedures is reported. Herein, we present our preliminary experience in the perioperative management of a patient who underwent a neurosurgical procedure for the resection of a primary malignant brain tumor using an intravenous P2Y12 inhibitor (cangrelor) as bridging therapy after a recent acute myocardial infarction treated with primary percutaneous coronary intervention and stenting. The oral P2Y12 inhibitor (clopidogrel) was withdrawn 5 days prior to the surgical procedure and continuous infusion of cangrelor was started 3 days before the surgery at a dose of 0.75 μg/kg/min. Cangrelor was discontinued 2 hours before surgery and resumed 72 hours after tumor resection for further 60 hours. Neither cangrelor-related bleeding nor cardiac ischemic events were observed in the perioperative period and the following 90 days, supporting data regarding the feasibility and safety of this bridging scheme. Further studies are needed to confirm our promising results.
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Affiliation(s)
- Giacomo Bertolini
- Neurosurgery Unit, Head and Neck Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Laura Belli
- Neurosurgery Unit, Head and Neck Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Stefania Mazza
- Neurosurgery Unit, Head and Neck Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Pietro Tito Ugolotti
- Department of Surgery, Cardiology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Iacopo Tadonio
- Department of Surgery, Cardiology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Patrizia Ceccarelli
- Department of Anesthesiology and Intensive Care Medicine, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Sandra Rossi
- Department of Anesthesiology and Intensive Care Medicine, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Salvatore Ippolito
- Neurosurgery Unit, Head and Neck Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
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Lahidheb D, Komarov R, Alikhanov R, Tlisov B, Ismailbaev A, Dhif I. Uncommon using of the pulmonary homograft in oncological case - three years follow up. J Cardiothorac Surg 2024; 19:204. [PMID: 38615010 PMCID: PMC11015555 DOI: 10.1186/s13019-024-02684-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 03/24/2024] [Indexed: 04/15/2024] Open
Abstract
INTRODUCTION There are enough cases of colorectal cancer with liver metastasis, but inferior vena cava infiltraion with dissemination to the right atrium is an infrequent event. PRESENTATION OF CASE This is the first case of surgical treatment of recurrent liver metastasis with the infiltration to the inferior vena cava and to the right atrium of the heart, using a cryopreserved pulmonary homograft. DISCUSSION The choice of a cryopreserved pulmonary homograft was preferred by the need for a radical and wide resection of tissues involved in the metastasis, as well as to potentially reduce the risk of thrombosis in the short- and long-term postoperative period. CONCLUSION The use of a cryopreserved homograft in operation undergoing cardiopulmonary bypass allowed us to perform the required volume of radical resection and to replace an extended section of the inferior vena cava.
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Affiliation(s)
- Dhaker Lahidheb
- Faculty of medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Roman Komarov
- Department of Cardiac surgery, The First Clinical Hospital, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Ruslan Alikhanov
- Department of Cardiac surgery, The First Clinical Hospital, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Boris Tlisov
- Department of Cardiac surgery, The First Clinical Hospital, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
| | - Alisher Ismailbaev
- Department of Cardiac surgery, The First Clinical Hospital, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Ines Dhif
- Department of Cardiac surgery, The First Clinical Hospital, Sechenov First Moscow State Medical University, Moscow, Russian Federation
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Hailstone L, Tovmassian D, Nguyen CL, Wong P, Le Page PA, Martin D, Taylor C. Medium-Term Outcomes from a Series of 1000 One Anastomosis Gastric Bypass in Australia: A Case Series. Obes Surg 2024:10.1007/s11695-024-07213-5. [PMID: 38609707 DOI: 10.1007/s11695-024-07213-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024]
Abstract
PURPOSE This study presents the short- (less than 6 months) and medium-term (6 months to 2 years) outcomes for weight loss and type 2 diabetes mellitus (T2DM) for all patients undergoing one anastomosis gastric bypass (OAGB) across multiple institutions between 2015 and 2021. MATERIALS AND METHODS A retrospective analysis of prospectively collected databases was performed including 1022 participants who underwent OAGB at multiple institutions by multiple surgeons between 2015 and 2021. Primary outcome was percentage total weight loss (TWL) and secondary outcomes were achieving resolution of T2DM; OAGB specific short- and medium-term complications including bile reflux, marginal ulceration and internal herniation. RESULTS One thousand and twenty-two patients underwent OAGB (81% primary surgery). A percentage of 34.1% (n = 349) had a preoperative diagnosis of type 2 diabetes mellitus (T2DM). Mean TWL was 33.6 ± 9% with a T2DM remission rate of 74% at 1-year post-op. Rates of bile reflux and marginal ulceration was 1.1% (n = 11) and 1.1% (n = 11). There were no cases of internal herniation during the follow-up period. CONCLUSION OAGB results has echoed previously published work as being efficacious and safe in a short-medium term. The prevalence of complications, especially bile reflux is overall low in our population and no current evidence exists to support an increased risk of metaplasia or malignancy related to bile within the stomach.
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Affiliation(s)
- Laura Hailstone
- Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - David Tovmassian
- Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Sydney, NSW, Australia.
- University of Sydney, Sydney, NSW, Australia.
| | - Chu Luan Nguyen
- Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
| | - Pearl Wong
- Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | | | - David Martin
- Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Craig Taylor
- Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Sydney, NSW, Australia
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Norimatsu Y, Takemura N, Yoshikawa K, Ito K, Inagaki F, Mihara F, Yamada K, Kokudo N. A case of multidrug-resistant intractable pylephlebitis and intra-abdominal abscess due to perforated appendicitis successfully treated with open abdominal management. Surg Case Rep 2024; 10:84. [PMID: 38607465 PMCID: PMC11014825 DOI: 10.1186/s40792-024-01882-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Pylephlebitis, a rare and lethal form of portal venous septic thrombophlebitis, often arises from infections in regions drained by the portal vein. Herein, we report a case of peritonitis with portal vein thrombosis due to acute severe appendicitis, managed with intensive intraperitoneal drainage via open abdominal management (OAM). CASE PRESENTATION A 19-year-old male with severe appendicitis, liver abscesses, and portal vein thrombosis developed septic shock and multi-organ failure. After emergency interventions, the patient was admitted to the intensive care unit. Antibiotic treatment based on cultures revealing multidrug-resistant Escherichia coli and Bacteroides fragilis and anticoagulation therapy (using heparin and edoxaban) was initiated. Despite continuous antibiotic therapy, the laboratory results consistently showed elevated levels of inflammatory markers. On the 13th day, open abdominal irrigation was performed for infection control. Extensive intestinal edema precluded wound closure, necessitating open-abdominal management in the intensive care unit. Anticoagulation therapy was continued, and intra-abdominal washouts were performed every 5 days. On the 34th day, wound closure was achieved using the anterior rectus abdominis sheath turnover method. The patient recovered successfully and was discharged on the 81st day. CONCLUSIONS Alongside appropriate antibiotic selection, early surgical drainage and OAM are invaluable. This case underscores the potential of anticoagulation therapy in facilitating safe surgical procedures.
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Affiliation(s)
- Yu Norimatsu
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Nobuyuki Takemura
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Kaoru Yoshikawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kyoji Ito
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Fuyuki Inagaki
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Fuminori Mihara
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kazuhiko Yamada
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Norihiro Kokudo
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
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Huq S, Shanahan RM, Adida S, Bin-Alamer O, Abou-Al-Shaar H, Niranjan A, Hadjipanayis CG, Lunsford LD. Gamma knife radiosurgery for clival metastasis: case series and systematic review. J Neurooncol 2024:10.1007/s11060-024-04648-9. [PMID: 38598088 DOI: 10.1007/s11060-024-04648-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/14/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE Clival metastatic cancer is rare and has limited literature to guide management. We describe management of clival metastasis with Gamma Knife radiosurgery (GKRS). We augment our findings with a systematic review of all forms of radiation therapy for clival metastasis. METHODS Records of 14 patients with clival metastasis who underwent GKRS at the University of Pittsburgh Medical Center from 2002 to 2023 were reviewed. Treatment parameters and clinical outcomes were assessed. A systematic review was conducted using evidence-based guidelines. RESULTS The average age was 61 years with male predominance (n = 10) and average follow-up of 12.4 months. The most common primary cancers were prostate (n = 3) and lung (n = 3). The average time from cancer diagnosis to clival metastasis was 34 months. The most common presenting symptoms were headache (n = 9) and diplopia (n = 7). Five patients presented with abducens nerve palsies, and two presented with oculomotor nerve palsies. The median tumor volume was 9.3 cc, and the median margin dose was 15 Gy. Eleven patients achieved tumor control after one procedure, and three with progression obtained tumor control after repeat GKRS. One patient recovered abducens nerve function. The median survival from cancer diagnosis and GKRS were 49.7 and 15.3 months, respectively. The cause of death was progression of systemic cancer in six patients, clival metastasis in one, and unknown in four. The systematic review included 31 studies with heterogeneous descriptions of treatment and outcomes. CONCLUSION Clival metastasis is rare and associated with poor prognosis. GKRS is a safe, effective treatment for clival metastasis.
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Affiliation(s)
- Sakibul Huq
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, Suite B-400, 15213, Pittsburgh, PA, USA.
| | - Regan M Shanahan
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, Suite B-400, 15213, Pittsburgh, PA, USA
| | - Samuel Adida
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, Suite B-400, 15213, Pittsburgh, PA, USA
| | - Othman Bin-Alamer
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, Suite B-400, 15213, Pittsburgh, PA, USA
| | - Hussam Abou-Al-Shaar
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, Suite B-400, 15213, Pittsburgh, PA, USA
| | - Ajay Niranjan
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, Suite B-400, 15213, Pittsburgh, PA, USA
| | - Constantinos G Hadjipanayis
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, Suite B-400, 15213, Pittsburgh, PA, USA
| | - L Dade Lunsford
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, Suite B-400, 15213, Pittsburgh, PA, USA
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Okuno K, Wang L, Almeida FR. Focus of dental sleep medicine on obstructive sleep apnea in older adults: A narrative review. J Prosthodont Res 2024; 68:227-236. [PMID: 37648523 DOI: 10.2186/jpr.jpr_d_23_00047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
PURPOSE To review dental sleep medicine in older adults based on the literature. STUDY SELECTION This narrative review focuses on sleep physiology, common sleep disorders, and obstructive sleep apnea (OSA) in older adults and their management. RESULTS Sleep physiology differs between older and younger adults, with sleep disturbances occurring more frequently in older adults. The prevalence of insomnia increases in older adults due to age-related changes in sleep physiology. Insomnia, sleep-disordered breathing, periodic limb movement disorder, restless legs syndrome, and rapid eye movement (REM) sleep behavior disorder are common sleep disorders in older adults. OSA is more prevalent in older adults, and its effects on them are considered more substantial than those on younger adults. The treatment of older patients with mandibular advancement devices may be less effective and more complex owing to potential impairments in oral and dental health. Furthermore, the prevalence of edentulism in older adults is decreasing while life expectancy is increasing. CONCLUSIONS As older adults have comorbidities that affect sleep quality, dentists should consider the effects of sleep physiology and sleep disorders in these patients. OSA may decrease the quality of life and increase the risk of developing other diseases. Therefore, dentists proposing treatment with mandibular advancement devices need to inform patients of their potential lack of efficacy and the requirement for careful follow-up owing to known and unknown side effects.
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Affiliation(s)
- Kentaro Okuno
- Department of Geriatric Dentistry, Osaka Dental University, Hirakata, Japan
- Center for Dental Sleep Medicine, Osaka Dental University Hospital, Osaka, Japan
| | - Liqin Wang
- Department of Geriatric Dentistry, Osaka Dental University, Hirakata, Japan
| | - Fernanda R Almeida
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
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Vanli S, Kurtoglu F, Alan BS, Akcakavak G, Ozdemir O. Investigation of the effects of Theranekron and Sorafenib treatments on carcinogenesis, apoptosis and biochemical profile in hepatocellular carcinoma in rats. Toxicol Mech Methods 2024:1-11. [PMID: 38577837 DOI: 10.1080/15376516.2024.2332909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/15/2024] [Indexed: 04/06/2024]
Abstract
This study aimed to investigate the effects of Tarantula cubensis alcohol extract (TCAE, Theranekron) and Sorafenib (S) treatments on carcinogenesis, apoptosis and biochemical profile of rats with experimentally induced hepatocellular carcinoma (HCC). In the presented study, 58 male rats were divided into 7 groups; Negative Control (NC, n = 6), NC + TCAE (NCT, n = 6), NC + Sorafenib (NCS, n = 6), Positive Control (PC, n = 10), Positive Control + TCAE (PCT, n = 10), Positive Control + Sorafenib (PCS, n = 10), Positive Control + TCAE + Sorafenib (PCTS, n = 10). The active ingredients Diethylnitrosamine (DEN, 120 mg/kg, single dose) and Nitrosomorpholine (NMOR, 50 ppm, 21 weeks orally) were used to induce HCC in rats. At the end of the experiment, the animals were euthanized under appropriate conditions and samples were collected for biochemical and pathological investigations. In the PC group, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase (GGT) levels were higher (p < 0.001) and urea levels were lower (p < 0.001) compared to all other groups. Treatment groups reorganized the relevant markers (ALT, AST, GGT, and urea). A significant increase was detected in Caspase-10, Caspase-3 and Granzyme-B (GrzB) (p < 0.001) in blood and Caspase-10 and GrzB (p < 0.05) in liver tissue in PCT, PCS and PCTS groups compared to the PC group. Histopathological examination revealed that the PC group showed cancer morphology, and the treatment groups caused a decrease in tumor incidence and size. Our current findings suggest that the mechanism of action of TCAE in HCC is through the NKs/CTLs-GrzB-Casp10-Casp3 signaling pathway and can be used in combination with chemotherapy drugs for the development of future drug designs.
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Affiliation(s)
- Serdar Vanli
- Ministry of Agriculture and Forestry, Ilgin District Directorate of Agriculture and Forestry, Konya, Turkey
| | - Firuze Kurtoglu
- Department of Biochemistry, Faculty of Veterinary Sciences, Selcuk University, Konya, Turkey
| | - Beyza S Alan
- Department of Biochemistry, Faculty of Veterinary Sciences, Selcuk University, Konya, Turkey
| | - Gokhan Akcakavak
- Department of Pathology, Faculty of Veterinary Sciences, Yozgat Bozok University, Yozgat, Turkey
| | - Ozgur Ozdemir
- Department of Pathology, Faculty of Veterinary Sciences, Selcuk University, Konya, Turkey
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Geerts JH, de Haas JWA, Nieuwenhuijs VB. Lessons learned from revision procedures: a case series pleading for reinforcement of the anterior hiatus in recurrent hiatal hernia. Surg Endosc 2024:10.1007/s00464-024-10703-3. [PMID: 38565689 DOI: 10.1007/s00464-024-10703-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/16/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Hiatal Hernia (HH) is a common structural defect of the diaphragm. Laparoscopic repair with suturing of the hiatal pillars followed by fundoplication has become standard practice. In an attempt to lower HH recurrence rates, mesh reinforcement, commonly located at the posterior site of the esophageal hiatus, has been used. However, effectiveness of posterior mesh augmentation is still up to debate. There is a lack of understanding of the mechanism of recurrence requiring further investigation. We investigated the anatomic location of HH recurrences in an attempt to assess why HH recurrence rates remain high despite various attempts with mesh reinforcement. METHODS A retrospective case series of prospectively collected data from patients with hiatal hernia repair between 2012 and 2020 was performed. In total, 54 patients with a recurrent hiatal hernia operation were included in the study. Video clips from the revision procedure were analyzed by a surgical registrar and senior surgeon to assess the anatomic location of recurrent HH. For the assessment, the esophageal hiatus was divided into four equal quadrants. Additionally, patient demographics, hiatal hernia characteristics, and operation details were collected and analyzed. RESULTS 54 patients were included. The median time between primary repair and revision procedure was 25 months (IQR 13-95, range 0-250). The left-anterior quadrant was involved in 43 patients (80%), the right-anterior quadrant in 21 patients (39%), the left-posterior quadrant in 21 patients (39%), and the right-posterior quadrant in 10 patients (19%). CONCLUSION In this study, hiatal hernia recurrences occured most commonly at the left-anterior quadrant of the hiatus, however, posterior recurrences were not uncommon. Based on our results, we hypothesize that both posterior and anterior hiatal reinforcement might be a suitable solution to lower the recurrence rate of hiatal hernia. A randomized controlled trial using a circular, bio-absorbable mesh has been initiated to test our hypothesis.
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Dabora AA, Nogoud A, Abdulsakhi M, Rafei A, Khalifa HA. Jejunal angiodysplasia: surgery can be life-saving - a case report. Ann Med Surg (Lond) 2024; 86:2204-2207. [PMID: 38576924 PMCID: PMC10990319 DOI: 10.1097/ms9.0000000000001799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/26/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Angiodysplasia, a rare cause of gastrointestinal (GI) bleeding, presents a spectrum of clinical manifestations from anemia to life-threatening hemorrhage. This case study emphasizes the significance of considering intestinal vascular malformations as a differential diagnosis, especially in the context of chronic anemia and GI bleeding. Jejunal angiodysplasia, though infrequent, poses diagnostic challenges due to the hidden nature of the small bowel in the GI system. Case presentation A 23-year-old male presented with acute hematochezia and melena, necessitating prompt intervention. Despite a normal esophagogastroduodenoscopy, colonoscopy was hindered, CT angiography could not be performed due to the patient's unstable condition, leading to a planned exploratory laparotomy. Surgical exploration revealed a mucosal vascular lesion in the jejunum, prompting resection, and anastomosis. The patient's postoperative course was uneventful, reinforcing the importance of swift diagnosis and intervention. Clinical discussion Angiodysplasia's pathogenesis remains unclear, with hypotheses implicating vascular endothelial growth factor and submucosal changes. Challenges in management revolve around lesion localization and stabilizing hemodynamics, necessitating a multidisciplinary approach. While endoscopy is often diagnostic and therapeutic, advanced modalities such as CT angiography may be required. Literature review highlights diverse presentations and successful interventions, including embolization and surgical resection. Conclusion Jejunal angiodysplasia demands a comprehensive diagnostic and therapeutic strategy. The presented case underscores the pivotal role of endoscopy, embolization, and surgery in managing this condition. Timely diagnosis and intervention are crucial for mitigating the impact of angiodysplasia, necessitating further research and collaborative efforts for improved management of this rare condition.
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Affiliation(s)
| | | | | | - Ahmed Rafei
- Department of Research, National Center for Gastroenterology and Liver Disease, Khartoum, Sudan
| | - Hossam A. Khalifa
- General Surgery, Hepatobiliary Department, Ibn Sina Specialized Hospital
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Zeer ZMM, Noman M, Zeer AMM, Mahamid YH, Arafat H, Abomoch M, Abu Aqeel B. A Rare Case of Concurrent Chromophobe Renal Cell Cancer with Lung Neuroendocrine Tumor: A Case Report and Literature Review. Ann Med Surg (Lond) 2024; 86:2230-2235. [PMID: 38576925 PMCID: PMC10990380 DOI: 10.1097/ms9.0000000000001841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/25/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Multiple primary malignancies (MPM) may be in one organ or in multiple separate organs. They are categorized into synchronous and metachronous according to the time interval between the two malignancies. Multiple risk factors could be attributed to the development of second primary malignancy. Case presentation The authors report a case of a 51-year-old male patient with renal cell carcinoma. During his evaluation, he seemed to have a lung mass which revealed to be a carcinoid tumour. As the patient had two primary malignancies, he was managed according to the treatment options for each tumour. Discussion Although MPMs have been reported increasingly in the past decade, overall incidence is still very rare. Appropriate management and survival depend on distinguishing between dual primary tumours from metastatic disease. Conclusion Multidisciplinary approach is very crucial for diagnosis and management such rare cases.
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Affiliation(s)
| | | | | | | | - Hasan Arafat
- Medical Resident at Augusta Victoria Hospital, Jerusalem, Palestine
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Nakamura S, Ozeki M, Hayashi D, Yasue S, Endo S, Ohnishi H. Sirolimus monotherapy for Kasabach-Merritt phenomenon in a neonate; Case report. Int J Surg Case Rep 2024; 117:109497. [PMID: 38518465 PMCID: PMC10972789 DOI: 10.1016/j.ijscr.2024.109497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/24/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE The Kasabach-Merritt Phenomenon (KMP), characterized by thrombocytopenia and consumptive coagulopathy due to endothelial cell growth in the infantile vascular tumor kaposiform hemangioendothelioma, presents a therapeutic challenge. This case highlights the novel use of sirolimus in a neonate, an approach less explored in this age group. CASE PRESENTATION A female neonate presented with a right anterior chest mass, progressing to respiratory distress and congestive heart failure. Diagnosed with KMP, she exhibited low platelet count and coagulation abnormalities. Treatment with sirolimus (0.06 mg/day) led to mass reduction, improved bleeding, and a stable tumor after 12 months, without side effects. This case contrasts with existing literature advocating for combination therapy or higher sirolimus concentrations for effective treatment. Yet, our patient achieved favorable outcomes with low-dose monotherapy, suggesting a potentially safer approach in neonates with immature hepatic and renal metabolism. CLINICAL DISCUSSION This case demonstrates the efficacy of low-dose sirolimus monotherapy in treating KMP in a neonate, challenging current preferences for combination therapies or higher doses. It emphasizes the need for further research into age-specific treatment protocols in KMP, considering the unique metabolic profiles of neonates and infants. CONCLUSION Sirolimus has demonstrated potential in treating KMP in pediatric patients. While initial results are promising, determining optimal dosages and trough concentrations, especially in neonates and infants, remains essential.
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Affiliation(s)
- Shoji Nakamura
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Michio Ozeki
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan.
| | - Daichi Hayashi
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Shiho Yasue
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Saori Endo
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Hidenori Ohnishi
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
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Nagashima F, Inoue S, Oda T, Hamagami T, Matsuda T, Kobayashi M, Inoue A, Hifumi T, Sakamoto T, Kuroda Y. Optimal chest compression for cardiac arrest until the establishment of ECPR: Secondary analysis of the SAVE-J II study. Am J Emerg Med 2024; 78:102-111. [PMID: 38244243 DOI: 10.1016/j.ajem.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 01/22/2024] Open
Abstract
INTRODUCTION The widespread incorporation of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest requires the delivery of effective and high-quality chest compressions prior to the initiation of ECPR. The aim of this study was to evaluate and compare the effectiveness of mechanical and manual chest compressions until the initiation of ECPR. METHODS This study was a secondary analysis of the Japanese retrospective multicenter registry "Study of Advanced Life Support for Ventricular Fibrillation by Extracorporeal Circulation II (SAVE-J II)". Patients were divided into two groups, one receiving mechanical chest compressions and the other receiving manual chest compressions. The primary outcome measure was mortality at hospital discharge, while the secondary outcome was the cerebral performance category (CPC) score at discharge. RESULTS Of the 2157 patients enrolled in the SAVE-J II trial, 453 patients (329 in the manual compression group and 124 in the mechanical compression group) were included in the final analysis. Univariate analysis showed a significantly higher mortality rate at hospital discharge in the mechanical compression group compared to the manual compression group (odds ratio [95% CI] = 2.32 [1.34-4.02], p = 0.0026). Multivariate analysis showed that mechanical chest compressions were an independent factor associated with increased mortality at hospital discharge (adjusted odds ratio [95% CI] = 2.00 [1.11-3.58], p = 0.02). There was no statistically significant difference in CPC between the two groups. CONCLUSION For patients with out-of-hospital cardiopulmonary arrest who require ECPR, extreme caution should be used when performing mechanical chest compressions.
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Affiliation(s)
- Futoshi Nagashima
- Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital, Hyogo, Japan.
| | | | - Tomohiro Oda
- Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital, Hyogo, Japan.
| | - Tomohiro Hamagami
- Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital, Hyogo, Japan.
| | - Tomoya Matsuda
- Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital, Hyogo, Japan.
| | - Makoto Kobayashi
- Emergency Medical Center, Tottori Prefectural Central Hospital, Tottori, Japan.
| | - Akihiko Inoue
- Hyogo Emergency Medical Center, Department of Emergency and Critical Care Medicine, Hyogo, Japan.
| | - Toru Hifumi
- St. Luke's International Hospital, Department of Emergency and Critical Care Medicine, Tokyo, Japan.
| | - Tetsuya Sakamoto
- Teikyo University School of Medicine, Department of Emergency Medicine, Tokyo, Japan.
| | - Yasuhiro Kuroda
- Kagawa University Hospital, Department of Emergency, Disaster and Critical Care Medicine, Kagawa, Japan.
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Pilioneta M, Chen HH, Losito E, Bourgeois M, Chémaly N, Eiserman M, Guida L, Dangouloff-Ros V, Fumagalli L, Kaminska A, Boddaert N, Auvin S, Nabbout R, Sainte-Rose C, Blauwblomme T. Interhemispheric Vertical Hemispherotomy: Technique, Outcome, and Pitfalls-A Bicentric Retrospective Case Series of 39 Cases. Oper Neurosurg (Hagerstown) 2024; 26:413-422. [PMID: 37994857 DOI: 10.1227/ons.0000000000000992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/23/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES When seizure onset affects a whole hemisphere, hemispheric disconnections are efficient and safe procedures. However, both lateral peri-insular hemispherotomy and vertical paramedian hemispherotomy approaches report a failure rate around 20%, which can be explained by residual connections giving rise to persistent seizures. In this study, we present the interhemispheric vertical hemispherotomy (IVH), a technical variation of the vertical paramedian hemispherotomy approach, that aims to increase seizure control avoiding residual connections while exposing the corpus callosum. METHODS This is a retrospective study of IVH in two centers, with analysis of clinical and MRI data and outcomes. A detailed description of the technique is provided with a video. RESULTS IVH was performed in 39 children. The mean age at surgery was 7.2 years, and etiologies were as follows: malformations of cortical development (n = 14), Rasmussen's encephalitis (n = 10), stroke (n = 10), post-traumatic (3), and Sturge-Weber Syndrome (2). Hemispheric disconnection was complete on postoperative MRI in 34 cases. There was no mortality, hydrocephalus occurred in one case, and subdural collection occurred in four cases. A second surgery was performed in four cases because of seizure relapse (n = 3) and/or incomplete disconnection on MRI (n = 4). With a mean follow-up of 3.2 years, International League Against Epilepsy class I epilepsy outcome was obtained for 37/39 patients. CONCLUSION IVH is a safe and effective variation of the vertical approaches for hemispheric disconnection. It allows a good exposure and anatomic control of the corpus callosum, which is a frequent site of incomplete disconnection. IVH may be limited by the thalamic volume and the ventricular size, notably in hemimegalencephaly cases.
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Affiliation(s)
- Martin Pilioneta
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
| | | | - Emma Losito
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
| | - Marie Bourgeois
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
| | - Nicole Chémaly
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
| | - Monika Eiserman
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
| | - Lelio Guida
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
- Université de Paris Cité, Paris , France
| | - Volodia Dangouloff-Ros
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
- Université de Paris Cité, Paris , France
| | - Luca Fumagalli
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
| | - Anna Kaminska
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
| | - Nathalie Boddaert
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
- Université de Paris Cité, Paris , France
| | - Stéphane Auvin
- Université de Paris Cité, Paris , France
- Hôpital Robert Debré, Assistance Publique Hôpitaux de Paris, Paris , France
| | - Rima Nabbout
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
- Université de Paris Cité, Paris , France
| | | | - Thomas Blauwblomme
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris , France
- Université de Paris Cité, Paris , France
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Mattioni G, Orlandi R, Rubino B, Garatti A, Pastorino U. An unusual case of recurrent haemoptysis after ablation for atrial fibrillation requiring pneumonectomy: a case report. Eur Heart J Case Rep 2024; 8:ytae140. [PMID: 38572018 PMCID: PMC10990059 DOI: 10.1093/ehjcr/ytae140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/31/2023] [Accepted: 03/14/2024] [Indexed: 04/05/2024]
Abstract
Background Pulmonary vein (PV) stenosis is a rare complication after catheter ablation for atrial fibrillation (AF). While there have been reported anecdotal cases of complete PV stenosis requiring pulmonary lobectomy, only one case of pneumonectomy has been documented so far. Case summary A 42-year-old man was referred to our Thoracic Surgery Unit for recurrent haemoptysis and exertional dyspnoea over the past 4 years and a recent finding of left PV occlusion. He suffered of relapsing AF that had almost five recurrences and that underwent a total of two percutaneous catheter ablations within a 7-year period. He also experienced a hospitalization for multifocal lobar pneumonia. Two attempts of percutaneous transluminal angioplasty (PTA) were unsuccessful. Due to the severity and the duration of PV occlusion, the previous PTA failure, the patient's age, and his symptoms, a left pneumonectomy was performed. During the postoperative period, the patient experienced only mild anaemia effectively managed with blood transfusions. Five months after surgery, he has no recurrence of symptoms. Discussion When the PV stenosis is complete, PTA may face high failure and recurrence rates. In this setting, anatomical pulmonary resections may represent a valid option to allow symptom relief and resolution.
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Affiliation(s)
- Giovanni Mattioni
- Thoracic Surgery Unit, IRCCS National Cancer Institute of Milan, Via Giacomo Venezian, 1, 20133 Milano, MI, Italy
- School of Thoracic Surgery, University of Milan, Via Festa del Perdono, 7, 20122 Milano, MI, Italy
| | - Riccardo Orlandi
- Thoracic Surgery Unit, IRCCS National Cancer Institute of Milan, Via Giacomo Venezian, 1, 20133 Milano, MI, Italy
- School of Thoracic Surgery, University of Milan, Via Festa del Perdono, 7, 20122 Milano, MI, Italy
| | - Barbara Rubino
- Pathology and Cytology Unit, IRCCS Galeazzi-Sant’Ambrogio Hospital, Via Cristina Belgioioso, 173, 20157 Milano, MI, Italy
| | - Andrea Garatti
- Cardiac Surgery Unit, IRCCS Policlinico San Donato, Piazza Edmondo Malan, 2, 20097 San Donato Milanese, MI, Italy
| | - Ugo Pastorino
- Thoracic Surgery Unit, IRCCS National Cancer Institute of Milan, Via Giacomo Venezian, 1, 20133 Milano, MI, Italy
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Abdeljaleel F, Azar J, Ayasa LA, Rabaia D. Kaposi sarcoma-induced immune reconstitution syndrome: a case report. Ann Med Surg (Lond) 2024; 86:2242-2247. [PMID: 38576974 PMCID: PMC10990315 DOI: 10.1097/ms9.0000000000001842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/08/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction and importance Kaposi sarcoma (KS) is an angioproliferative disease, that mostly affects HIV-infected patients with a high viral load and a low CD4 count. In rare cases, the paradoxical worsening of a pre-existing or previously unrecognized opportunistic infection occurs in a phenomenon known as immune reconstitution inflammatory response (IRIS). Case presentation The authors presented a male patient in his 30s with HIV, who developed a series of complications caused by KS following the initiation of antiretroviral therapy. Despite ongoing antiretroviral therapy (ART), chemotherapy, and supportive measures, the patient developed KS-related IRIS, characterized by rapid clinical deterioration, multiorgan failure, and ultimately succumbed to the disease. Clinical discussion To the best of our knowledge, very rare cases have been reported with KS-IRIS after the initiation of ART. Many predictors of KS-IRIS development have been identified. Patients must meet the known diagnostic criteria to be diagnosed with IRIS. The treatment of KS-IRIS depends on the stage of KS. ART alone is usually adequate in mild cutaneous KS. Chemotherapy and ART are recommended for patients with severe cutaneous and visceral KS. Conclusion HIV patients with KS undergoing ART initiation or modification should be closely monitored, particularly during the early stages and in those with extensive disease. Treating opportunistic infections before ART initiation may reduce the risk of KS-IRIS. The increasing prevalence of KS in ART-treated patients with HIV warrants further attention and highlights the need for better management strategies in this population.
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Affiliation(s)
| | - Jehad Azar
- Mayo Clinic Health System, Cleveland, Ohio
| | | | - Dima Rabaia
- Faculty of Medicine and Health Science, An-Najah National University, Nablus, Palestine
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Díaz-Martínez J, Hizojo-Aloé FT, Rivera-Chávez RJ, González-Hernández NA. Misdiagnosed superior mesenteric artery syndrome due to diabetic gastroparesis. Case report and literature review. Int J Surg Case Rep 2024; 117:109543. [PMID: 38513416 PMCID: PMC10966178 DOI: 10.1016/j.ijscr.2024.109543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION Superior mesenteric artery syndrome (SMAS) is a rare cause of upper intestinal obstruction. This occurs due to duodenal compression between the superior mesenteric artery and the aorta. Anatomical alterations, eating disorders, after some surgical procedures, and trauma are frequent causes of this rare syndrome. Diabetes is a highly prevalent disease that can cause gastroparesis in up to 12 %. Its association with SMAS is extremely rare and challenging to identify. CASE PRESENTATION A 32-year-old man experienced nausea and vomiting after diagnosis and treatment for type II diabetes. He was treated for diabetic gastroparesis for 2 years without improvement until he lost 40 kg of weight. After imaging studies, a distance between the superior mesenteric artery and the aorta of 5.3 mm and an angle of 17 degrees were detected, corroborating the diagnosis of SMAS syndrome. Due to medical failure, surgical treatment via duodenojejunostomy was performed. DISCUSSION Diabetes is a very prevalent disease in the world population that can cause gastrointestinal symptoms. In our patient, diabetic gastroparesis delayed the diagnosis of SMAS until severe symptoms of upper intestinal obstruction and significant weight loss occurred. In our patient, due to medical failure, surgical treatment significantly improved his symptoms and stopped his weight loss. CONCLUSION Superior mesenteric artery syndrome is a rare syndrome, and challenging to differentiate from diabetic gastroparesis. Delays in management may result in excessive weight loss. Surgical treatment can improve symptoms and weight loss.
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Affiliation(s)
- Jair Díaz-Martínez
- General Surgery Service, High Specialty Regional Hospital "Centenario de la Revolución Mexicana" ISSSTE, Morelos, México.
| | - Francisco Tomás Hizojo-Aloé
- General Surgery Service, High Specialty Regional Hospital "Centenario de la Revolución Mexicana" ISSSTE, Morelos, México
| | - Renata Jimena Rivera-Chávez
- General Surgery Service, High Specialty Regional Hospital "Centenario de la Revolución Mexicana" ISSSTE, Morelos, México
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Soh GT, Ndong A, Diallo AC, Tendeng JN, Diao ML, Konate I. Bezoar in Meckel's diverticulum: Case report and narrative review. Int J Surg Case Rep 2024; 117:109512. [PMID: 38471214 PMCID: PMC10945273 DOI: 10.1016/j.ijscr.2024.109512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/01/2024] [Accepted: 03/07/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION Bezoars are a known cause of complications in Meckel's diverticulum. We present a case in which a bezoar in a Meckel's diverticulum resulted in intestinal obstruction. In addition, we conducted a narrative review to explore the association between Meckel's diverticulum and bezoars. CASE PRESENTATION We present the case of a 22-year-old patient admitted for bowel obstruction persisting for three days and periumbilical tenderness. Abdominal CT tomography revealed a hyper dense circular structure with a diameter of 2 cm, small bowel distension of 41 mm, and free fluid. During surgical exploration, a Meckel diverticulum was found between the antimesenteric border of the small bowel and posterior wall of the umbilicus. The Meckel diverticulum was resected, and upon examination, it was found to contain a calcified phytobezoar. The postoperative course was uneventful. DISCUSSION The clinical and paraclinical presentation of bezoars in Meckel's diverticulum is nonspecific and diagnosis remains challenging despite improved diagnostic modalities. The association between Meckel's diverticulum and bezoars is often identified during surgery, as it is difficult to diagnose using CT scans. The choice between laparoscopic and open surgery depends on the patient's situation. CONCLUSION Diagnosing a bezoar in a Meckel's diverticulum remains challenging. Treatment involves surgery, and the choice of surgical approach depends on the context.
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Affiliation(s)
| | | | | | | | | | - Ibrahima Konate
- Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
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Pu LY, Li Z, Huang F, Li L, Ma Y, Ma M, Hu S, Wu Z. Efficient synthesis of novel colchicine-magnolol hybrids and evaluation of their inhibitory activity on key proteases of 2019-nCoV replication and acute lung injury. Nat Prod Res 2024; 38:1238-1247. [PMID: 36302171 DOI: 10.1080/14786419.2022.2138870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 10/31/2022]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCoV), is a life-threatening infectious condition. Acute lung injury is a common complication in patients with COVID-19. 3-chymotrypsin-like protease (3CLpro) of 2019-nCoV and neutrophil elastase are critical targets of COVID-19 and acute lung injury, respectively. Colchicine and magnolol are reported to exert inhibitory effects on inflammatory response, the severe comorbidity in both COVID-19 and acute lung injury. We thus designed and synthesized a series of novel colchicine-magnolol hybrids based on a two-step synthetic sequence. It was found that these novel hybrids provided unexpected inhibition on 3CLpro and neutrophil elastase, a bioactivity that colchicine and magnolol did not possess. These findings not only provide perquisites for further in vitro and in vivo investigation to confirm the therapeutic potentiality of novel colchicine-magnolol hybrids, but also suggest that the concurrent inhibition of 3CLpro and neutrophil elastase may enable novel colchicine-magnolol hybrids as effective multi-target drug compounds.
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Affiliation(s)
| | - Zhiyue Li
- Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Shenzhen Institute of Geriatrics, Shenzhen, China
| | - Feijuan Huang
- Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Shenzhen Institute of Geriatrics, Shenzhen, China
| | - Limin Li
- Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Shenzhen Institute of Geriatrics, Shenzhen, China
| | - Yucui Ma
- Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Shenzhen Institute of Geriatrics, Shenzhen, China
| | - Min Ma
- Integrated Chinese and Western Medicine Postdoctoral Research Station, Jinan University, Guangzhou, China
| | - Shengquan Hu
- Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Shenzhen Institute of Geriatrics, Shenzhen, China
| | - Zhengzhi Wu
- Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Shenzhen Institute of Geriatrics, Shenzhen, China
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Bzeih W, Kbar M, Rihan O. Congenital single kidney in tuberous sclerosis complex (Bourneville disease). Ann Med Surg (Lond) 2024; 86:2158-2161. [PMID: 38576950 PMCID: PMC10990388 DOI: 10.1097/ms9.0000000000001834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/05/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Bournevile disease is a rare global condition that presents a diagnostic challenge due to its diverse multisystemic involvement. Case presentation This report presents the case of a 14-year-old male with a medical history of congenital single kidney, heart rate abnormalities, Bournevile disease with cognitive deficits, brain lesions, and dermatological features. The patient presented with sudden onset renal angiolipomatosis, and the diagnosis was based on specific computed tomography (CT) findings. Despite having these complex medical conditions, the patient had never been admitted to the hospital since infancy, and treatment was limited to surveillance only. Clinical discussion Bourneville disease is a multisystemic disease that affects several organ systems within the human body and thus demands multidisciplinary approach in the treatment and follow-up options. Conclusion This case report highlights Bournevile disease in a patient with a congenital single kidney, a rare finding that further complicates the disease. It emphasises the importance of recognising and managing this condition to ensure appropriate care for affected individuals.
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Affiliation(s)
- Wafaa Bzeih
- Faculty of Medical Sciences, Lebanese University, Hadath
| | - Mohammad Kbar
- Faculty of Medical Sciences, Lebanese University, Hadath
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Muzembo BA, Kitahara K, Ohno A, Khatiwada J, Dutta S, Miyoshi SI. Vibriosis in South Asia: A systematic review and meta-analysis. Int J Infect Dis 2024; 141:106955. [PMID: 38311027 DOI: 10.1016/j.ijid.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/04/2024] [Accepted: 01/29/2024] [Indexed: 02/06/2024] Open
Abstract
OBJECTIVES South Asia remains home to foodborne diseases caused by the Vibrio species. We aimed to compile and update information on the epidemiology of vibriosis in South Asia. METHODS For this systematic review and meta-analysis, we searched PubMed, Web of Science, EMBASE, and Google Scholar for studies related to vibriosis in South Asia published up to May 2023. A random-effects meta-analysis was used to estimate the pooled isolation rate of non-cholera-causing Vibrio species. RESULTS In total, 38 studies were included. Seven of these were case reports and 22 were included in the meta-analysis. The reported vibriosis cases were caused by non-O1/non-O139 V. cholerae, V. parahaemolyticus, V. fluvialis, and V. vulnificus. The overall pooled isolation rate was 4.0% (95% confidence interval [CI] 3.0-5.0%) in patients with diarrhea. Heterogeneity was high (I2 = 98.0%). The isolation rate of non-O1/non-O139 V. cholerae, V. parahaemolyticus, and V. fluvialis were 9.0 (95% CI 7.0-10.0%), 1.0 (95% CI 1.0-2.0%), and 2.0 (95% CI: 1.0-3.0%), respectively. Regarding V. parahaemolyticus, O3:K6 was the most frequently isolated serotype. Cases peaked during summer. Several studies reported antibiotic-resistant strains and those harboring extended-spectrum beta-lactamases genes. CONCLUSIONS This study demonstrates a high burden of infections caused by non-cholera-causing Vibrio species in South Asia.
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Affiliation(s)
- Basilua Andre Muzembo
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
| | - Kei Kitahara
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan; Collaborative Research Centre of Okayama University for Infectious Diseases in India at ICMR-NICED, Kolkata, India
| | - Ayumu Ohno
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan; Collaborative Research Centre of Okayama University for Infectious Diseases in India at ICMR-NICED, Kolkata, India
| | | | - Shanta Dutta
- Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shin-Ichi Miyoshi
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Calvanese F, Auricchio AM, Vasankari V, Raj R, Gallè CLC, Niemelä M, Lehecka M. Digital 3D Exoscope is Safe and Effective in Surgery for Intradural Extramedullary Tumors: A Comparative Series. World Neurosurg 2024; 184:e1-e8. [PMID: 38307199 DOI: 10.1016/j.wneu.2024.01.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Digital 3D exoscopes have been shown to be comparably safe and effective as surgical microscopes in complex microneurosurgical procedures. However, the results of exoscopic spinal tumor surgeries are scarce. The purpose of this study is to compare results of a transition from microscope to exoscope in surgeries for spinal intradural extramedullary tumors. METHODS We included all consecutive patients with intradural extramedullary spinal tumors operated on by the senior author during January 2016 to October 2023. The 3D exoscope was used in the latter half of the series from November 2020. We evaluated pre- and postoperative clinical findings, imaging studies, intra- and postoperative events, and analyzed surgical videos from the operations retrospectively. RESULTS We operated 35 patients (exoscope n = 19, microscope n = 16) for intradural extramedullary tumors (meningioma n = 18, schwannoma n = 12, other n = 5). Tumors in the cervical and thoracic spine were more common than in the lumbar region. The duration of surgery was slightly longer (median 220 vs. 185 minutes) in the exoscope group. However, the rate of gross total resection of the tumor was higher (81% vs. 67%) and the tumors more often located anteriorly to the spinal cord (42% vs. 13%) in the exoscope group. No major complications (i.e., permanent motor deficit or postoperative hematoma) occurred in either group. We saw postoperative gait improvement in 81% and 85% of the patients with preoperative deterioration of gait after exoscopic and microscopic surgeries, respectively. CONCLUSIONS This study demonstrates that exoscope-assisted surgery for spinal intradural extramedullary tumors is comparable in safety and effectiveness to traditional microscopic surgery.
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Affiliation(s)
- Francesco Calvanese
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna Maria Auricchio
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Ville Vasankari
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Rahul Raj
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Mika Niemelä
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Martin Lehecka
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Ghimire S, Simkhada S, Thapa S, Ghising K. Alstrom syndrome with classical findings: a rare case report of monogenic ciliopathy co-occurrence in twins. Ann Med Surg (Lond) 2024; 86:2218-2224. [PMID: 38576930 PMCID: PMC10990414 DOI: 10.1097/ms9.0000000000001796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/24/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction and importance Alstrom syndrome is one of the rarest monogenic ciliopathy belonging to autosomal recessive disorder. The pathophysiology of Alstrom syndrome is not well understood but based upon the available medical literature its mechanism can be linked with recessive mutation in Alstrom syndrome 1(ALSM1) gene resulting in various multiple organ involvement and poor prognosis. Moreover the co-occurrence of such syndrome simultaneously in twins in same period of time is considered rare. Case presentation Monochorionic diamniotic twins male born to healthy parents with significant antenatal and natal history along with decreased vision in both eyes in both twins since neonatal period. Throughout the childhood the disease progressed without any confirmatory diagnosis during which the twins underwent simultaneous multiple systemic involvement such as legal blindness in both twins at the age of 11 years, insulin resistance and features of diabetes mellitus, sensorineural hearing loss, subclinical hypothyroidism and various deranged metabolic panels. Certain diagnosis of Alstrom syndrome was made at the age of 16 years in both twins after whole-exome sequencing. Clinical discussion Based on genetic profile alstrom syndrome is a unique diagnosis. Along with its multi-organ involvement features, its progression and prognosis should also be looked upon while diagnosis and management in such syndromic patients. The diagnostic delay in such cases is also a matter of concern which can result in further delay in halting adverse effects of the disease itself. The multidisciplinary approach with involvement of endocrionologist, ophthalmologist and audiologist can bring upon improvement in quality of life of the patients. Conclusion With the prevalence of 1 in million cases Alstrom Hallgren syndrome is one of the rare genetic disorder with poor prognosis. In our case we present classical findings in twins who were diagnosed as Alstrom syndrome concurrently and further diseases progressed simultaneously.
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Affiliation(s)
| | - Suman Simkhada
- Internal Medicine, KIST Medical College and Teaching Hospital, Gwarko, Lalitpur, Nepal
| | - Samir Thapa
- Internal Medicine, KIST Medical College and Teaching Hospital, Gwarko, Lalitpur, Nepal
| | - Kiran Ghising
- Internal Medicine, KIST Medical College and Teaching Hospital, Gwarko, Lalitpur, Nepal
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Thapa BR, katwal S. Intracranial osteochondroma arising from the posterior clinoid process: a rare case report with diagnostic challenges and comprehensive literature review. Ann Med Surg (Lond) 2024; 86:2352-2356. [PMID: 38576951 PMCID: PMC10990327 DOI: 10.1097/ms9.0000000000001855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/12/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction and importance Intracranial osteochondroma is rare, presenting diagnostic challenges due to overlapping imaging findings with other pathologies. This case report highlights the significance of considering osteochondroma in calcified tumour differentials near bone. Case presentation A 34-year-old man with vision deterioration and headaches had an MRI revealing a suprasellar lesion. Intraoperatively, a bony hard tumour was partially resected. Subsequent computed tomography (CT) confirmed a calcified mass contiguous with the posterior clinoid. Clinical discussion Reviewing 28 cases, skull base osteochondromas were common, with differential diagnoses including craniopharyngioma and meningioma. Surgical decision-making involved balancing complete resection for convexity and falx cases versus partial resection for skull base tumours due to proximity to critical structures. Conclusion Intracranial osteochondroma poses diagnostic challenges, especially near bone. Tailored surgical approaches are vital, with complete resection yielding good outcomes for convexity and falx cases. Close follow-up is crucial for monitoring recurrences and complications.
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Affiliation(s)
| | - Shailendra katwal
- Department of Radiology, Dadeldhura Subregional Hospital, Dadeldhura, Nepal
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Romero-Marcos JM, Sampson-Dávila JG, Cuenca-Gómez C, Altet-Torné J, González-Abós S, Ojeda-Jiménez I, Galaviz-Sosa ML, Delgado-Rivilla S. Colorectal procedures with the novel Hugo™ RAS system: training process and case series report from a non-robotic surgical team. Surg Endosc 2024; 38:2160-2168. [PMID: 38448626 DOI: 10.1007/s00464-024-10760-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/16/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND The landscape of robotic surgery is evolving with the emergence of new platforms. However, reports on their applicability in different surgical fields are still limited and come from teams with robotics experience. This study aims to describe the training process for colorectal surgery with the Hugo™ RAS system of a robotics-inexperienced surgical team and present the initial patient series. METHODS The training process is depicted, and data from the first 10 consecutive patients operated on for colorectal conditions with the Hugo™ RAS system by a surgical team with no prior experience in robotic surgery were prospectively recorded and analysed. RESULTS The team received intensive training in robotic surgery and specifically in the Hugo™ RAS system previously to the first case. Between May 2023 and December 2023, 10 patients underwent colorectal procedures: 5 right colectomies, 3 sigmoid resections, 1 high rectal resection and 1 ventral mesh rectopexy. The first case was proctored by an expert. Median docking time was 14 min and median total operative time was 185 min. The only technical difficulty during the procedures was occasional clashing of robotic arms. None had to be converted, and no intraoperative or postoperative morbidity was recorded. Hospital stays ranged from 2 to 4 days. A median of 21 lymph nodes were yielded in the operations for malignant conditions. CONCLUSIONS Common colorectal procedures can be safely performed using the Hugo™ RAS platform. Prior experience in robotic surgery is not a necessary requirement, but following a structured training program is essential.
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Affiliation(s)
- Juan-Manuel Romero-Marcos
- Department of General Surgery, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain.
- , Plaça del Doctor Robert, 5, 08221, Terrassa, Barcelona, Spain.
| | | | - Carlota Cuenca-Gómez
- Department of General Surgery, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Juan Altet-Torné
- Department of General Surgery, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Sandra González-Abós
- Department of General Surgery, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Iris Ojeda-Jiménez
- Department of General Surgery, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
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Gomes FH, Fonseca MDF, Favorito LA, Gasparoni MP, da Silva Filho FS, Diniz ALL, de Resende Júnior JAD. Changes in lower urinary tract function after minimally invasive nerve-sparing for complete excision of endometriosis: An observational study. Neurourol Urodyn 2024; 43:862-873. [PMID: 38497524 DOI: 10.1002/nau.25414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/04/2024] [Accepted: 01/24/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES The objective of this paper is to evaluate changes in lower urinary tract symptoms (LUTS), severity of pain and urodynamic parameters after minimally invasive nerve-sparing surgery for patients with endometriosis. METHODS We analyzed 143 patients undergoing minimally invasive nerve-sparing surgery for endometriosis excision (laparoscopy/robot-assisted). The endometriosis was confirmed by preoperative clinical evaluation, magnetic resonance imaging (MRI) showing at least one lesion deeper than 5 mm, and histological confirmation after laparoscopy. We evaluated three points prior and after surgery: LUTS parameters according to the International Urogynecological Association; urodynamic measures of storage and voiding and the severity of the dyspareunia, dyschezia and dysmenorrhea assessed on a self-reported 11-point numeric rating scale. The Wilcoxon signed rank and McNemar tests were used for statistical analyses (p < 0.05). RESULTS We observed significant improvements in LUTS after the surgery with postoperative symptom-free probabilities in urgency (64.5%), daytime frequency (38.5%), and dysuria (87.1%). However, slow stream prevalence increased significantly postsurgery (p = 0.022), with a 20.5% risk of asymptomatic patients developing this symptom. Urodynamic responses varied; for instance, maximum cystometric capacity improved significantly (p = 0.004), while postvoiding residual worsened (p = 0.006). Significant worsening in postvoiding residual occurred in women with normal preoperative values (p = 0.002), with a 17.7% risk of normal values becoming abnormal. Compliance or maximum cystometric capacity not considered normal preoperatively showed significant improvements (p < 0.001), but the risk of normal values becoming abnormal after surgery was 14.5%. CONCLUSION The minimally invasive nerve-sparing surgery for endometriosis excision shows improvement in lower urinary tract symptoms, urodynamics parameters and severity of pain. The majority of patients became asymptomatic in the postoperative period. When compared to the benefits of the patients' surgical treatment, particularly when considering the reduction of pain, the risks of the lower urinary tract treatment seem to be acceptable. The surgical intervention seems to be a safe alternative in patients with endometriosis, although studies with larger samples are needed to confirm these findings.
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Affiliation(s)
- Fernanda Hack Gomes
- Hospital Federal da Lagoa and Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luciano Alves Favorito
- Hospital Federal da Lagoa and Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - André Luiz Lima Diniz
- Hospital Federal da Lagoa and Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Wang AJ, Lee CK, Blanch M, Talati PA, Gray ST, Bleier BS, Scangas GA, Holbrook EH, Curry WT. Endoscopic endonasal approach for olfactory groove meningioma resection: Strategies and outcomes in a retrospective case series. J Clin Neurosci 2024; 122:93-102. [PMID: 38492512 DOI: 10.1016/j.jocn.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/20/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE Though the endoscopic endonasal approach (EEA) is a widely accepted treatment for skull base tumors, the specific use of EEA for olfactory groove meningiomas (OGMs) is debated, with variable outcomes reported in the literature. We review the surgical results of OGM resections for one surgeon including the operative approach, surgical nuances, and outcomes, with a focus on factors relating to patient selection which favor EEA over transcranial approaches. METHODS We retrospectively reviewed thirteen cases of endoscopic endonasal resection of olfactory groove meningiomas. Patient characteristics, clinical characteristics, surgical outcomes, and complications were analyzed. Extent of resection was determined based on volumetric analysis of pre- and postoperative MRI. RESULTS Anatomic characteristics that render a tumor difficult to access fully are lateral extension beyond the mid-orbit and anterior extension to the falx. Simpson Grade I resection was achieved in 11/13 (84.6 %) cases. Mean pre-operative tumor volume was 8.99 cm3 (range 2.19-16.79 cm3), and 92 % of tumors were WHO grade I. We demonstrate 2 cases of smell preservation, possible with small unilateral tumors and tumors that are confined to either the anterior or posterior portion of the cribriform plate. The post-operative CSF leak rate was 7.7 %, without prophylactic lumbar CSF drainage. The mortality rate was 7.7 % (n = 1) after infectious complications following CSF leak. CONCLUSIONS Endoscopic endonasal resection of olfactory groove meningiomas is an effective and safe operative method with outcomes and complication rates comparable to transcranial approaches. Key considerations include careful patient selection and familiarity with technical nuances of endoscopic endonasal approach for this specific tumor type.
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Affiliation(s)
- Amy J Wang
- Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
| | - Christine K Lee
- Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
| | - Max Blanch
- Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
| | - Pratik A Talati
- Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
| | - Stacey T Gray
- Department of Otolaryngology, Massachusetts Eye and Ear, 243 Charles St., Boston, MA, 02114, USA
| | - Benjamin S Bleier
- Department of Otolaryngology, Massachusetts Eye and Ear, 243 Charles St., Boston, MA, 02114, USA
| | - George A Scangas
- Department of Otolaryngology, Massachusetts Eye and Ear, 243 Charles St., Boston, MA, 02114, USA
| | - Eric H Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear, 243 Charles St., Boston, MA, 02114, USA
| | - William T Curry
- Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
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Hua R, Zhong J, Xian J, Liang Y, Gan Z, Deng S. Perforation of descending colonic cancer as a rare cause of gas gangrene of the lower limb in an 80-year-old female: a case report. J Surg Case Rep 2024; 2024:rjae033. [PMID: 38605695 PMCID: PMC11007638 DOI: 10.1093/jscr/rjae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/14/2024] [Indexed: 04/13/2024] Open
Abstract
Gas gangrene is a rare, severe gas-producing infection that can be related to colorectal cancer. Gas gangrene can be confirmed by radiologic findings and crepitation on touch. Spontaneous gas gangrene can be associated with colorectal cancer. An 80-year-old female complaint about a sudden abdominal pain, accompanied with progressive swelling pain in thigh and fever. Diagnosis based on assessment findings were gas gangrene and descending colonic cancer perforation. Emergency surgery was performed for debridement and drainage, followed by vacuum sealing drainage (VSD) with polyurethane (PU). Two more surgical interventions were given before the colonic tumor surgery. The patient recovered well in the long-term follow-up. This report demonstrates the diagnosis, treatment, and management of a successful case of gas gangrene caused by perforation of descending colonic cancer. Accurate preoperative diagnosis and reasonable use of VSD (PU) material played an important role in the treatment of this case.
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Affiliation(s)
- Ruoyue Hua
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Jun Zhong
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Jianlin Xian
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Yaoqi Liang
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Zilin Gan
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Shoupeng Deng
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
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Luo F, Li M, Chen Y, Song S, Yu H, Zhang P, Xiao C, Lv G, Chen X. Immunosuppressive enzyme-responsive nanoparticles for enhanced accumulation in liver allograft to overcome acute rejection. Biomaterials 2024; 306:122476. [PMID: 38266349 DOI: 10.1016/j.biomaterials.2024.122476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 01/26/2024]
Abstract
Acute rejection is a life-threatening complication after liver transplantation. Immunosuppressants such as tacrolimus are used to inhibit acute rejection of liver grafts in clinic. However, inefficient intragraft accumulation may reduce the therapeutic outcomes of tacrolimus. Here, an enzyme-responsive nanoparticle is developed to selectively enhance the accumulation of tacrolimus in liver allograft through enzyme-induced aggregation to refine immunotherapeutic efficacy of tacrolimus. The nanoparticles are composed of amphiphilic tacrolimus prodrugs synthesized by covalently conjugating tacrolimus and matrix metalloproteinase 9 (MMP9)-cleavable peptide-containing methoxy poly (ethylene glycol) to poly (l-glutamic acid). Upon exposure to MMP9, which is overexpressed in rejected liver allografts, the nanoparticles undergo a morphological transition from spherical micellar nanoparticles to microscale aggregate-like scaffolds. Intravenous administration of MMP9-responsive nanoparticles into a rat model of acute liver graft rejection results in enhanced nanoparticle accumulation in allograft as compared to nonresponsive nanoparticles. Consequently, the MMP9-responsive nanoparticles significantly inhibit intragraft inflammatory cell infiltration and proliferation, maintain intragraft immunosuppressive environment, alleviate graft damage, improve liver allograft function, abate weight loss and prolong recipient survival. This work proves that morphology-switchable enzyme-responsive nanoparticles represent an innovative strategy for selectively enhancing intragraft accumulation of immunosuppressive agents to improve treatment of liver allograft rejection.
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Affiliation(s)
- Feixiang Luo
- General Surgery Center, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, 130021, PR China
| | - Mingqian Li
- General Surgery Center, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, 130021, PR China
| | - Yuguo Chen
- General Surgery Center, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, 130021, PR China
| | - Shifei Song
- General Surgery Center, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, 130021, PR China
| | - Haiyang Yu
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, PR China
| | - Peng Zhang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, PR China.
| | - Chunsheng Xiao
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, PR China.
| | - Guoyue Lv
- General Surgery Center, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, 130021, PR China.
| | - Xuesi Chen
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, PR China
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katwal S, Chataut D, Suwal S, Thapa A, Paudel P, Bhandari S. Post-traumatic jejunal branch of superior mesenteric artery pseudoaneurysm in paediatrics: a compelling case report highlighting early diagnosis and successful endovascular embolization. Ann Med Surg (Lond) 2024; 86:2326-2329. [PMID: 38576984 PMCID: PMC10990360 DOI: 10.1097/ms9.0000000000001856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/12/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction and importance This manuscript underscores the critical significance of prompt diagnosis and intervention in cases of post-traumatic gastroduodenal artery pseudoaneurysms. Such occurrences, particularly in the paediatric population, are rare but potentially life-threatening complications following abdominal trauma, necessitating heightened clinical awareness. Despite their rarity, the devastating consequences of delayed recognition and management emphasize the necessity for advanced imaging modalities and individualized treatment strategies. Case presentation A 17-year-old male presented with severe epigastric pain following a football fall. Despite initial stability, persistent symptoms prompted further investigation. Conventional screening methods proved inconclusive, leading to a contrast-enhanced computed tomography (CT) scan that revealed a jejunal branch of superior mesenteric artery (SMA) pseudoaneurysm. The subsequent fluoroscopy-guided angiography and successful embolization using glue exemplify the importance of timely intervention in such cases. Conclusion This case highlights the importance of early recognition and appropriate intervention in post-traumatic jejunal branch of SMA pseudoaneurysms. The successful outcome achieved through endovascular embolization underscores the necessity for vigilant monitoring and tailored management strategies in similar clinical scenarios.
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Affiliation(s)
- Shailendra katwal
- Department of Radiology, Dadeldhura Subregional Hospital, Dadeldhura
| | | | - Sundar Suwal
- Department of Radiology, Maharajgunj Medical Campus
| | - Ajit Thapa
- Department of Radiology, Maharajgunj Medical Campus
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Hafez AS, Asar MM, Farid S, Abdelsamad A, Hamdy NM. Laparoscopic retroperitoneal lymphadenectomy for ovarian mixed germ cell tumor in a patient with situs inversus totalis; reporting the first case worldwide with literature review and in silico analysis. Pathol Res Pract 2024; 256:155228. [PMID: 38460244 DOI: 10.1016/j.prp.2024.155228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/10/2024] [Accepted: 02/25/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Situs inversus totalis (SIT) is a rare autosomal recessive inheritance at which the abdomino-thoracic organs are mirror-image transposed. Germ cell tumors originate from the primitive germ cell of the ovary and testis. CASE REPORT PRESENTATION A rare association between malignant ovarian mixed germ cell tumor and SIT was presented in a 32-years-old Egyptian female, successfully treated with laparoscopic total abdominal hysterectomy, right salpingo-oophorectomy, and retroperitoneal lymphadenectomy (laparoscopic retroperitoneal lymphadenectomy) of both sides. This case is considered the first of its kind worldwide. CONCLUSION SIT may be associated with malignant ovarian germ cell tumors. Surgical intervention could be done laparoscopically.
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Affiliation(s)
- Ahmed Shoukry Hafez
- Chairman of Surgical Dept. and Head of Minimally Invasive Surgery Unit, Al-Salam Oncology Center, Cairo 11788, Egypt
| | - Mohammed Mamdouh Asar
- Surgical Oncology Dept., Faculty of Medicine, Al-Azhar University, Cairo 11651, Egypt
| | - Sayed Farid
- Senior Registrar of Surgical Oncology, Al-Salam Oncology Center, Cairo 11788, Egypt
| | - Ahmed Abdelsamad
- Head of Robotic Surgery and GIT Surgery, Evangelical Hospital, Lippstadt 59555, Germany
| | - Nadia M Hamdy
- Biochemistry Dept., Faculty of Pharmacy, Ain Shams University, Abassia, Cairo 11566, Egypt.
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Grün P, Pfaffeneder-Mantai F, Schneider B, Meier M, Bytyqi D, Bandura P, Turhani D. Can jaw bone healed from chronic sclerosing osteomyelitis be considered healthy when planning dental implants? Case report with 20-year follow-up. Ann Med Surg (Lond) 2024; 86:2266-2276. [PMID: 38576989 PMCID: PMC10990345 DOI: 10.1097/ms9.0000000000001826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/02/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction and importance Extraction of mandibular third molars can lead to complications such as chronic sclerosing osteomyelitis (CSO), an inflammatory bone marrow disease that tends to progress. CSO involves the cortical plates and often the periosteal tissues and is caused by a variety of microorganisms, including Corynebacterium spp. The treatment of chronic osteomyelitis (CO) and CSO remains challenging, as there is no universal treatment protocol. This case report investigated whether jaw bone that has healed from chronic sclerosing osteomyelitis can be considered healthy bone when planning dental implants. Case presentation A 21-year-old Caucasian woman developed CO and CSO after third molar surgery. Clinical discussion A combination of alveolar ridge bone resection, extraction of teeth 47-32, and long-term specific antibiotic therapy against Corynebacterium spp. was administered. An attempt at preprosthetic alveolar ridge reconstruction with an anterior superior iliac crest bone graft resulted in graft failure and the patient refused further harvesting procedures. Implantation in the intraforaminal zone also resulted in the loss of two implants after loading. Finally, inferior alveolar nerve transposition resulted in the successful reimplantation of two implants, which were fully functional almost 11 years later. Conclusion This case report presents the treatment history of this patient. With a longitudinal observation period of greater than 20 years, the results of this case demonstrate the successful treatment of bone with CO, CSO, and Corynebacterium spp. infection. Following the removal of infected bone, radical debridement, and long-term antibiotic therapy, bone health was restored.
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Affiliation(s)
- Pascal Grün
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
| | - Florian Pfaffeneder-Mantai
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
- Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | | | - Marius Meier
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
| | - Ditjon Bytyqi
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
| | - Patrick Bandura
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
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Kovacs JM, Mazdarani P, Nielsen MBM, Miles JE. Objective and owner-reported outcomes after modified cranial closing wedge ostectomy: a case series. Vet Res Commun 2024; 48:877-887. [PMID: 37978161 PMCID: PMC10998822 DOI: 10.1007/s11259-023-10261-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023]
Abstract
Immediate and longer-term outcomes of a cranial closing wedge ostectomy variant for management of canine cranial cruciate ligament disease were assessed in this single-center retrospective consecutive study. Records and radiographs were retrieved and assessed by three independent observers to evaluate tibial plateau angle, anatomical-mechanical axis angle, tibial tuberosity distalization, and mechanical axis length before and after surgery. Kinetic gait analysis and owner questionnaires were used to assess clinical outcomes. Seventeen stifles from fifteen dogs were evaluated radiographically. Mean error from target tibial plateau angle was 0.4 degrees. Anatomical-mechanical axis angles reduced from mean 2.9 degrees preoperatively to mean - 0.9 degrees postoperatively. Tibial tuberosity distalization was mean 5.0% of mechanical axis length, and mean reduction in mechanical axis length was 0.1%. Increased tibial plateau angles were noted in 8/17 stifles, with a mean of 9.6 degrees at short-term follow-up. Major complications were observed in 9/17 stifles. Long term follow-up (mean 832 days) was obtained with gait analysis in 8/15 dogs and with questionnaire in 11/15. Most dogs (9/11) were weakly to moderately affected by osteoarthritis symptoms. All values for peak vertical force and vertical impulse normalized to body weight exceeded local lower reference limits for normal dogs, indicating acceptable limb use. Satisfactory immediate and long-term clinical outcomes appear to be possible with this technique, but the high incidence of shorter-term complications may caution against the technique or the fixation and management described here.
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Affiliation(s)
- Jenny M Kovacs
- Lunds Djursjukhus Evidensia, Porfyrvägen 6, Lund, 22478, Sweden
| | - Parisa Mazdarani
- College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave, Gainesville, FL, 32608, USA
| | - Michelle B M Nielsen
- Department of Veterinary Clinical Sciences, University Hospital for Companion Animals, University of Copenhagen, Dyrlægevej 16, Frederiksberg C, 1870, Denmark
| | - James E Miles
- Department of Veterinary Clinical Sciences, University Hospital for Companion Animals, University of Copenhagen, Dyrlægevej 16, Frederiksberg C, 1870, Denmark.
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Rennert RC, Atai NA, Nguyen VN, Abedi A, Sternbach S, Chu J, Carey JN, Russin JJ. Three-Vessel Anastomosis for Direct Multiterritory Cerebral Revascularization: Case Series. Oper Neurosurg (Hagerstown) 2024; 26:423-432. [PMID: 38084991 DOI: 10.1227/ons.0000000000001013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/29/2023] [Indexed: 03/16/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Cerebral revascularization of multiple territories traditionally requires multiple constructs, serial anastomoses, or a combination of direct and indirect approaches. A novel 3-vessel anastomosis technique allows for direct, simultaneous multiterritory cerebral revascularization using a single interposition graft. We herein present our experience with this approach. METHODS Retrospective review of perioperative data and outcomes for patients undergoing multiterritory cerebral revascularization using a 3-vessel anastomosis from 2019 to 2023. RESULTS Five patients met inclusion criteria (median age 53 years [range 12-73]). Three patients with complex middle cerebral artery aneurysms (1 ruptured) were treated with proximal ligation or partial/complete clip trapping and multiterritory external carotid artery-M2-M2 revascularization using a saphenous vein interposition graft. Two patients with moyamoya disease, prior strokes, and predominately bilateral anterior cerebral artery hypoperfusion were treated with proximal superficial temporal artery-A3-A3 revascularization using a radial artery or radial artery fascial flow-through free flap graft. No patients experienced significant surgery-related ischemia. Bypass patency was 100%. One patient had new strokes from vasospasm after subarachnoid hemorrhage. One patient required a revision surgery for subdural hematoma evacuation and radial artery fascial flow-through free flap debridement, without affecting bypass patency or neurologic outcome. On hospital discharge, median Glasgow Outcome Scale and modified Rankin Scale scores were 4 (range 3-5) and 2 (range 0-5), respectively. On follow-up, 1 patient died from medical complications of their presenting stroke; Glasgow Outcome Scale and modified Rankin Scale scores were otherwise stable or improved. CONCLUSION The 3-vessel anastomosis technique can be considered for simultaneous revascularization of multiple intracranial territories.
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Affiliation(s)
- Robert C Rennert
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
| | - Nadia A Atai
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
- Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
| | - Vincent N Nguyen
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
| | - Aidin Abedi
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
- Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
| | - Sarah Sternbach
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
| | - Jason Chu
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
- Department of Neurosurgery, Children's Hospital Los Angeles, Los Angeles , California , USA
| | - Joseph N Carey
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
| | - Jonathan J Russin
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
- Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles , California , USA
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Upreti A, Mandal P, Upreti A, Sapkota S, Acharya S, Yogi A, Gauchan B, Bhattarai S, Thapa L. Ataxia telangiectasia: a rare case report from Nepal. Ann Med Surg (Lond) 2024; 86:2149-2153. [PMID: 38576962 PMCID: PMC10990361 DOI: 10.1097/ms9.0000000000001831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/04/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction and importance Ataxia telangiectasia (A-T) is a rare autosomal recessive neurodegenerative disorder with early childhood onset. It is characterized by ataxia, oculocutaneous telangiectasia, immunodeficiency, and lymphoid-origin cancer predisposition due to ataxia telangiectasia mutated gene mutations. Case presentation The authors present a 19-year-old girl with spastic movements since 18 months, leading to wheelchair dependence. Ocular telangiectasia, dystonic posture, and slurred speech were evident. Diagnosis involved elevated alpha-fetoprotein levels and typical brain imaging. Clinical discussion A-T due to ataxia telangiectasia mutated gene mutations located on chromosome 11q22-23. It has varied presentations categorized by age and features. Timely diagnosis relies on characteristic symptoms, lab findings, and imaging. Radiation sensitivity and increased cancer risk underscore cautious radiation use. Conclusion A-T is a complex disorder with no cure. Genetic counseling for parents is vital. Its poor prognosis due to infection susceptibility and cancer risk necessitates supportive care. Comprehensive management, including genetic counseling and careful surveillance, is imperative.
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Affiliation(s)
- Apil Upreti
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Maharajgunj
| | - Prince Mandal
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Maharajgunj
| | - Amit Upreti
- Special School for Disabled and Rehabilitation Center
| | - Srijana Sapkota
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Maharajgunj
| | | | - Avash Yogi
- Department of Psychiatry, B.P. Koirala Institute of Health Science, Dharan, Nepal
| | - Bikash Gauchan
- Infectious Disease and Communicable Disease Hospital, Teku
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Moga DFC, Gavrilă GA, Dan AA, Smarandache CG. Complete regression of intrahepatic cholangiocarcinoma after right portal vein ligation. Case report. Int J Surg Case Rep 2024; 117:109580. [PMID: 38547696 PMCID: PMC11010678 DOI: 10.1016/j.ijscr.2024.109580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/07/2024] Open
Abstract
INTRODUCTION Spontaneous tumor regression is an extremely rare phenomenon in the oncology field. PRESENTATION OF CASE We present the case of a 72-years-old male patient presenting with a bulky hepatic tumor mass located in segment V and extending into segments IVb and VI with MRI features of atypical cholangiocarcinoma with a liver metastasis in segment III. In first surgical step, excision of the metastasis, and ligation of the right portal vein was done. A new MRI examination performed 5 weeks later shows significant tumor regression, and 2 weeks later, during the second surgery, the tumor was not found. Under these conditions we performed a limited segment V liver resection, in the area indicated by the radiologist as the site of the tumor. No viable malignant cells existed in the tumor specimen, and a third MRI examination didn't identify any residual tumor. DISCUSSION From our literature study this is the only case of complete tumor regression of an intrahepatic cholangiocarcinoma following portal vein ligation. We believe the portal vein ligation resulted in a marked regression/deficiency in the tumor blood supply. CONCLUSION Serial MRI examinations demonstrated the regression of intrahepatic cholangiocarcinoma after portal vein ligation. Intrahepatic cholangiocarcinoma should be included in the tumors that could extremely rarely spontaneously regress.
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Affiliation(s)
- Doru-Florian-Cornel Moga
- Clinical Department of Surgery, Military Clinical Emergency Hospital Sibiu and Lucian Blaga University Sibiu, Romania.
| | - Gabriela-Ariadna Gavrilă
- Medical Analysis Laboratory, Military Clinical Emergency Hospital Sibiu and Lucian Blaga University Sibiu, Romania
| | - Andreea-Alina Dan
- Department of Radiology, Military Clinical Emergency Hospital Sibiu, Romania
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