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Rafraf M, Molani-Gol R, Sahebjam M. Effect of COVID-19 pandemic on eating habits and lifestyle of college students in Tabriz, Iran: a cross-sectional study. Front Public Health 2023; 11:1185681. [PMID: 37601215 PMCID: PMC10437127 DOI: 10.3389/fpubh.2023.1185681] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
Background The pandemic of coronavirus disease (COVID-19) has influenced lifestyle behaviors and the health of populations worldwide. The purpose of this study was to determine the effects of the COVID-19 pandemic on the eating habits and lifestyle behaviors of Tabriz University of Medical Sciences students in Tabriz, Iran. Methods This cross-sectional study was conducted on 220 college students selected using a convenience sampling method in May-June 2022. Data were collected by the questionnaire, which included information on eating habits, physical activity, smoking, watching television, social media use, sleep, anxiety and stress, and smoking before and during the pandemic. The Chi-square test was used to analyze the association of COVID-19 with lifestyle behaviors. Results The median age of participants was 22.00 (IQR: 3.00) years old. The median BMI was 21.69 (IQR: 3.82) kg/m2, and 74.5% of participants had a BMI of 18.5 to 25 kg/m2. Around 34.5% of participants reported a weight gain during the pandemic. During the pandemic, students' eating habits improved by maintaining a regular meal pattern, eating a balanced diet, consuming 2-3 servings of milk or its products, consuming one or more servings of pulses, eggs, or meat per day, decreasing consumption of fast food, fried, and junk foods, adding less sugar to meals and beverages, and consuming fewer sugar-sweetened beverages and foods with high sugar (all p = 0.000). They also reported less physical activity and more sitting and screen time. Sleep time and poorer quality of sleep increased during the pandemic (p = 0.000). Feeling stress or anxiety in a day increased, and 2.2% of our participants decided to smoke. The biggest reasons for eating habits changes were less eating out, fear of coronavirus spreading through food, preferring home-cooked food, and improved knowledge about nutrition. Conclusion The results indicated that the eating habits of university students improved; however, participants stated increased weight gain, screen, sitting, and sleep time, declined physical activity, worse sleep quality, and feeling stress or anxiety during the COVID-19 pandemic. The findings can help to develop nutritional and behavioral recommendations for maintaining adults' health during and after the pandemic.
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Affiliation(s)
- Maryam Rafraf
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghayeh Molani-Gol
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Sahebjam
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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Thoma A, Murphy J, Arneja J. Guidelines for Authors and Reviewers of Plastic Surgery. Plast Surg (Oakv) 2023; 31:306-310. [PMID: 37654536 PMCID: PMC10467442 DOI: 10.1177/22925503211054136] [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: 06/11/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 09/02/2023] Open
Abstract
Credible clinical research is a precondition of evidence-based surgery. If clinical research is not conducted and reported properly, such research can be unreliable, unclear, and misleading. Our journal, Plastic Surgery, aims to improve its quality and thus enhance interest, submissions, and readership. To do so, we must ensure that the articles published in our journal align with these goals. This article guides future clinical research contributors, how to design, conduct and report valuable and reliable research. Readers are informed how to choose a title and keywords that properly reflect the content of the article. The proper organization of a manuscript, and the information that goes into each section is described. Valuable tools like the EQUATOR Network Guidelines, the FINER Criteria and the PICOT Format are described for the reader. These resources help formulate a proper research question and ensure transparency in reporting. Commonly used study designs, and the research questions they answer are presented. This ensures that those engaged in research are choosing the right study design for their research. We outline the statistical information that should be presented in the Methods section and differentiate between the content that should be found in the Results and Discussion sections. As Plastic Surgery strives to publish high-quality, reliable research, it is by the standards presented in this article that we will judge all manuscripts submitted for publication.
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Affiliation(s)
| | | | - Jugpal Arneja
- University of British Columbia, Vancouver, BC, Canada
- Sauder School of Business, University of British Columbia, Vancouver, BC, Canada
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Poudel B, Lamsal A, Poudel CM. High mortality diphtheritic myocarditis with conduction disturbance, case series, and review of literature. Ann Med Surg (Lond) 2023; 85:3797-3800. [PMID: 37554864 PMCID: PMC10406067 DOI: 10.1097/ms9.0000000000001037] [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: 04/26/2023] [Accepted: 06/25/2023] [Indexed: 08/10/2023] Open
Abstract
UNLABELLED Diphtheria cases are still being reported in various parts of the globe. Although complete heart block resulting from diphtheric myocarditis is infrequent, it can lead to fatality. Awareness and recognition of this help strengthen the importance of vaccines and their proper management. CASE PRESENTATION The authors report two young patients who presented in the interval of a month, to the emergency department with signs and symptoms of diphtheria. Both developed diphtheric myocarditis with complete heart block and severe left ventricular systolic dysfunction, which did not respond to temporary pacing. DISCUSSION Diphtheria remains rare but few cases continue to emerge, especially in developing countries. Those who develop it have high mortality, particularly from cardiomyopathy, airway compromise, and organ failure. Conduction abnormalities are diagnostic of diphtheric myocarditis and have a grim prognosis and treatment options are limited. CONCLUSION Diphtheric myocarditis has a poor prognosis and is an independent predictor of mortality. Since aggressive invasive treatment has not been shown to improve survival, early recognition along with antitoxin at the earliest suspicion and proper supportive care are the current best available options.
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Affiliation(s)
| | - Aastha Lamsal
- Kist Medical College, Tribhuvan University, Lalitpur, Nepal
| | - Chandra M. Poudel
- Manamohan Cardiovascular Thoracic and Transplant Centre, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu
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104
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Petitt JC, Murayi R, Potter T, Ahorukomeye P, Jarmula J, Recinos PF, Barnett GH, Kshettry VR. Percutaneous Rhizotomy of the Gasserian Ganglion in Patients With Mass Lesion-Associated Trigeminal Neuralgia: A Case Series. Oper Neurosurg (Hagerstown) 2023; 25:142-149. [PMID: 37039576 DOI: 10.1227/ons.0000000000000707] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/13/2022] [Accepted: 02/08/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Patients with trigeminal neuralgia (TN) secondary to mass lesions are typically treated by directly addressing the underlying pathology. In cases of TN not alleviated by treatment of the pathology, percutaneous balloon compression (PBC) and glycerol rhizotomy (Gly) are simple and effective ways to alleviate pain. However, there is limited literature on the use of these techniques for patients with TN caused by mass lesions. OBJECTIVE To describe the use of PBC/Gly to treat mass lesion-related TN. METHODS We report a retrospective, single-institution, descriptive case series of patients who presented with TN secondary to tumor or mass-like inflammatory lesion from 1999 to 2021. Patients with primary, idiopathic, or multiple sclerosis-related TN were excluded. Outcomes included Barrow Neurological Institute (BNI) pain intensity and hypesthesia scores, pain persistence, and postoperative complications. RESULTS A total of 459 procedures were identified, of which 16 patients met the inclusion criterion (14 PBC and 2 Gly). Of the 15 patients with tumors, 12 had TN pain despite prior tumor-targeted radiation. Short-term (<3 months) BNI pain intensity improvement occurred in 15 (93.8%) patients. The mean follow-up was 54.4 months. Thirteen (81.3%) patients were pain-free (Barrow Neurological Institute pain intensity scale: IIIa-50%; I-25.0%; II-6.3%) for a mean of 23.8 (range 1-137) months. Ten patients (62.5%) had pain relief for ≥6 months from first procedure. New facial numbness developed immediately postprocedure in 8 (50%) patients. Transient, partial abducens nerve palsy occurred in 1 patient. CONCLUSION PBC/Gly is an effective option for medically refractory TN in patients with mass-associated TN and is a viable option for repeat treatment.
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Affiliation(s)
- Jordan C Petitt
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Roger Murayi
- Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Tamia Potter
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Peter Ahorukomeye
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Jakub Jarmula
- Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Pablo F Recinos
- Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
- Department of Neurosurgery, Rosa Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gene H Barnett
- Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
- Department of Neurosurgery, Rosa Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Varun R Kshettry
- Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
- Department of Neurosurgery, Rosa Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Quang PV, Lai VT, Cuong DC, Duc NM. Laparoscopic treatment of Mirizzi syndrome with subtotal cholecystectomy and electrohydraulic lithotripsy: A case report. Radiol Case Rep 2023; 18:2667-2672. [PMID: 37287723 PMCID: PMC10241654 DOI: 10.1016/j.radcr.2023.05.014] [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: 03/16/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 06/09/2023] Open
Abstract
Mirizzi syndrome is a rare chronic cholecystitis complication. However, the current consensus on managing this condition remains controversial, especially through laparoscopic surgery. This report describes the feasibility of treating type I Mirizzi syndrome with laparoscopic subtotal cholecystectomy and electrohydraulic lithotripsic gallstone removal. A 53-year-old woman presented with dark urine and right upper quadrant pain for 1 month. On examination, she was jaundiced. Blood tests showed highly elevated liver and biliary enzyme levels. Abdominal ultrasound showed a slightly dilated common bile duct with suspicion of choledocholithiasis. However, endoscopic retrograde cholangiopancreatography showed a narrowed common bile duct extrinsically compressed by a gallstone in the cystic duct, establishing a Mirizzi syndrome diagnosis. Elective laparoscopic cholecystectomy was planned. At operation, the trans-infundibulum approach was used since dissection around the cystic duct was difficult due to severe local inflammation of Calot's triangle. The gallbladder's neck was opened, and the stone was removed by lithotripsy via a flexible choledochoscope. Common bile duct exploration through the cystic duct was normal. The fundus and body of the gallbladder were resected, followed by T-tube drainage and suturing of the gallbladder's neck. The patient's postoperative clinical course was uneventful. Treating Mirizzi syndrome remains a major challenge for hepatobiliary specialists even with open surgery due to high complication rates, including bile duct injuries. Treatment is primarily to clear out the responsible stone and necrotic tissue. Due to advances in endoscopic surgery and equipment, subtotal cholecystectomy with laparoscopic gallstone extraction provides a safe and effective option for patients with Mirizzi syndrome. Laparoscopic subtotal cholecystectomy with electrohydraulic lithotripsy is a feasible and useful approach for treating Mirizzi syndrome that avoids iatrogenic bile duct injury.
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Affiliation(s)
- Pham Vinh Quang
- Department of Hepatobiliary and Pancreatic Surgery, Binh Dan Hospital, Ho Chi Minh City, Vietnam
| | - Vo Thien Lai
- Department of Hepatobiliary and Pancreatic Surgery, Binh Dan Hospital, Ho Chi Minh City, Vietnam
| | - Dam Chi Cuong
- Department of Radiology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, 2 Duong Quang Trung Ward 12 Distric..., Ho Chi Minh City, 700000, Vietnam
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Al Hassan MS, El Ansari W, Issa N, Darweesh A, Abdelaal A. Severe hypercalcemia secondary to parathyroid adenoma: Series of four consecutive cases at a tertiary care hospital in Qatar. Int J Surg Case Rep 2023; 109:108560. [PMID: 37544096 PMCID: PMC10428114 DOI: 10.1016/j.ijscr.2023.108560] [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: 06/19/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION In most cases of parathyroid adenoma (PA), it is not palpable and physical examination shows no remarkable findings. Hence diagnosis requires an index of suspicion. The current paper describes four cases of severe hypercalcemia secondary to PA. PRESENTATION OF CASES Case 1 - 29 years old Sudanese female with history of nausea/vomiting, fatigue, loss of appetite and bone aches. She had large palpable left lower neck swelling, and high calcium and PTH. Ultrasound (US) neck and SPECT/CT scan after sestamibi injection showed left inferior PA. Case 2-73 years old Sudanese male referred with history of abdominal pain and flatulence. He had severely high calcium, elevated parathormone (PTH), and high 24-hour urine calcium. US and SPECT/CT showed a left inferior PA. Case 3-54 years old Bangladeshi male, referred with history of renal colic/urolithiasis. Laboratory results showed severely high calcium and PTH levels. US and SPECT/CT scan showed right inferior PA. Case 4-35 years old Tunisian female, 12 weeks pregnant, referred with recurrent nausea and vomiting of increasing frequency from the second week of pregnancy. Laboratory tests revealed severe hypercalcemia and high PTH. US showed two parathyroid lesions. DISCUSSION The patients were admitted as emergency cases and investigations diagnosed severe hypercalcemia secondary to PA. All patients underwent neck exploration and PA excision. Histology confirmed PA. The four cases were swiftly assessed and treated before progressing into the more serious hypercalcemic crisis which can lead to grave consequences, particularly in the case of the pregnant female. All patients recovered with no complications and were clinically well with normal calcium level on follow up. CONCLUSION Severe hypercalcemia must be swiftly and thoroughly assessed to prevent the more serious hypercalcemic crisis. Clinicians need to be suspicious of parathyroid adenoma as a probable cause. Severe hypercalcemia is often accompanied with vomiting, and in pregnant females, this could be mistaken for hyperemesis gravidarum. Excision of the parathyroid adenoma treats the condition and follow up of serum calcium and PTH confirms the favorable outcome of surgery.
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Affiliation(s)
| | - Walid El Ansari
- Department of Surgery, Hamad General Hospital, Doha, Qatar; College of Medicine, Qatar University, Doha, Qatar; Weill Cornell Medicine - Qatar, Doha, Qatar.
| | | | - Adham Darweesh
- Department of Clinical Imaging, Hamad General Hospital, Doha, Qatar
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107
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Boutaybi M, Aloutmani B, El-Azrak M, Ismaili N, El Ouafi N. Acute coronary syndromes in chronic hemodialysis patients: a series of 34 cases (case series). Ann Med Surg (Lond) 2023; 85:3791-3796. [PMID: 37554882 PMCID: PMC10406026 DOI: 10.1097/ms9.0000000000000941] [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: 03/21/2023] [Accepted: 05/31/2023] [Indexed: 08/10/2023] Open
Abstract
UNLABELLED Cardiovascular diseases, particularly acute coronary syndrome, are the leading cause of death in chronic hemodialysis patients. Our study aims to analyze the pathophysiological, clinical, angiographic, and therapeutic characteristics of coronary heart disease in hemodialysis patients. PATIENTS AND METHODS This single-centered retrospective descriptive study included 34 hemodialysis patients hospitalized in the cardiovascular ICU. RESULTS The mean age of patients in our study was 64.4±11.3 years. The main cardiovascular risk factor found in our study was age, with a prevalence of 76.50%, followed by hypertension, with a prevalence of 67.60%. Diabetes was present in 55.90% of patients. The authors also found that 17.90% of patients were obese, and 29.40% had abdominal obesity. The main cause of renal disease in our study was diabetic nephropathy (52.90% of cases), followed by hypertensive nephropathy (23.50% of cases). ST segment elevation myocardial infarction was found in 14.70% of cases, and non-ST-segment elevation myocardial infarction in 85.30% of cases. Coronary angiography was performed in 76.40% of patients. Single-vessel coronary artery disease (CAD) was found in 20%, two-vessel CAD in 50%, and three-vessel CAD in 30% of the cases. Coronary artery calcifications were observed in 21.42% of cases. 38.23% had an angioplasty, and 20.58% were referred for a coronary artery bypass graft. CONCLUSION Despite the high mortality rate after acute coronary syndrome, hemodialysis patients are less likely to undergo diagnostic angiography or coronary revascularization. Patients on hemodialysis tend to have multiple, diffuse, calcified CAD.
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Affiliation(s)
| | | | | | - Nabila Ismaili
- Department of Cardiology, Mohammed VI University Hospital
- Epidemiological Laboratory of Clinical Research and Public Health, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, Morocco
| | - Noha El Ouafi
- Department of Cardiology, Mohammed VI University Hospital
- Epidemiological Laboratory of Clinical Research and Public Health, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, Morocco
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Bove I, Pangal DJ, Ruzevick JJ, Cheok S, Amar A, Mack W, Ference ED, Wrobel B, Swanson M, Hur K, Zada G. Anatomic Considerations Guiding Single Versus Multiportal Endoscopic Approaches for Resection of Juvenile Nasopharyngeal Angiofibroma: Cases Series With Graded Multicorridor Resections. Oper Neurosurg (Hagerstown) 2023; 25:150-160. [PMID: 37166983 DOI: 10.1227/ons.0000000000000709] [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: 11/10/2022] [Accepted: 02/08/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Juvenile nasopharyngeal angiofibromas (JNAs) are characterized by expansive and destructive growth, often invading the midline/paranasal sinuses, pterygopalatine fossa, and infratemporal fossa and can extend into the orbit, cavernous sinus, or intracranially. OBJECTIVE To evaluete the major benefits of the extended endoscopic endonasal approach (EEA) for JNA resection as compared with more traditional and invasive transpalatal and transfacial approaches. When JNAs extend into lateral anatomic compartments, the optimal operative trajectory often requires additional approach strategies or surgical staging. METHODS We retrospectively reviewed 8 cases of large JNAs arising in symptomatic adolescent boys (University of Pittsburgh Medical Center Stages II, III, and V) and discuss anatomic and tumor considerations guiding the decision of a pure EEA vs combined EEA and sublabial transmaxillary approach (Caldwell-Luc). RESULTS A pure extended EEA was used in 6 JNA cases (UPMC Stages II-III); a multiportal EEA + Caldwell-Luc maxillotomy was used in 2 cases. One of the 2 patients (UPMC Stage V) previously treated with multiportal EEA + Caldwell-Luc maxillotomy underwent staged left temporal/transzygomatic craniotomy, obtaining gross total resection. Seven patients ultimately underwent complete removal without recurrence. One patient with a small residual JNA (UPMC II) underwent stereotactic radiosurgery without progression to date. CONCLUSION JNAs with lateral extension into the infratemporal fossa often benefited from additional lateral exposure using a Caldwell-Luc maxillotomy. Cases with significant skull base and/or dural involvement may undergo staged surgical treatment; temporalis + transzygomatic craniotomy is often useful for second-stage approaches for residual tumor in these lateral infratemporal or intracranial regions. SRS should be considered for residual tumor if additional surgery is not warranted.
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Affiliation(s)
- Ilaria Bove
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Dhiraj J Pangal
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Jacob J Ruzevick
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Stephanie Cheok
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Arun Amar
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - William Mack
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Elisabeth D Ference
- USC Caruso Department of Otolaryngology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Bozena Wrobel
- USC Caruso Department of Otolaryngology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Mark Swanson
- USC Caruso Department of Otolaryngology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Kevin Hur
- USC Caruso Department of Otolaryngology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Gabriel Zada
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
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Rhatomy S, Shiddieqy ABA, Prathama GB, Belantara LAS, Alkarni MD, Septian R, Canintika AF. Sartorius muscle pedicle iliac bone graft for treating neglected femoral neck fracture: A case series. Int J Surg Case Rep 2023; 109:108410. [PMID: 37437327 PMCID: PMC10362283 DOI: 10.1016/j.ijscr.2023.108410] [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: 10/14/2022] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION Femoral neck fractures in patients less than 50 years account for less than 5 % of all hip fractures. Controversy remains regarding timing of surgery, operative technique, and optimal implant construct because of a lack of prospective clinical trials. The blood supply to the femoral head is tenuous and easily injured in the setting of displaced fractures. An alternative using sartorius muscle pedicle iliac bone graft has not been discussed widely. CASE PRESENTATION Four patients with neglected femoral neck fracture were included in the series; all underwent cannulated screws fixation and osteomuscular pedicled graft using sartorius muscle. All patients achieved bone healing after 6-months of follow-up. CONCLUSION Our series demonstrate that sartorius muscle pedicle graft may be a good choice for treating neglected femoral neck fractures. Further studies are required to investigate its outcome and complications.
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Affiliation(s)
- Sholahuddin Rhatomy
- Department of Orthopaedics and Traumatology, Soeradji Tirtonegoro Hospital, Klaten, Indonesia; Faculty of Medicine, Public Health of Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | | | - Ginanjar Budhi Prathama
- Department of Orthopaedics and Traumatology, Siaga Medika Hospital, Banyumas, Central Java, Indonesia
| | | | - Muhammad Dedy Alkarni
- Department of Orthopaedics and Traumatology, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rian Septian
- Department of Orthopaedics and Traumatology, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Anissa Feby Canintika
- Department of Orthopaedics and Traumatology, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Kusumo Rahardjo A, Lesmana T, Wibowo HS, Prabowo R, Rosita E. One-stage laparoscopic cholecystectomy with intraoperative endoscopic retrograde cholangiography bile duct stone extraction is a feasible option in Indonesia within the National Health Insurance System. Int J Surg Case Rep 2023; 109:108550. [PMID: 37499351 PMCID: PMC10413057 DOI: 10.1016/j.ijscr.2023.108550] [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: 06/09/2023] [Revised: 07/08/2023] [Accepted: 07/15/2023] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Bile duct stones are a widespread condition that can pose a significant risk to life due to the occurrence of complications. In recent years, there has been a growing inclination toward the use of one-stage minimally invasive procedures for the treatment of this condition. However, it is important to note that in developing countries, such as Indonesia, where the National Healthcare Insurance System is established, the implementation of these procedures is still relatively uncommon due to limitations in healthcare facilities. CASE PRESENTATION This study presents a case series involving 13 patients who underwent a consecutive initial attempt of one-stage Laparoscopic Cholecystectomy with subsequent Intraoperative Endoscopic Retrograde Cholangiopancreatography (LC-ERCP) for the extraction of bile duct stones. These patients were among the 124 individuals treated for bile duct stones at our hospital for one year (June 2022 to May 2023). All the participants in this study were covered by the National Health Insurance. CLINICAL DISCUSSION Among the 124 patients diagnosed with bile duct stones, thirteen (10.5 %) were subjected to an initial attempt of one-stage LC-ERCP procedure, which had a success rate of 76.4 %. However, three of them experienced difficulties during the cannulation of bile duct, leading to the failure of this approach. The patients included in the study had a mean age of 46.5 years, with average serum levels of total bilirubin and direct bilirubin measuring 2.1 and 1.4 mg/dL, respectively. The average duration of successful and unsuccessful procedures was 121.5 min and 183.3 min, respectively. The average length of postoperative hospital stay was 3.5 days, and no instances of mortality or complications were recorded during the study. CONCLUSION One-stage LC-ERCP procedure offered a promising treatment option for bile duct stones in Indonesia, particularly for patients registered under the National Healthcare Insurance System. This approach could serve as a viable alternative for facilities that lack proficiency in LC-CBDE skills. Furthermore, the ability to perform ERCP in a supine position is crucial in achieving a high success rate. The results of this study showed the need for advancements in Indonesian public healthcare facilities to meet the growing demand for improved treatment modalities.
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Affiliation(s)
- Arif Kusumo Rahardjo
- Division of Digestive Surgery, Department of Surgery, Dr. Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | - Tomy Lesmana
- Division of Digestive Surgery, Department of Surgery, Dr. Soetomo General Hospital, Airlangga University, Surabaya, Indonesia.
| | - Heru Seno Wibowo
- Division of Digestive Surgery, Dr. Ramelan Naval Center Hospital, Surabaya, Indonesia
| | - Rianto Prabowo
- Division of Digestive Surgery, Dr. Ramelan Naval Center Hospital, Surabaya, Indonesia
| | - Emilia Rosita
- Division of Digestive Surgery, Dr. Ramelan Naval Center Hospital, Surabaya, Indonesia
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Flores-Milan G, Cuello CC, Pressman E, Marek J, Krafft PR, McBride P, Gassie K, Hayman E, Alikhani P. Risk Factors for Adjacent Segment Disease in Short Segment Lumbar Interbody Fusion-A Case Series. Oper Neurosurg (Hagerstown) 2023; 25:136-141. [PMID: 37163706 DOI: 10.1227/ons.0000000000000743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/12/2022] [Accepted: 03/07/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Adjacent segment disease (ASD) is a common problem after lumbar spinal fusions. Ways to reduce the rates of ASD are highly sought after to reduce the need for reoperation. OBJECTIVE To find predisposing factors of ASD after lumbar interbody fusions, especially in mismatch of pelvic incidence and lumbar lordosis (PI-LL). METHODS We conducted a retrospective cohort study of all patients undergoing lumbar interbody fusions of less than 4 levels from June 2015 to July 2020 with at least 1 year of follow-up and in those who had obtained postoperative standing X-rays. RESULTS We found 243 patients who fit inclusion and exclusion criteria. Fourteen patients (5.8%) developed ASD, at a median of 24 months. Postoperative lumbar lordosis was significantly higher in the non-ASD cohort (median 46.4° ± 1.4° vs 36.9° ± 3.6°, P < .001), pelvic tilt was significantly lower in the non-ASD cohort (16.0° ± 0.66° vs 20.3° ± 2.4°, P = .002), PI-LL mismatch was significantly lower in the non-ASD cohort (5.28° ± 1.0° vs 17.1° ± 2.0°, P < .001), and age-appropriate PI-LL mismatch was less common in the non-ASD cohort (34 patients [14.8%] vs 13 [92.9%] of patients with high mismatch, P < .001). Using multivariate analysis, greater PI-LL mismatch was predictive of ASD (95% odds ratio CI = 1.393-2.458, P < .001) and age-appropriate PI-LL mismatch was predictive of ASD (95% odds ratio CI = 10.8-970.4, P < .001). CONCLUSION Higher PI-LL mismatch, both age-independent and when adjusted for age, after lumbar interbody fusion was predictive for developing ASD. In lumbar degenerative disease, correction of spinopelvic parameters should be a main goal of surgical correction.
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Affiliation(s)
- Gabriel Flores-Milan
- Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
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Zhang JK, Greenberg JK, Javeed S, Benedict B, Botterbush KS, Dibble CF, Khalifeh JM, Brehm S, Jain D, Dorward I, Santiago P, Molina C, Pennicooke BH, Ray WZ. Predictors of Postoperative Segmental and Overall Lumbar Lordosis in Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Consecutive Case Series. Global Spine J 2023:21925682231193610. [PMID: 37522797 DOI: 10.1177/21925682231193610] [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] [Indexed: 08/01/2023] Open
Abstract
STUDY DESIGN Retrospective Case-Series. OBJECTIVES Due to heterogeneity in previous studies, the effect of MI-TLIF on postoperative segmental lordosis (SL) and lumbar lordosis (LL) remains unclear. Therefore, we aim to identify radiographic factors associated with lordosis after surgery in a homogenous series of MI-TLIF patients. METHODS A single-center retrospective review identified consecutive patients who underwent single-level MI-TLIF for grade 1 degenerative spondylolisthesis from 2015-2020. All surgeries underwent unilateral facetectomies and a contralateral facet release with expandable interbody cages. PROs included the ODI and NRS-BP for low-back pain. Radiographic measures included SL, disc height, percent spondylolisthesis, cage positioning, LL, PI-LL mismatch, sacral-slope, and pelvic-tilt. Surgeries were considered "lordosing" if the change in postoperative SL was ≥ +4° and "kyphosing" if ≤ -4°. Predictors of change in SL/LL were evaluated using Pearson's correlation and multivariable regression. RESULTS A total of 73 patients with an average follow-up of 22.5 (range 12-61) months were included. Patients experienced significant improvements in ODI (29% ± 22% improvement, P < .001) and NRS-BP (3.3 ± 3 point improvement, P < .001). There was a significant increase in mean SL (Δ3.43° ± 4.37°, P < .001) while LL (Δ0.17° ± 6.98°, P > .05) remained stable. Thirty-eight (52%) patients experienced lordosing MI-TLIFs, compared to 4 (5%) kyphosing and 31 (43%) neutral MI-TLIFs. A lower preoperative SL and more anterior cage placement were associated with the greatest improvement in SL (β = -.45° P = .001, β = 15.06° P < .001, respectively). CONCLUSIONS In our series, the majority of patients experienced lordosing or neutral MI-TLIFs (n = 69, 95%). Preoperative radiographic alignment and anterior cage placement were significantly associated with target SL following MI-TLIF.
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Affiliation(s)
- Justin K Zhang
- Department of Neurological Surgery, Washington University, St. Louis, MO, USA
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA
| | - Jacob K Greenberg
- Department of Neurological Surgery, Washington University, St. Louis, MO, USA
| | - Saad Javeed
- Department of Neurological Surgery, Washington University, St. Louis, MO, USA
| | - Braeden Benedict
- Department of Neurological Surgery, Washington University, St. Louis, MO, USA
| | | | | | - Jawad M Khalifeh
- Department of Neurological Surgery, Johns Hopkins University, Baltimore, MD
| | - Samuel Brehm
- Department of Neurological Surgery, Washington University, St. Louis, MO, USA
| | - Deeptee Jain
- Department of Orthopedic Surgery, Washington University, St. Louis, MO, USA
| | - Ian Dorward
- Department of Neurological Surgery, Washington University, St. Louis, MO, USA
| | - Paul Santiago
- Department of Neurological Surgery, Washington University, St. Louis, MO, USA
| | - Camilo Molina
- Department of Neurological Surgery, Washington University, St. Louis, MO, USA
| | | | - Wilson Z Ray
- Department of Neurological Surgery, Washington University, St. Louis, MO, USA
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Sax FH, Fink B. Total Knee Arthroplasty in Unrecognized Septic Arthritis-A Descriptive Case Series Study. Antibiotics (Basel) 2023; 12:1153. [PMID: 37508249 PMCID: PMC10376461 DOI: 10.3390/antibiotics12071153] [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: 05/08/2023] [Revised: 06/23/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Synovitis, like that associated with chronic bacterial arthritis, is a very rare finding during the implantation of knee endoprostheses. In such cases, we fix the knee prostheses with cement containing two antibiotics and carry out a course of systemic antibiotic administration. The aim was to analyze these cases for incidence, detection of bacteria, risk factors, and outcome. METHODS Out of 7534 knee replacements between January 2013 and December 2020, 25 cases were suspected during the surgical procedure to have suffered from bacterial arthritis and were treated accordingly. Total synovectomy was carried out, whereby five intraoperative synovial samples were examined bacteriologically, and the complete synovitis was analyzed histologically. The mean follow-up was 65.3 ± 27.1 (24-85) months. RESULTS In nine cases (0.12%), the diagnosis of bacterial arthritis was made histologically and by clinical chemistry (elevated CRP), and in two of these cases, pathogen verification was performed. Eight of these nine patients had previously had injections or surgery associated with the corresponding knee joint or had an underlying immunomodulatory disease. None of the patients developed a periprosthetic infection at a later stage. CONCLUSION With an incidence of 0.12%, it is rare to unexpectedly detect bacterial synovitis during surgery. Total synovectomy, use of bone cement with two antibiotics, and immediate systemic antibiotic therapy seem to keep the risk of periprosthetic infection low.
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Affiliation(s)
- Florian Hubert Sax
- Department of Joint Replacement, General and Rheumatic Orthopaedics, Orthopaedic Clinic Markgröningen gGmbH, Kurt-Lindemann-Weg 10, 71706 Markgröningen, Germany
| | - Bernd Fink
- Department of Joint Replacement, General and Rheumatic Orthopaedics, Orthopaedic Clinic Markgröningen gGmbH, Kurt-Lindemann-Weg 10, 71706 Markgröningen, Germany
- Orthopaedic Department, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
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Naicker D, Leola K, Mkhaliphi MM, Mpanza MN, Ouma J, Nakwa FL, Velaphi S, Profyris C. Single surgeon case series of myelomeningocele repairs in a developing world setting: Challenges and lessons. World Neurosurg X 2023; 19:100213. [PMID: 37260695 PMCID: PMC10227453 DOI: 10.1016/j.wnsx.2023.100213] [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: 07/15/2022] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 06/02/2023] Open
Abstract
Purpose Neural Tube Defects are the second most common group of birth malformations following congenital heart anomalies, with myelomeningoceles being the most severe manifestation (MMC). They require expedited surgical repair, preferably within 72 h of birth. In low- and middle-income countries (LMIC) where resources are limited, timing to MMC repair is not optimal and leads to undesirable outcomes. The purpose of this study was to determine whether a proactive approach in a setting from a LMIC could achieve repair within 72 h. Methods A concerted effort to expedite repair of all neonates referred with a MMC was undertaken from 01 January 2014 to 1 August 2015. A consensus was reached between neonatologists and neurosurgeons that neonates born or admitted with a MMC are referred immediately to surgeons and that repair will be performed within 72 h of birth. Hospital records of neonates who had MMC repaired during this period were reviewed for infant characteristics and hospital outcomes. Results 24 patients with a MMC were operated upon by the senior author (CP) during the study period. Only 13 of these patients were born at the treating institution and 11 were referred from outside hospitals. Most MMCs were in the lumbosacral region and mean MMC surface area was 19.4 cm2. Mean time to repair for the entire series was 13.6 days. Patients born at the treating institution has a mean time to repair of 10.5 days and patients referred from outside had a mean time to repair of 17.3 days. Series wide, only 21% of neonates were operated upon in less than 72 h. Conclusion Despite a pro-active commitment to repairing MMCs within 72 h for the duration of this series, satisfactory time to repair was not achieved. Late referral, referral from outside hospitals and operating theatre availability were the predominant factors leading to delay in MMC repair. Nevertheless, time to repair in our series was significantly shorter than that reported in MMC repair series based in similar environments. This suggests that even if the gold-standard of a 72-h window cannot be achieved, neonates benefit from much quicker repair when a concerted effort to minimise repair time is employed. This study also highlights the urgent need to address health care constraints in LMIC to improve outcomes for this vulnerable group.
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Affiliation(s)
- Denver Naicker
- Department of Neurosurgery, Chris Hani Baragwanath Academic Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Keletso Leola
- Department of Neurosurgery, Helen Joseph Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mlamuli Mzamo Mkhaliphi
- Department of Neurosurgery, Helen Joseph Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Morena Nthuse Mpanza
- Department of Neurosurgery, Helen Joseph Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - John Ouma
- Department of Neurosurgery, Chris Hani Baragwanath Academic Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Firdose Lambey Nakwa
- Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sithembiso Velaphi
- Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Christos Profyris
- Department of Neurosurgery, Helen Joseph Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Mamarelis G, Goldring MA, Srikantharajah D, Tytherleigh-Strong G. Superior Sternoclavicular Dislocation Treated with Costoclavicular Ligament Reconstruction Using Autograft: A Case Report. JBJS Case Connect 2023; 13:01709767-202309000-00030. [PMID: 37535769 DOI: 10.2106/jbjs.cc.23.00192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
CASE We describe a case of a traumatic superior dislocation of the sternoclavicular joint (SCJ) due to an isolated rupture of the costoclavicular ligament (CCL). A magnetic resonance imaging (MRI) scan demonstrated the CCL rupture with preservation of the anterior and posterior SCJ ligaments. This was successfully treated with an isolated hamstring tendon reconstruction of the CCL, resulting in a satisfactory outcome at 1 year after the procedure. CONCLUSION Isolated CCL reconstruction with a hamstring tendon in a patient with a superior SCJ dislocation provided a satisfactory outcome.
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Durga Bhavani G, Rathod T, Parveen N, Tirupathi P, Dharavattu P, Sekhar V, Sharma D, Anlesteffy SG. Assessment of the Antimicrobial Effectiveness of Herbal Root Canal Irrigants (Propolis, Triphala, and Aloe Vera) and Chlorhexidine Against Enterococcus Faecalis. Cureus 2023; 15:e41628. [PMID: 37565091 PMCID: PMC10410603 DOI: 10.7759/cureus.41628] [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] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Complete microbial eradication from the root canal and 3-dimensional obturation of the canal space are necessary for an efficient root canal procedure. AIM The current research was conducted to assess the antimicrobial effectiveness of herbal root canal irrigants and Chlorhexidine against Enterococcus faecalis. MATERIALS AND METHODS The brain heart infusion (BHI) broth was used to grow the E. faecalis (ATCC) bacterial culture overnight before it was inoculated onto Mueller-Hinton agar plates. Agar-well diffusion was used to measure antibacterial inhibition. Respective propolis, Triphala, aloe vera, and chlorhexidine irrigants were added to the appropriate wells in agar plates and incubated for 24 hours at 37°C. Each well's bacterial inhibition zone was measured and recorded. Statistics were used to tabulate and analyze the results. RESULTS Chlorhexidine indicated the maximum inhibitory zone against E. faecalis, subsequently propolis and Triphala, and the lowest by A. vera extract. CONCLUSION Propolis, Triphala, and aloe vera were tested herbal remedies that demonstrated an inhibitory zone against E. faecalis. These irrigants are therefore, suitable for use as root canal irrigating solutions.
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Affiliation(s)
- Gondi Durga Bhavani
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Kadapa, IND
| | - Tejasree Rathod
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Kadapa, IND
| | - Nusrath Parveen
- Independent Practitioner, Conservative Dentistry and Endodontics, Hyderabad, IND
| | - Pudu Tirupathi
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Kadapa, IND
| | - Prabhakar Dharavattu
- Department of Conservative Dentistry and Endodontics, Gitam Dental College, Visakhapatnam, IND
| | - Vssk Sekhar
- Department of Conservative Dentistry and Endodontics, Sree Sai Dental College and Research Institute, Srikakulam, IND
| | | | - S G Anlesteffy
- Periyar University, Department of Microbiology, Salem, IND
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Hunt PJ, Amit M, Kabotyanski KE, Aashiq M, Hanna EY, Kupferman ME, Su SY, Gidley PW, Nader ME, DeMonte F, Raza SM. Predictors of postoperative performance status after surgical management of infratemporal fossa malignancies. Neurosurg Rev 2023; 46:157. [PMID: 37386212 DOI: 10.1007/s10143-023-02063-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/01/2023]
Abstract
Infratemporal fossa (ITF) tumors are difficult to access surgically due to anatomical constraints. Moreover, aggressive ITF carcinomas and sarcomas necessitate aggressive treatment strategies that, along with tumor-related symptoms, contribute to decreases in patient performance status. To assess factors that predict postoperative performance in patients undergoing surgery for ITF tumors. We reviewed medical records for all patients surgically treated for an ITF malignancy between January 1, 1999, and December 31, 2017, at our institution. We collected patient demographics, preoperative performance, tumor stage, tumor characteristics, treatment modalities, pathological data, and postoperative performance data. The 5-year survival rate was 62.2%. Higher preoperative Karnofsky Performance Status (KPS) score (n = 64; p < 0.001), short length of stay (p = 0.002), prior surgery at site (n = 61; p = 0.0164), and diagnosis of sarcoma (n = 62; p = 0.0398) were predictors of higher postoperative KPS scores. Percutaneous endoscopic gastrostomy (PEG) (n = 9; p = 0.0327), and tracheostomy tube placement (n = 20; p = 0.0436) were predictors of lower postoperative KPS scores, whereas age at presentation (p = 0.72), intracranial tumor spread (p = 0.8197), and perineural invasion (n = 40; p = 0.2195) were not. Male patients and patients with carcinomas showed the greatest decreases in KPS scores between pretreatment and posttreatment. Higher preoperative KPS score and short length of stay were the best predictors of higher postoperative KPS scores. This work provides treatment teams and patients with better information on outcomes for shared decision-making.
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Affiliation(s)
- Patrick J Hunt
- Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd, Rm FC7.2000, Unit 442, Houston, TX, 77030, USA
| | - Moran Amit
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Katherine E Kabotyanski
- Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd, Rm FC7.2000, Unit 442, Houston, TX, 77030, USA
| | - Mohamed Aashiq
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael E Kupferman
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shirley Y Su
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Paul W Gidley
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marc-Elie Nader
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Franco DeMonte
- Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd, Rm FC7.2000, Unit 442, Houston, TX, 77030, USA
| | - Shaan M Raza
- Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd, Rm FC7.2000, Unit 442, Houston, TX, 77030, USA.
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Lodhia J, Suleman M, Chugulu S, Chilonga K, Msuya D. Chest tube thoracostomy: A simple life-saving procedure with potential hazardous risks. Int J Surg Case Rep 2023; 108:108416. [PMID: 37343502 PMCID: PMC10382721 DOI: 10.1016/j.ijscr.2023.108416] [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: 04/12/2023] [Revised: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Chest tube thoracostomy is a simple life-saving procedure with many benefits but comes with significant potential morbidity. Potentially all intra-thoracic organs are at risk of possible injury as well as peritoneal. CASE PRESENTATION We present four patients who had chest tube thoracostomy with potential complications fortunately were managed promptly and recovered fully. CLINICAL DISCUSSION Complications related to tube thoracostomy is reported up to 25 % especially when done under emergency conditions. While the procedure is reported safe, it's associated morbidity is not well described. Additionally, clinicians are urged to follow standard operating procedures and address the potential complications with consent to their patients. CONCLUSION Chest tube thoracostomy is an invasive life-saving procedure performed across various clinical ranks and sub-specialties. It has potential life-threatening risks and complications therefore clinicians should be well trained to identify such complications and address accordingly.
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Affiliation(s)
- Jay Lodhia
- Department of General Surgery, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Faculty of Medicine, P O Box 2240, Moshi, Tanzania.
| | - Mujaheed Suleman
- Department of General Surgery, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania
| | - Samwel Chugulu
- Department of General Surgery, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Faculty of Medicine, P O Box 2240, Moshi, Tanzania
| | - Kondo Chilonga
- Department of General Surgery, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Faculty of Medicine, P O Box 2240, Moshi, Tanzania
| | - David Msuya
- Department of General Surgery, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Faculty of Medicine, P O Box 2240, Moshi, Tanzania
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Alpan B, Civan M, Eralp L, Özger H. Treatment of neuropathic unstable knee osteoarthritis by a condylar, rotating-hinge prosthesis with cementless pentagonal stem: a case series. Int J Surg Case Rep 2023; 108:108389. [PMID: 37348203 PMCID: PMC10382728 DOI: 10.1016/j.ijscr.2023.108389] [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: 04/02/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Total knee arthroplasty (TKA) in the neuropathic unstable knee (NUK) setting is classically a challenging orthopedic problem due to intraoperative technical difficulties and a higher frequency of periprosthetic complications. More recently, satisfactory results have been reported using improved constraints, stems and revision-type TKA components. The study aims to present long-term results of a small case series with NUK osteoarthritis reconstructed by a condylar, semi-constrained prosthesis with a polygonal, hydroxyapatite-coated (HA-coated) press-fit stem. CASE PRESENTATION From 2009 through 2010, three knees in three patients with advanced NUK arthropathy underwent TKAs in our institution using the PENTA® prosthesis. The average age at surgery was 44 years (32-58). The patients were followed up for a mean period of 124 months (120-128). The etiology of NUK was determined to be poliomyelitis sequela in 2 cases and spinal cord injury in one case. Functional outcomes were assessed with Knee Society (KS) Knee and Function Scores, and radiological outcomes were evaluated with ISOLS radiographic implant scores. Patients were monitored for complications clinically and radiologically. CLINICAL DISCUSSION KS knee scores improved from a mean of 12,3 (0-37) preoperatively to 71,3 (65-77) and KS function scores improved from a mean of 1,7 (0-5) preoperatively to 68,3 (55-80) at the latest follow-up. Radiological outcomes were excellent according to ISOLS scores, and no complications were observed. CONCLUSION Although this is a small case series, the significant improvement in functional scores, excellent radiological outcome, and implant survival at the end of a long follow-up period warrants TKA with a semi-constrained hinged implant in the setting of NUK. PENTA® prosthesis offers a good choice of implant with its hydroxyapatite-coated, press-fit, pentagonal stem and precisely designed rotating hinge.
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Affiliation(s)
- Bugra Alpan
- Acibadem Mehmet Ali Aydinlar University, School of Medicine, Dept. of Orthopaedics and Traumatology, Kayısdagi Cad. 34752 Atasehir, Istanbul, Turkey
| | - Melih Civan
- Basaksehir Pine and Sakura City Hospital, Dept. of Orthopaedics and Traumatology, Basaksehir Olimpiyat Bulvarı 34480 Basaksehir, Istanbul, Turkey.
| | - Levent Eralp
- Istanbul University, Istanbul Faculty of Medicine, Dept. of Orthopaedics and Traumatology (retired), Capa 34093 Fatih, Istanbul, Turkey
| | - Harzem Özger
- Istanbul University, Istanbul Faculty of Medicine, Dept. of Orthopaedics and Traumatology (retired), Capa 34093 Fatih, Istanbul, Turkey
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Munday J, Ramis MA, Kynoch K, Maffey S, Steelman V, Osborne S. Hypothermia With Paradoxical Symptoms: A Case Series of Cesarean Deliveries With Intrathecal Morphine. AORN J 2023; 117:e1-e9. [PMID: 37235623 DOI: 10.1002/aorn.13932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/10/2022] [Accepted: 11/02/2022] [Indexed: 05/28/2023]
Abstract
Women receiving intrathecal morphine for cesarean delivery may experience hypothermia with paradoxical symptoms of sweating, nausea, and shivering. Despite being relatively rare in comparison to commonly experienced symptoms of perioperative hypothermia, hypothermia with paradoxical symptoms affects early maternal recovery and comfort. The cause is undetermined, and treatment approaches vary. Regular active-warming strategies may not be tolerated because of the paradoxical symptoms of sweating and feeling overheated. This case series aims to explore the phenomenon through the evaluation of health care records of women receiving intrathecal morphine for cesarean delivery at a single, tertiary health care institution in Australia from 2015 to 2018. We also summarize published literature to review treatment approaches used in the care of women experiencing profound heat loss while feeling overheated.
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Guadix SW, Marianayagam NJ, Weidman EK, Yuan M, Liechty B, Greenfield JP, Souweidane MM. Defining Occult High-Risk Cysts of the Pineal Region: A Case Series. Oper Neurosurg (Hagerstown) 2023; 24:572-581. [PMID: 36716050 DOI: 10.1227/ons.0000000000000620] [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: 04/29/2022] [Accepted: 11/08/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Absence of hydrocephalus on neuroimaging may impart a false sense of security for patients with pineal cysts. In this case series, we characterize a subset of patients with pineal cysts having an occult presentation. Unifying features of worsening paroxysmal headaches suggesting intermittent obstructive hydrocephalus and radiographic evidence of third ventricular invagination characterize these patients as high risk. OBJECTIVE To define features of occult, high-risk pineal cysts and outcomes of endoscopic cyst fenestration. METHODS Charts were retrospectively reviewed for patients with pineal cysts evaluated at our institution between 2018 and 2021 who underwent endoscopic cyst fenestration. To capture cysts presenting as occult, patients were excluded if hydrocephalus was noted at presentation. Relevant clinical history, imaging, operative data, and clinical outcomes were reviewed. RESULTS Of 50 pineal cyst patients, 4 satisfied inclusion criteria. All patients presented with worsening paroxysmal headaches. In addition, 75% (3/4) also experienced intermittent syncope. Patients exhibited no hydrocephalus (n = 3) or fluctuating ventricular size on longitudinal imaging (n = 1). In all cases, high-resolution sagittal 3-dimensional T2 magnetic resonance imaging demonstrated invagination of the cyst anteriorly into the posterior third ventricle. All patients underwent endoscopic cyst fenestration with complete symptom resolution (mean follow-up of 20.6 months; range 3.5-37.4 months). CONCLUSION The clinical history for occult, high-risk pineal cysts is notable for worsening paroxysmal headaches and episodic alterations of consciousness suggesting intermittent obstructive hydrocephalus. Because ventricular size can appear normal on standard imaging protocols, clinical suspicion should trigger workup with high-resolution magnetic resonance imaging designed to detect these cysts. Endoscopic cyst fenestration is a safe and efficacious management strategy.
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Affiliation(s)
- Sergio W Guadix
- Department of Neurological Surgery, Weill Cornell Medical Center, NewYork Presbyterian Hospital, New York, New York, USA
| | - Neelan J Marianayagam
- Department of Neurological Surgery, Weill Cornell Medical Center, NewYork Presbyterian Hospital, New York, New York, USA
| | - Elizabeth K Weidman
- Department of Radiology, Weill Cornell Medical Center, NewYork Presbyterian Hospital, New York, New York, USA
| | - Melissa Yuan
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Benjamin Liechty
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical Center, NewYork Presbyterian Hospital, New York, New York, USA
| | - Jeffrey P Greenfield
- Department of Neurological Surgery, Weill Cornell Medical Center, NewYork Presbyterian Hospital, New York, New York, USA
| | - Mark M Souweidane
- Department of Neurological Surgery, Weill Cornell Medical Center, NewYork Presbyterian Hospital, New York, New York, USA
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Rennert RC, Brandel MG, Budohoski KP, Twitchell S, Fredrickson VL, Grandhi R, Couldwell WT. Influence of Patient and Technical Variables on Combined Direct and Indirect Cerebral Revascularization: Case Series. Oper Neurosurg (Hagerstown) 2023; 24:610-618. [PMID: 36786755 DOI: 10.1227/ons.0000000000000618] [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: 09/07/2022] [Accepted: 11/05/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Cerebral bypass for flow augmentation is an important technique for selected neurosurgical patients, with multiple techniques used (direct, indirect, or combined). OBJECTIVE To assess the impact of patient and technical variables on direct and indirect bypass flow after combined revascularization. METHODS This was a retrospective, single-institution review of patients undergoing direct superficial temporal artery-to-middle cerebral artery bypass with indirect encephaloduro-myosynangiosis for moyamoya disease and steno-occlusive cerebrovascular disease over a 2-year period. We evaluated the effect of baseline patient characteristics, preoperative imaging characteristics, and operative variables on direct and indirect patency grades. RESULTS Twenty-six hemispheres (8 moyamoya disease and 18 steno-occlusive cerebrovascular disease) in 23 patients were treated with combined revascularization. The mean patient age was 53.4 ± 19.1 years. Direct bypass patency was 96%. Over a mean follow-up of 8.3 ± 5.4 months, there were 3 strokes in the treated hemispheres (11.5%). The mean modified Rankin Scale score improved from 1.3 ± 1.1 preoperatively to 0.7 ± 0.8 postoperatively. Preservation of the nondonor superficial temporal artery branch was associated with a lower direct bypass grade ( P < .01), whereas greater mean time to maximum perfusion (Tmax)> 4 and >6 seconds and mismatch volumes were associated with higher direct bypass grades ( P < .05). Tmax >4-second volume inversely predicted indirect bypass patency. CONCLUSION Patient and technical variables may influence the relative contributions of the direct and indirect components of combined revascularizations.
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Affiliation(s)
- Robert C Rennert
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Michael G Brandel
- Department of Neurological Surgery, University of California San Diego, San Diego, California, USA
| | - Karol P Budohoski
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Spencer Twitchell
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Vance L Fredrickson
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Ramesh Grandhi
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - William T Couldwell
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
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Wibowo V, Munshi B, Ziolkowski J, Wilson I, Ma R, Jansen S. The Role of Near Infrared Spectroscopy in Diagnosing Stump Ischaemia in Patients with Below Knee Amputation: Case Reports. EJVES Vasc Forum 2023; 60:14-18. [PMID: 37448526 PMCID: PMC10336405 DOI: 10.1016/j.ejvsvf.2023.05.012] [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: 01/22/2023] [Revised: 04/20/2023] [Accepted: 05/23/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Functional near infrared spectroscopy (fNIRS) can be used to quantify stump oxygen saturation (SaO2) as one of many possible causes of pain following major amputation. Although commonly used for cerebral perfusion monitoring during carotid or cardiac surgery, it can also be used to monitor tissue perfusion in the lower limb and predict healing following below knee amputation (BKA). The aim of this study was to measure the SaO2 trend as there is no validated oxygen threshold to diagnose insufficient flow into the arterial collateral network currently. Report NIRS was used to measure SaO2 while performing treadmill exercise. Two BKA patients with chronic stump pain were asked to perform treadmill exercise while using their prosthesis and NIRS optode applied to the posterior stump to monitor SaO2. Cases 1 and 2 showed a decline in SaO2 of 25% and 18%, respectively, while walking on the prosthesis. After superficial femoral artery (SFA) recanalisation and stenting, Case 1 showed improvement by maintaining SaO2 between 54% and 60% throughout treadmill exercise. In Case 2, perfusion could not be further improved, and the patient underwent through knee amputation. Discussion fNIRS detected compressive ischaemia and exercise induced ischaemia as mechanisms of stump pain. Findings provided the multidisciplinary team with objective information, aiding decision making to treat stump pain.
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Affiliation(s)
- Valent Wibowo
- Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Bijit Munshi
- Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Jessica Ziolkowski
- Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Ian Wilson
- Department of Rehabilitation and Aged Care, Osborne Park Hospital, Perth, WA, Australia
| | - Robert Ma
- Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Shirley Jansen
- Vascular Surgery, Curtin Medical School, Curtin University, Perth, WA, Australia
- Professor Vascular Surgery, Curtin Medical School, Curtin University, Perth, WA, Australia
- Consultant Vascular and Endovascular Surgeon, Head of Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Director Heart and Vascular Research Institute, Harry Perkins Medical Research Institute, Perth, WA, Australia
- Clinical Professor University of Western Australia, Australia
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Maliki A, Djatisoesanto W, Hoetama S, Santoso AD. Parameatal urethral cyst: A case series of three rare cases and literature review. Int J Surg Case Rep 2023; 107:108341. [PMID: 37230059 DOI: 10.1016/j.ijscr.2023.108341] [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: 03/28/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Parameatal urethral cyst is a rare benign congenital urethral disorder with limited reports in the literature. The formation of the cyst is believed due to the obstruction of the paraurethral duct. This disorder usually does not produce symptoms even though, in an advanced case, urinary retention and flow disturbance may occur. CASE PRESENTATION Herewith, we report case series of parameatal urethral cysts in 5, 11, and 17 years old boys treated with complete surgical cyst excision. The first was 11 years-old-boy with asymptomatic 7 mm swelling in his urethral meatus. The second case was a 5 years-old-boy with 5 mm swelling in his urethral meatus with the complaint of urinary stream distortion. The third case involved a 17-year-old adolescent with a 4 mm cystic bulge in his urethral meatus that caused urinary distortion. CLINICAL DISCUSSIONS In these cases, the cysts were completely removed with surgical excision and the patients underwent circumcision. Histological examination revealed a cyst wall lined with squamous and columnar epithelium. Good cosmetic result without any recurrent mass and voiding difficulties was reported after 2 weeks of follow-up. CONCLUSIONS This study reported three cases of parameatal urethral cysts late presentation at an older age due to no prior symptoms. The patients were managed with surgical excision of the cyst resulting in good cosmesis outcome and without recurrence.
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Affiliation(s)
- Ahmad Maliki
- Department of Urology, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Wahjoe Djatisoesanto
- Department of Urology, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia.
| | - Sakti Hoetama
- Department of Urology, Dr. Ramelan Navy Hospital, Surabaya, East Java, Indonesia
| | - Anugrah Dianfitriani Santoso
- Department of Urology, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
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Hameed A, Gull H, Farooq Z, Khattak YR, Ahmad I. Do Case Reports on Total Mandibular, Extended, and Bilateral Total Temporomandibular Joint Reconstruction Prostheses Adhere to the Surgical CAse REport Guidelines? J Oral Maxillofac Surg 2023:S0278-2391(23)00395-6. [PMID: 37247813 DOI: 10.1016/j.joms.2023.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/06/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE The Surgical CAse REport (SCARE) guidelines are a standardized format for reporting surgical cases. The aim of this study was to evaluate the completeness of case reports documenting alloplastic reconstruction of large craniomaxillofacial defects involving total mandibular, bilateral, and extended temporomandibular joint in major high-quality craniomaxillofacial journals, based on the SCARE guidelines. METHODS An extensive online search was performed according to the Priority Reporting Items for Systematic Reviews and Meta-Analyses statement in PubMed, Embase, Scopus, Google Scholar, and Dimensions databases to identify relevant case reports. Each selected case report was assessed on 16 topics (38 items) of the SCARE guidelines, using a scoring scale of "0" (No/noncompliance), "1" (Yes/compliance), and 2" (unclear). The completeness of reporting (COR) score was calculated as the ratio of "yes" responses to "total" (ie, yes + no + unclear) responses. Adequacy of case reporting was denoted by a COR score of 70% or more. RESULTS A total of 35 case reports were selected, where the male to female patients ratio was 3:4 cases, mean ± standard deviation (SD) age: 34.9 ± 16.7 years, mean ± SD follow-up duration: 17.0 ± 12.9 months, and number of patients with left, right, and bilateral temporomandibular joint reconstruction prostheses were 16, 10, and 09, respectively. The mean ± SD COR score for all 35 case reports and the individual item of the SCARE guidelines was 70.2 ± 10.5% and 66.5 ± 31.2%, respectively. The minimum and maximum COR score was found for "Keywords" (0.0%) and "Introduction" (100%) and "Clinical Findings" (100%), respectively. Adequate reporting was found for 20/35 (57%) case reports. CONCLUSIONS This study revealed that case reports in major high-quality craniomaxillofacial journals suffer from insufficient reporting. Widespread adoption of available standards, such as SCARE guidelines, is proposed to improve the quality and robustness of case reporting.
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Affiliation(s)
- Ahsan Hameed
- Medical Officer, DHQ Teaching Hospital Sahiwal, Pakistan
| | - Hanan Gull
- Medical Officer, Farooq Hospital Lahore, Pakistan; Medical Officer, Akhtar Saeed Trust Hospital, Lahore, Pakistan
| | - Zunaira Farooq
- Medical Officer, Sahiwal Medical College, Sahiwal, Pakistan
| | - Yasir Rehman Khattak
- Assistant Professor, Oral and Maxillofacial Surgery, Hayatabad Medical Complex, Peshawar, Pakistan; Associate Professor, Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan.
| | - Iftikhar Ahmad
- Medical Officer, Sahiwal Medical College, Sahiwal, Pakistan
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Nguyen NH, Vu XV, Nguyen VQ, Nguyen TH, Du Nguyen H, Luong TH, Nguyen TK, Nguyen HH. Bach Mai Procedure for complete mesocolic excision, central vascular ligation, and D3 lymphadenectomy in total laparoscopic right hemicolectomy: a prospective study. World J Surg Oncol 2023; 21:140. [PMID: 37147674 PMCID: PMC10161467 DOI: 10.1186/s12957-023-03026-5] [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: 04/03/2023] [Accepted: 04/29/2023] [Indexed: 05/07/2023] Open
Abstract
PURPOSE Total laparoscopic right hemicolectomy with complete mesocolic excision (CME), central vascular ligation (CVL), and D3 lymphadenectomy is still the most challenging colon procedures for gastrointestinal surgeons. We herein report the technical details and our preliminary experience of Bach Mai Procedure - a novel-combining (cranial, medial to lateral, and caudal) approach with early resection of the terminal ileum. METHODS The dissection stage was central vascular isolation and ligation by a combined multiple approaches in the following four steps: cranial approach, dissecting along the inferior aspect of pancreatic isthmus to reveal the middle colic vessels and the anterior aspect of the superior mesentery vein and then exposed the right gastroepiploic vein and the trunk of Henle; medial-to-lateral approach, exposing the surgical axis - the superior mesenteric vascular axis and then early resection of the terminal ileum to open the dissection from the bottom up; and caudal approach, radical ligation of the ileocecal artery and right colic artery (central vascular ligation), lymph node dissection (D3 lymphadenectomy), and resecting the Toldt fascia of the colon to release the entire right colon from the abdominal wall. RESULTS In 12 months, there were 32 cases of primary right-sided colon malignancies that have undergone tLRHD3, CME/CVL based on the Bach Mai Procedure. In 3 cases (9.4%), the tumor site was hepatic flexure. The median of lymph node number (LNN) was 38, with the maximum number which was 101. No serious postoperative complications (grade 3 or higher) neither inhospital mortality was detected. CONCLUSION This Bach Mai procedure, a novel-combining approach with early resection of the terminal ileum, is technically feasible and safe for tLRHD3, CME/CVL. Further investigations and follow-up must be proceeded to evaluate the long-term outcomes of our technique.
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Affiliation(s)
- Ngoc Hung Nguyen
- Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, Vietnam
| | - Xuan Vinh Vu
- Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, Vietnam
- Department of Surgery, Hanoi Medical University, Hanoi, Vietnam
| | - Vu Quang Nguyen
- Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, Vietnam
| | - The Hiep Nguyen
- Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, Vietnam
- Department of Surgery, Hanoi Medical University, Hanoi, Vietnam
| | - Huy Du Nguyen
- Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, Vietnam
| | - Tuan Hiep Luong
- Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, Vietnam.
| | - Thanh Khiem Nguyen
- Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, Vietnam
| | - Ham Hoi Nguyen
- Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, Vietnam
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Hamd ZY, Ali MAM, Alorainy AI, Gareeballah A, Hamdoun A, Manssor E, Alhomida BA. Persistent Mullerian duct syndrome with polycystic ovary in a young adult: A rare case report. Radiol Case Rep 2023; 18:1825-1829. [PMID: 36923385 PMCID: PMC10008828 DOI: 10.1016/j.radcr.2023.02.015] [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: 01/12/2023] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 03/07/2023] Open
Abstract
Persistent Mullerian Duct Syndrome (PMDS) is a type of pseudohermaphroditism that occurs in males. It is an autosomal recessive type of familial disease that is commonly associated with a history of consanguinity. We have documented this case of a 22-year-old adult male who came with acute right iliac pain; after an ultrasound scan and hormone investigations, he was diagnosed with polycystic ovarian syndrome (PCOS).
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Affiliation(s)
- Zuhal Y Hamd
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Muthab A Mohammed Ali
- Department of Medical Diagnostic Ultrasound, Alzaim Alazhari University, Khartoum, Sudan
| | - Amal I Alorainy
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Awadia Gareeballah
- Department of Diagnostic Radiologic Technology, College of Applied Medical Science, Taibah University, Madina, Saudi Arabia
| | - Anas Hamdoun
- Medical Imaging Department, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - E Manssor
- Department of Applied Radiologic Technology, University of Jeddah, College of Applied Medical Sciences, Jeddah, Saudi Arabia
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Bin-Alamer O, Faramand A, Alarifi NA, Wei Z, Mallela AN, Lu VM, Nabeel AM, Reda WA, Tawadros SR, Abdelkarim K, El-Shehaby AM, Emad RM, Peker S, Samanci Y, Lee CC, Yang HC, Delabar V, Mathieu D, Tripathi M, Kearns KN, Bunevicius A, Sheehan JP, Chytka T, Liscak R, Moreno NM, Álvarez RM, Grills IS, Parzen JS, Cifarelli CP, Rehman AA, Speckter H, Niranjan A, Lunsford LD, Abou-Al-Shaar H. Stereotactic Radiosurgery for Vestibular Schwannoma in Neurofibromatosis Type 2: An International Multicenter Case Series of Response and Malignant Transformation Risk. Neurosurgery 2023; 92:934-944. [PMID: 36861994 PMCID: PMC10079356 DOI: 10.1227/neu.0000000000002436] [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: 10/03/2022] [Accepted: 01/09/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Vestibular schwannomas (VSs) related to neurofibromatosis type 2 (NF2) are challenging tumors. The increasing use of stereotactic radiosurgery (SRS) necessitates further investigations of its role and safety. OBJECTIVE To evaluate tumor control, freedom from additional treatment (FFAT), serviceable hearing preservation, and radiation-related risks of patients with NF2 after SRS for VS. METHODS We performed a retrospective study of 267 patients with NF2 (328 VSs) who underwent single-session SRS at 12 centers participating in the International Radiosurgery Research Foundation. The median patient age was 31 years (IQR, 21-45 years), and 52% were male. RESULTS A total of 328 tumors underwent SRS during a median follow-up time of 59 months (IQR, 23-112 months). At 10 and 15 years, the tumor control rates were 77% (95% CI: 69%-84%) and 52% (95% CI: 40%-64%), respectively, and the FFAT rate were 85% (95% CI: 79%-90%) and 75% (95% CI: 65%-86%), respectively. At 5 and 10 years, the serviceable hearing preservation rates were 64% (95% CI: 55%-75%) and 35% (95% CI: 25%-54%), respectively. In the multivariate analysis, age (hazards ratio: 1.03 [95% CI: 1.01-1.05]; P = .02) and bilateral VSs (hazards ratio: 4.56 [95% CI: 1.05-19.78]; P = .04) were predictors for serviceable hearing loss. Neither radiation-induced tumors nor malignant transformation were encountered in this cohort. CONCLUSION Although the absolute volumetric tumor progression rate was 48% at 15 years, the rate of FFAT related to VS was 75% at 15 years after SRS. None of the patients with NF2-related VS developed a new radiation-related neoplasm or malignant transformation after SRS.
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Affiliation(s)
- Othman Bin-Alamer
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Andrew Faramand
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Norah A. Alarifi
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Department of Neurosurgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Zhishuo Wei
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Arka N. Mallela
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Victor M. Lu
- Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA
| | - Ahmed M. Nabeel
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Neurosurgery Department, Benha University, Qalubya, Egypt
| | - Wael A. Reda
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Neurosurgery Department, Ain Shams University, Cairo, Egypt
| | - Sameh R. Tawadros
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Neurosurgery Department, Ain Shams University, Cairo, Egypt
| | - Khaled Abdelkarim
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Clinical Oncology Department, Ain Shams University, Cairo, Egypt
| | - Amr M.N. El-Shehaby
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Neurosurgery Department, Ain Shams University, Cairo, Egypt
| | - Reem M. Emad
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Selcuk Peker
- Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey
| | - Yavuz Samanci
- Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey
| | - Cheng-chia Lee
- Department of Neurosurgery, Neurological Institute, Taipei Veteran General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Huai-che Yang
- Department of Neurosurgery, Neurological Institute, Taipei Veteran General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Violaine Delabar
- Department of Neurosurgery, Université de Sherbrooke, Centre de recherche du CHUS, Sherbrooke, Quebec, Canada
| | - David Mathieu
- Department of Neurosurgery, Université de Sherbrooke, Centre de recherche du CHUS, Sherbrooke, Quebec, Canada
| | - Manjul Tripathi
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kathryn Nicole Kearns
- Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Adomas Bunevicius
- Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Jason P. Sheehan
- Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Tomas Chytka
- Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
| | - Roman Liscak
- Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
| | | | | | - Inga S. Grills
- Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan, USA
| | - Jacob S. Parzen
- Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan, USA
| | | | - Azeem A. Rehman
- Department of Neurosurgery, West Virginia University, Morgantown, West Virginia, USA
| | - Herwin Speckter
- Department of Radiology, Centro Gamma Knife Dominicano and Radiology Department, Cedimat, Santo Domingo, Dominican Republic
| | - Ajay Niranjan
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - L. Dade Lunsford
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Hussam Abou-Al-Shaar
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Sohrabi C, Mathew G, Maria N, Kerwan A, Franchi T, Agha RA. The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg 2023; 109:1136-1140. [PMID: 37013953 PMCID: PMC10389401 DOI: 10.1097/js9.0000000000000373] [Citation(s) in RCA: 468] [Impact Index Per Article: 468.0] [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: 03/09/2023] [Accepted: 03/16/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND The Surgical CAse REport (SCARE) guidelines were first published in 2016 as a tool for surgeons to document and report their surgical cases in a standardised and comprehensive manner. However, with advances in technology and changes in the healthcare landscape, it is important to revise and update these guidelines to ensure they remain relevant and valuable for surgeons. MATERIALS AND METHODS The updated guidelines were produced through a Delphi consensus exercise. Members of the SCARE 2020 guidelines Delphi group, editorial board members, and peer reviewers were invited to participate. Potential contributors were contacted by e-mail. An online survey was completed to indicate their agreement with the proposed changes to the guideline items. RESULTS A total of 54 participants were invited to participate and 44 (81.5%) completed the survey. There was a high degree of agreement among reviewers, with 36 items (83.7%) meeting the threshold for inclusion. CONCLUSION Through a completed Delphi consensus exercise we present the SCARE 2023 guidelines. This will provide surgeons with a comprehensive and up-to-date tool for documenting and reporting their surgical cases while highlighting the importance of patient-centred care.
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Affiliation(s)
- Catrin Sohrabi
- Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Ginimol Mathew
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, United Kingdom
| | - Nicola Maria
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Ahmed Kerwan
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Thomas Franchi
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Riaz A Agha
- Harley Clinic Group, 10 Harley Street, London, United Kingdom
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130
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Ngowi BN, Bright F, Lazaro E, Lodhia J, Kimolo M, Mbwambo OJ. Triple penile fracture: A rare case report and review of literature. Int J Surg Case Rep 2023; 106:108245. [PMID: 37126924 PMCID: PMC10172890 DOI: 10.1016/j.ijscr.2023.108245] [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: 03/26/2023] [Revised: 04/15/2023] [Accepted: 04/19/2023] [Indexed: 05/03/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Penile fracture is uncommon entity that rarely involves all the three erectile bodies (the two corpora carvenosa and corpus spongiosum). The diagnosis is clinical as most cases presents with typical signs and symptoms. CASE PRESENTATION We present a case of young man who sustained penile fracture involving the two corpora cavernosum and corpus spongiosum with associated urethral injury that was successfully repaired primarily. CLINICAL DISCUSSION In this case apart from MRI confirming the diagnosis it showed the injury to involve all the three corpora bodies as well as the urethral. Although MRI is reserved for controversial cases, when available, apart from just confirming the diagnosis, it can help in showing the extent of the injury and assist surgeon in management. Primary repair of the erectile bodies as well as the urethral gives excellent outcome. CONCLUSION This case reminds surgeons the possibility of having such extensive injury with promising outcome if properly managed.
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Affiliation(s)
- Bartholomeo Nicholaus Ngowi
- Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania.
| | - Frank Bright
- Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Ester Lazaro
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Jay Lodhia
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania
| | - Mathias Kimolo
- Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Orgeness Jasper Mbwambo
- Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
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131
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Devia DA, Graffeo CS, Benner D, Scherschinski L, Thomas G, Koester SW, Srinivasan VM, Lawton MT. Experience and Balance: Long-Term Trends in Preferred Skull Base Approach for a Case Series of Cavernous Malformation Resections. Oper Neurosurg (Hagerstown) 2023:01787389-990000000-00684. [PMID: 37083737 DOI: 10.1227/ons.0000000000000718] [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: 08/12/2022] [Accepted: 02/16/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Skull base approaches are a foundation of modern cerebrovascular surgery; however, their application over time has varied. OBJECTIVE To assess trends in skull base approach selection for cavernous malformation (CM) resection. METHODS This is a retrospective case series of all first-time CM resections by a single surgeon from 1997 to 2021. Cases were classified by craniotomy and approach. Four sets of common comparator skull base approaches were identified by coauthor consensus: pterional and orbitozygomatic; retrosigmoid, extended retrosigmoid (xRS), and far-lateral; suboccipital and torcular; and trans-cerebellar peduncle (MCP) and transcerebellopontine angle. Counts were binned by 5-year or 10-year clusters for descriptive statistical assessment of temporal trends. RESULTS In total, 372 primary CM resections met the study criteria and were included. Orbitozygomatic approach use increased during the second 5-year period, after which the pterional approach rapidly became and remained the preferred approach. During the first two 5-year periods, the far-lateral approach was preferred to the retrosigmoid and xRS approaches, but the xRS approach grew in popularity and accounted for >50% of operations in this comparator group. Trans-MCP use compared with the transcerebellopontine angle approach closely mirrored the change in xRS use. The midline suboccipital approach accounted for a larger proportion (range, 62%-88%) of cases than the torcular approach (range, 12%-38%) across all periods. CONCLUSION The xRS and trans-MCP approaches have been increasingly used over time, while the orbitozygomatic and far-lateral approaches have become less common. These trends seem to reflect versatility, efficiency, and safety of these techniques.
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Affiliation(s)
- Diego A Devia
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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132
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Adli G, Rahman IA, Djatisoesanto W. Male genital trauma caused by self-mutilation: A first case series report in Indonesia. Int J Surg Case Rep 2023; 106:108196. [PMID: 37087931 PMCID: PMC10149339 DOI: 10.1016/j.ijscr.2023.108196] [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: 02/15/2023] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Genital self-mutilation (GSM) is a rare phenomenon with a spectrum ranging from a superficial laceration to complete amputation of the external genitalia. These could result in severe impairment of genitourinary functions. Psychotic disorder adds to the complexity of the patients. Since GSM is underreported, we report the first case series in Indonesia. CASE PRESENTATION Four included patients comprised different injuries to the external genitalia, from a superficial laceration to penile amputation. Notably, these patients exhibited psychotic traits. Initial management consisted of bleeding control, debridement, and primary suturing. Depending on the extent of the injury, the repair comprised of spermatic cord ligation, penile reconstruction using a skin flap, defect closure with urethral spatulation, and exploration. We successfully managed all the patients surgically before undergoing psychotherapy to improve the patient's overall well-being and to reduce the risk of similar reoccurrence of GSM behavior. CLINICAL DISCUSSION The majority of GSM cases were associated with psychotic disorders. The current reports' injuries include penile laceration, total penile amputation, unilateral castration, and combined injury to the penis and scrotum. Although most GSM is not life-threatening, it may cause emergent, complex, and serious complications such as massive hemorrhage and severe infections. Appropriate investigations with systematic treatment strategies are required, especially in complex cases. CONCLUSION The incidence of genital self-mutilation necessitates a prompt evaluation of organ viability and the possibility of preserving tissue for optimal urinary and sexual outcomes. Interdisciplinary collaboration is required as the primary concern for management in cases of genital self-mutilation involving male genitalia and underlying psychological disorders.
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Affiliation(s)
- Ghazian Adli
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Ilham Akbar Rahman
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Wahjoe Djatisoesanto
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia.
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133
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Jabra SB, Chaouch MA, Moussa A, Jallali M, Toumi O, Noomen F. Incomplete common mesentery with Ladd's band and Meckel's diverticulum: A rare cause of small bowel obstruction. Int J Surg Case Rep 2023; 106:108159. [PMID: 37086501 PMCID: PMC10154727 DOI: 10.1016/j.ijscr.2023.108159] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 02/15/2023] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 04/24/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The common mesentery is an abnormal rotation of the primitive intestinal loop or omphalomesenteric loop. It is not necessarily symptomatic, but a clinical presentation of acute bowel obstruction on the band or volvulus can reveal it. We report a case of small bowel obstruction due to Ladd's band and Meckel's diverticulum on the incomplete common mesentery. PRESENTATION OF CASE We report a case of a 54-year-old man with no previous abdominal surgery who experienced periumbilical abdominal pain and vomiting. Physical examination revealed a diffusely tender and distended abdomen. Laboratory data showed a biological inflammatory syndrome. An abdominal CT scan revealed a small bowel mechanical obstruction with a double transitional level under the umbilical without a loop enhancement. An emergent laparotomy was performed. We found an incomplete common mesentery. The small bowel obstruction was due to a Ladd's band attrapping the Meckel's diverticulum. This association was responsible for dilating ileal loops at the superior part of the mechanical obstruction with necrosis of 30 cm of the small bowel. We have sectioned the congenital band and resected the necrotic segment, followed by an intestinal anastomosis. The postoperative follow-up was uneventful. CLINICAL DISCUSSION Incomplete common mesentery with Ladd's band and Meckel's diverticulum is an extremely rare association. Causing a small bowel obstruction remains an uncommon complication and circumstance of discovery. This complication presents a life-threatening condition. An abdominal CT scan could help for the diagnosis in some cases. Surgery is the standard treatment in most cases. CONCLUSION The association of incomplete common mesentery with Ladd's band and Meckel's diverticulum is uncommon and should be known to avoid intraoperative misdiagnose.
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Affiliation(s)
- Sadok Ben Jabra
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia
| | - Mohamed Ali Chaouch
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia.
| | - Amani Moussa
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia
| | - Maissa Jallali
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia
| | - Omar Toumi
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia
| | - Faouzi Noomen
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia
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134
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Muhammad N, Sioutas GS, Gajjar A, Salem MM, Kandregula S, Srinivasan VM, Jankowitz BT, Burkhardt JK. Intraoperative angiography via popliteal artery access for spinal neurovascular lesions: an institutional experience and systematic review. J Neurointerv Surg 2023:jnis-2023-020071. [PMID: 37028944 DOI: 10.1136/jnis-2023-020071] [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: 01/17/2023] [Accepted: 03/22/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Intraoperative DSA is used to confirm complete obliteration of neurovascular pathologies. For spinal neurovascular lesions, femoral access can be challenging given the need to flip the patient after sheath placement. Similarly, radial access can be complicated by arch navigation difficulties. Vascular access via the popliteal artery represents an appealing alternative option; however, data regarding its utility and efficacy in these cases are limited. METHODS A retrospective series of four consecutive patients between July 2016 and August 2022 who underwent intraoperative spinal DSA via the popliteal artery was analyzed. Additionally, a systematic review was conducted to collect previously reported such cases. Collective patient demographics and operative details are presented to consolidate the available evidence supporting popliteal access. RESULTS Four patients met the inclusion criteria from our institution. The systematic review yielded six previously published studies reporting 16 additional transpopliteal access cases. Of the 20 total cases (mean±SD age 60.8±17.2 years), 60% were men. Most treated lesions were dural arteriovenous fistulas (80%) located in the thoracic spine (55%) or cervical spine (25%). The left popliteal artery was most accessed and the highest visualized level was the craniocervical junction. All outcomes were either stable or improving after surgery, and no complications were observed. CONCLUSIONS We report the safety and feasibility of transpopliteal access for intraoperative DSA in the prone position in four cases in addition to 16 previously reported cases in the literature. Our case series highlights popliteal artery access as an alternative to transfemoral or transradial access in this setting.
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Affiliation(s)
- Najib Muhammad
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Georgios S Sioutas
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Avi Gajjar
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Mohamed M Salem
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
| | | | - Visish M Srinivasan
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Brian T Jankowitz
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Jan-Karl Burkhardt
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
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135
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Suleman M, Tendai J, Lodhia J. Burr hole as a management for extra axial hematomas in a low-resource setting. Int J Surg Case Rep 2023; 105:108125. [PMID: 37028184 PMCID: PMC10106472 DOI: 10.1016/j.ijscr.2023.108125] [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: 02/17/2023] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE In a low-resource setting, the availability of neurosurgeons and neurosurgical equipment for neurosurgery has proved to be a challenge for the management of extra-axial hematomas hence general surgeons perform burr hole surgeries for emergencies. CASE PRESENTATION We share our experience with three patients who presented with extra-axial hematomas and managed successfully in our institute with craniostomy as the surgical approach. CLINICAL DISCUSSION Traumatic brain injury is a major global health burden as it is a leading cause of death among the middle-aged population. Mortality associated with brain injury is highest in low- and middle-income countries. From our experience, we had good outcome in terms of improved Glasgow Coma Scale and overall clinical status in those who underwent burr hole surgery for extra axial hematoma. CONCLUSION The need for neurosurgeons in sub-Saharan Africa is high but training comes at a cost hence general surgeons can perform life-saving emergency procedures with good outcomes.
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Affiliation(s)
- Mujaheed Suleman
- Department of General Surgery, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania
| | - Joylene Tendai
- Department of General Surgery, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania
| | - Jay Lodhia
- Department of General Surgery, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Faculty of Medicine, PO Box 2240, Moshi, Tanzania.
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136
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Lunevicius R, Nzenwa IC. Multiple logistic regression model to predict bile leak associated with subtotal cholecystectomy. Surg Endosc 2023:10.1007/s00464-023-10049-2. [PMID: 37016083 PMCID: PMC10072799 DOI: 10.1007/s00464-023-10049-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/04/2022] [Accepted: 03/26/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND There are no prediction models for bile leakage associated with subtotal cholecystectomy (STC). Therefore, this study aimed to generate a multivariable prediction model for post-STC bile leakage and evaluate its overall performance. METHODS We analysed prospectively managed data of patients who underwent STC by a single consultant surgeon between 14 May 2013 and 21 December 2021. STC was schematised into four variants with five subvariants and classified broadly as closed-tract or open-tract STC. A contingency table was used to detect independent risk factors for bile leakage. A multiple logistic regression analysis was used to generate a model. Discrimination and calibration statistics were computed to assess the accuracy of the model. RESULTS A total of 81 patients underwent the STC procedure. Twenty-eight patients (35%) developed bile leakage. Of these, 18 patients (64%) required secondary surgical intervention. Multivariable logistic regression revealed two independent predictors of post-STC bile leak: open-tract STC (odds ratio [OR], 7.07; 95% confidence interval [CI], 2.191-25.89; P = 0.0170) and acute cholecystitis (OR, 5.449; 95% CI, 1.584-23.48; P = 0.0121). The area under the receiver-operating characteristic curve was 82.11% (95% CI, 72.87-91.34; P < 0.0001). Tjur's pseudo-R2 was 0.3189 and the Hosmer-Lemeshow goodness-of-fit statistic was 4.916 (P = 0.7665). CONCLUSIONS Open-tract STC and acute cholecystitis are the most reliable predictors of bile leakage associated with STC. Future prospective, multicentre studies with higher statistical power are needed to generate more specific and externally validated prediction models for post-STC bile leaks.
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Affiliation(s)
- Raimundas Lunevicius
- Department of General Surgery, Liverpool University Hospitals NHS Foundation Trust, Aintree Hospital, Lower Lane, Liverpool, L9 7AL, UK.
| | - Ikemsinachi C Nzenwa
- School of Medicine, University of Liverpool, Cedar House, Ashton St, Liverpool, L69 3GE, UK
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137
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Baig Mirza A, Pedro Lavrador J, Gebreyohanes A, Vastani A, China M, Kalaitzoglou D, Bartram J, Eid H, Bleil C, Bell D, Thomas N, Malik I, Grahovac G. Prognostic Factors for Surgically Managed Spontaneous Spinal Epidural Hematoma: A Single-Center Case Series of 18 Patients. Oper Neurosurg (Hagerstown) 2023; 24:391-403. [PMID: 36701561 DOI: 10.1227/ons.0000000000000562] [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: 06/29/2022] [Accepted: 09/30/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Spontaneous spinal epidural hematoma (SSEH) is a rare pathology, which carries a significant morbidity. OBJECTIVE To review our institutional experience of surgically managed patients with SSEH, seeking to better understand clinical prognostic factors related to postoperative outcomes and thereby improve counseling of patients before treatment. METHODS All patients who underwent surgical management of SSEH between September 2011 and 2021. Baseline and postoperative clinical and radiological characteristics are presented, including the American Spinal Injury Association grade (ASIA). Statistical analyses were performed using Stata 13.1. RESULTS Eighteen patients were identified in total (11 male patients and 7 female patients) with a median age of 59.5 (range 3-83) years. The most common spinal region affected was cervicothoracic (33.3%). Limb weakness (94.4%) and urinary dysfunction (83.3%) represented the most common presenting symptoms. Preoperatively, the presence of spinal cord edema on imaging was associated with worse preoperative Medical Research Council (MRC) grade ( P = .033), female sex was associated with preserved saddle sensation ( P = .04), and patients receiving antiplatelet medication were associated with a higher risk of preoperative axial back pain ( P = .005). Higher postoperative MRC grade was associated with higher preoperative ASIA ( P = .012) and MRC grade ( P = .005), and preservation of saddle sensation ( P = .018). Postoperative improvements in axial back pain were associated with higher preoperative ASIA grade ( P = .035) and anticoagulation treatment ( P = .029). CONCLUSION Neurosurgical intervention for SSEH yields positive outcomes and benefits patients. Patients with higher preoperative ASIA, MRC grade, and those presenting with preserved saddle sensation may experience further improved clinical outcomes after intervention.
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Affiliation(s)
- Asfand Baig Mirza
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Jose Pedro Lavrador
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Axumawi Gebreyohanes
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Amisha Vastani
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Musa China
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, UK.,University College London (UCL) Medical School, London, UK
| | - Dimitrios Kalaitzoglou
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - James Bartram
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Hazem Eid
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Christina Bleil
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - David Bell
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Nicholas Thomas
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Irfan Malik
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Gordan Grahovac
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
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138
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Huang W, Cai W, Cheng M, Hu X, Fang M, Sun Z, Wang S, Yan W. Modified Iliac Screw in Lumbopelvic Fixation After Sacral Tumor Resection: A Single-Center Case Series. Oper Neurosurg (Hagerstown) 2023; 24:350-356. [PMID: 36716021 DOI: 10.1227/ons.0000000000000539] [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: 05/21/2022] [Accepted: 09/18/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Traditional iliac screw, S2-alar iliac screw, and modified iliac screw are the 3 common techniques for lumbopelvic fixation. The application of the modified iliac technique in sacral spinal tumors has been rarely reported. OBJECTIVE To report the feasibility and safety of modified iliac screws after sacral tumor resection and their preliminary clinical outcomes. METHODS Twenty-seven patients who underwent sacral tumor resection with modified iliac screw fixation between August 2017 and August 2021 at our center were clinically and radiographically evaluated. RESULTS A total of 59 iliac screws were inserted by freehand according to the anatomic landmarks. The mean operation time was 207 minutes (range, 140-435 minutes). The average estimated blood loss was 1396 mL (300-4200 mL). Computed tomography scans showed that 2 (3.4%) screws penetrated the iliac cortex, indicating a 96.6% implantation accuracy rate. There were no iatrogenic neurovascular or visceral structure complications observed. The mean minimal distances from the screw head to the skin were 24.9 and 25.8 mm on the left and right sides, respectively. The mean minimal distances from the screw head to the horizontal level of the posterior superior iliac spine were 7.9 and 8.3 mm on the left and right sides, respectively. Two patients (7.4%) underwent reoperation for wound infection. At the latest follow-up, no patient had complications of screw head prominence, pseudarthrosis, or instrument failure. CONCLUSION The modified iliac screw is characterized by its minimal invasiveness and simplicity of placement. It is an ideal alternative for lumbopelvic fixation after sacral tumor resection.
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Affiliation(s)
- Wending Huang
- Spine Tumor Center, Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Weiluo Cai
- Spine Tumor Center, Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Mo Cheng
- Spine Tumor Center, Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xianglin Hu
- Spine Tumor Center, Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Meng Fang
- Spine Tumor Center, Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhengwang Sun
- Spine Tumor Center, Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shengping Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Radiology, Fudan University, Shanghai Cancer Center, Shanghai, China
| | - Wangjun Yan
- Spine Tumor Center, Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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139
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Haidar Ahmad H, Ibrahim R, Fadel A. Neck Sinus Post-Thyroidectomy Secondary to Retained Oxidized Regenerated Cellulose: A Case Report. Cureus 2023; 15:e37605. [PMID: 37197101 PMCID: PMC10184474 DOI: 10.7759/cureus.37605] [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] [Accepted: 04/15/2023] [Indexed: 05/19/2023] Open
Abstract
The present study aims to report the first case of chronic neck sinus post-thyroidectomy caused by oxidized regenerated cellulose (ORC). A 55-year-old female patient underwent a total thyroidectomy operation. Three months after the surgery, the patient presented with persistent purulent discharge and sinus at the site of the drain. A CT scan of the neck showed a fistula tract, deep-neck fluid collection, and bilateral paratracheal high-density lesions at the thyroid bed, suggesting infected foreign bodies. The patient underwent surgery, during which the mesh of the ORC was found nonresorbed at the paratracheal space. The treatment involved neck exploration with the removal of all retained material and excision of the sinus tract. The patient had a favorable outcome following the surgical excision of the sinus tract and the removal of retained hemostatic materials. Further research is needed to explore the risk factors and preventive measures for neck sinus formation to enhance the safety and outcomes of thyroidectomy.
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Affiliation(s)
| | - Rana Ibrahim
- Research Department, Saint George Hospital, Beirut, LBN
| | - Abbas Fadel
- Infectious Diseases Department, Saint George Hospital, Beirut, LBN
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Carroll CP, Andaluz NO, Kosty JA, Zuccarello M, Zimmer LA. Long-Term Results of Endoscopic Endonasal Marsupialization of Rathke Cleft Cysts With Bioabsorbable Steroid-Eluting Stents-Technical Case Series and Review of the Literature. Oper Neurosurg (Hagerstown) 2023; 24:368-376. [PMID: 36701658 DOI: 10.1227/ons.0000000000000543] [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: 06/14/2022] [Accepted: 09/22/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Rathke cleft cysts (RCCs) are common benign skull-base lesions arising from embryologic remnants of Rathke pouch. Though frequently asymptomatic, RCCs can become symptomatic because of compression of adjacent neural structures. Transcranial and neuroendoscopic surgical treatments have been described for symptomatic RCCs, but recurrence rates remain as high as 30%. Bioabsorbable steroid-eluting (BASE) stents significantly decrease adhesions and recurrent ostia obstruction after endoscopic sinus surgery. We sought to use BASE stents to aid marsupialization of symptomatic RCCs. OBJECTIVE To present long-term results of our initial experience with endoscopic-endonasal fenestration and placement of BASE stents for RCCs. METHODS Patients undergoing neuroendoscopic transsphenoidal fenestration of RCCs with BASE stent placement were identified and their medical records retrospectively reviewed. RESULTS Four patients underwent neuroendoscopic transsphenoidal fenestration and BASE stent placement from March 2016 to April 2018 for symptomatic RCCs. After the cyst contents were evacuated, a BASE stent was deployed in the cyst fenestration to prevent cyst wall regrowth or closure and facilitate marsupialization to the sphenoid sinus. No perioperative complications were encountered, and all patients reported symptom resolution by 2 weeks postoperatively. Postoperative endoscopic evaluation demonstrated epithelization of the cyst wall opening and patent marsupialization into the sphenoid sinus in all cases. After a mean follow-up of 56 ± 12 months, all patients remained asymptomatic with baseline visual function and no radiographic evidence of recurrence. CONCLUSION Bioabsorbable steroid-eluting stent placement is a safe, facile, viable augmentation of neuroendoscopic technique for symptomatic RCCs with the potential to reduce long-term recurrence rates.
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Affiliation(s)
- Christopher P Carroll
- Department of Brain and Spine Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA.,Department of Surgery, Division of Neurosurgery, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
| | - Norberto O Andaluz
- Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jennifer A Kosty
- Department of Neurosurgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA
| | - Mario Zuccarello
- Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Lee A Zimmer
- Department of Otolaryngology, Mercy Health, Cincinnati, Ohio, USA
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141
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Colasurdo M, Edhayan G, Al Taweel A, Barghash M, Kan P, Raghuram K. The Rationale Behind Transcirculation Neuroendovascular Interventions: Literature Review Through a Case-Series Approach. Oper Neurosurg (Hagerstown) 2023; 24:357-367. [PMID: 36701756 DOI: 10.1227/ons.0000000000000540] [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: 05/21/2022] [Accepted: 09/20/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND With the development of advanced endovascular techniques and materials, neurointerventionalists can perform challenging and complex cases that were previously difficult to perform. Transcirculation approaches could be a useful tool used in complicated cases, providing access to the target vessel, through the contralateral or opposite circulation, when anterograde access is difficult or nonachievable. OBJECTIVE To retrospectively review cerebrovascular interventions performed through a transcirculation approach performed by staff at our Institution. METHODS English-language studies, published until August 2022, reporting transcirculation interventions in the cerebrovascular circulation were retrospectively collected. Type of intervention, number of cases, rationale, and complications were analyzed. Furthermore, similar cases performed by staff currently at our institution were also reviewed and described. RESULTS Including our cases, a total of 273 transcirculation treatment approaches have been reported. Intracranial aneurysm embolization, stroke thrombectomies, intra-arterial ophthalmic chemotherapy, arteriovenous malformationss, arteriovenous fistulas embolizations, and intracranial angioplasty and stenting are common indications. Reason for using a retrograde approach were stent/balloon-assisted coiling of wide neck aneurysm in 116 cases, difficult angulation of branch in 91 cases, occlusion of parent vessel in 55 cases, and bailout/other in 11 cases. CONCLUSION Transcirculation approaches can be considered for cases where conventional anterograde treatment options are not feasible or as a bailout strategy in failed or complicated treatment attempts. They represent a strategy to consider when facing challenging cases, and if performed by experienced and dedicated neurointerventionalists, they can represent a safe alternative.
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Affiliation(s)
- Marco Colasurdo
- Department of Radiology, Division of Neuroradiology, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Gautam Edhayan
- Department of Radiology, Division of Neuroradiology, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Alaha Al Taweel
- Department of Radiology, Division of Neuroradiology, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Maggie Barghash
- Department of Radiology, Division of Neuroradiology, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Peter Kan
- Department of Neurosurgery, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Karthikram Raghuram
- Department of Radiology, Division of Neuroradiology, The University of Texas Medical Branch, Galveston, Texas, USA
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142
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Hermi A, Saadi A, Mokadem S, Boussaffa H, Zaghbib S, Haroun A, Bouzouita A, Derouiche A, Chakroun M, Ben Slama MR. Retrovesical hydatid cyst: an unusual location of hydatid disease about a case series. Ann Med Surg (Lond) 2023; 85:722-726. [PMID: 37113869 PMCID: PMC10129112 DOI: 10.1097/ms9.0000000000000380] [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: 02/06/2023] [Accepted: 02/25/2023] [Indexed: 04/29/2023] Open
Abstract
Hydatid disease is an endemic zoonosis in regions with temperate climates where pastoral farming is common. Retrovesical localization is rare. Given the rarity of this entity, the lack of personal clinical experience, and the difficulty with detecting early symptoms, the diagnosis remains elusive for years. Methods This is a 30-year retrospective, descriptive and analytic study of seven patients who were hospitalized and operated on in the Department of Urology during 30 years (1990-2019). Outcomes The average patient age was 54 years (range: 28-76). Signs of bladder irritation were the predominant presenting complaint. No cases of hydaturia were noted. Preoperative diagnosis was based on ultrasonography and serology tests. Hydatid serology was positive for three patients. In three cases, a hydatid cyst of the liver was associated. A partial cystopericystectomy was performed for five patients, it was total for one patient. The resection of the prominent dome was realized once. No cystovesical fistula was found. The mean postoperative stay was 16 days. The postoperative course was uneventful for five patients. Urinary fistula occurred in one patient. One case of infection of the residual cavity was observed. One patient had a retroperitoneal cyst recurrence requiring reoperation. Conclusion The preoperative diagnosis of retrovesical hydatid cysts is based mainly on ultrasonography. Open surgery is the treatment of choice. Different approaches are possible. Given the rarity of this entity, management should be guided by experienced experts.
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Affiliation(s)
- Amine Hermi
- Corresponding author. Address: Department of Urology, Faculty of Medicine, Charles Nicolle Hospital, Tunis, Tunisia 1007. Tel.: +216 5570 4699. E-mail address: (A. Hermi)
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143
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Youssef S, Tomson P, Akbari AR, Archer N, Shah F, Heran J, Kandhari S, Pai S, Mehrotra S, Batt JM. The Impact of the Preferred Reporting Items for Case Reports in Endodontics (PRICE) 2020 Guidelines on the Reporting of Endodontic Case Reports. Cureus 2023; 15:e37553. [PMID: 37197127 PMCID: PMC10184739 DOI: 10.7759/cureus.37553] [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] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
Aim The aim of this study is to evaluate the impact of the Preferred Reporting Items for Case reports in Endodontics (PRICE) 2020 guideline on the reporting of published endodontic case reports (CRs). Methodology All case reports published in the International Endodontic Journal, European Endodontic Journal, Journal of Endodontics and Restorative Dentistry and Endodontics, in the year before and after the release of PRICE 2020, were included for analysis. Two panels comprising dentists scored case reports against a scoring system adapted from the guideline. Individual items were scored up to a maximum of 1; scores were then summated to provide an overall maximum of 47 for each CR. Each report provided an overall percentage adherence, and panel agreement was calculated using the intraclass correlation coefficient (ICC). Disagreement on scoring was discussed until a consensus was reached. Scores before and after PRICE guideline publication were compared using an unpaired two-tailed t test. Results A total 19 CRs were identified in both the pre- and post-PRICE guideline publication. Mean adherence to PRICE 2020 increased by 7.9% (p=0.003) from 70.0%±8.89 to 77.9%±6.23 following its publication. Agreement between panels was moderate (ICC pre-PRICE: 0.673 {p=0.011}; ICC post-PRICE: 0.742 {p=0.003}). Items 1a, 6c, 6e, 6f, 6g, 6j, 6q, 6s, 7a, 9a, 11a, 12c and 12d experienced a fall in compliance. Conclusion The PRICE 2020 guideline has resulted in a modest improvement in the reporting of endodontic case reports. Greater awareness and a wider acceptance and implementation of the guideline in endodontic journals are needed to improve adherence to the novel guideline.
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Affiliation(s)
- Sofian Youssef
- Academic Research, University of Nottingham, Nottingham, GBR
| | | | | | | | - Fayjel Shah
- Endodontics, University of Birmingham, Birmingham, GBR
| | - Jasmeet Heran
- Endodontics, University of Birmingham, Birmingham, GBR
| | | | - Sandeep Pai
- Endodontics, University of Birmingham, Birmingham, GBR
| | | | - Joanna M Batt
- Restorative Dentistry, University of Birmingham, Birmingham, GBR
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144
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Maheo A, Vithiya B SM, Arul Prasad T A, Mangesh VL, Perumal T, Al-Qahtani WH, Govindasamy M. Cytotoxic, Antidiabetic, and Antioxidant Study of Biogenically Improvised Elsholtzia blanda and Chitosan-Assisted Zinc Oxide Nanoparticles. ACS Omega 2023; 8:10954-10967. [PMID: 37008090 PMCID: PMC10061636 DOI: 10.1021/acsomega.2c07530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/06/2023] [Indexed: 06/19/2023]
Abstract
In the present study, we have improvised a biogenic method to fabricate zinc oxide nanoparticles (ZnO NPs) using chitosan and an aqueous extract of the leaves of Elsholtzia blanda. Characterization of the fabricated products was carried out with the help of ultraviolet-visible, Fourier transform infrared, X-ray diffraction, field emission scanning electron microscopy, high-resolution transmission electron microscopy, selected area electron diffraction, and energy-dispersive X-ray analyses. The size of the improvised ZnO NP measured between 20 and 70 nm and had a spherical and hexagonal shape. The ZnO NPs proved to be highly effective in the antidiabetic test as the sample showed the highest percentage of enzyme inhibition at 74% ± 3.7, while in the antioxidant test, 78% was the maximum percentage of 2,2-diphenyl-1-picrylhydrazyl hydrate scavenging activity. The cytotoxic effect was investigated against the human osteosarcoma (MG-63) cell line, and the IC50 value was 62.61 μg/mL. Photocatalytic efficiency was studied by the degradation of Congo red where 91% of dye degradation was observed. From the various analyses, it can be concluded that the as-synthesized NPs may be suitable for various biomedical applications as well as for environmental remediation.
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Affiliation(s)
- Athisa
Roselyn Maheo
- PG
and Research Department of Chemistry, Auxilium
College (Autonomous) (Affiliated to Thiruvalluvar University, Serkadu), Vellore 632006, India
| | - Scholastica Mary Vithiya B
- PG
and Research Department of Chemistry, Auxilium
College (Autonomous) (Affiliated to Thiruvalluvar University, Serkadu), Vellore 632006, India
| | - Augustine Arul Prasad T
- PG
and Research Department of Chemistry, Dwarakadoss
Goverdhandoss Vaishnav College (Autonomous) (Affiliated to University
of Madras), Chennai 600106, India
| | - V. L. Mangesh
- Department
of Mechanical Engineering, Koneru Lakshmaiah
Education Foundation, Vaddeswaram, Guntur 522502, Andhra
Pradesh, India
| | - Tamizhdurai Perumal
- PG
and Research Department of Chemistry, Dwarakadoss
Goverdhandoss Vaishnav College (Autonomous) (Affiliated to University
of Madras), Chennai 600106, India
| | - Wahidah H. Al-Qahtani
- Department
of Food Sciences & Nutrition, College of Food & Agriculture
Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mani Govindasamy
- Faculty,
International Ph.D. Program in Innovative Technology of Biomedical
Engineering and Medical Devices, Ming Chi
University of Technology, New Taipei
City 243303, Taiwan
- Adjunct
Faculty,
Department of Research and Innovation, Saveetha School of Engineering, SIMATS, Thandalam, Chennai 602105, India
- Korea
University of Technology and Education, Cheonan-si 31253, Chungcheongnam-do, Republic of Korea
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145
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Wu BT, Feld Z, Creinin MD. Management of Cesarean Scar Ectopic Pregnancies at an Academic Referral Center: A Case Series. Contraception 2023:110021. [PMID: 36940910 DOI: 10.1016/j.contraception.2023.110021] [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: 12/06/2022] [Revised: 03/04/2023] [Accepted: 03/13/2023] [Indexed: 03/22/2023]
Abstract
OBJECTIVE To describe treatment and outcomes of patients with confirmed cesarean scar ectopic pregnancy (CSEP) at a tertiary referral center. STUDY DESIGN We reviewed a de-identified family planning clinical database for patients seen by our subspecialty service for CSEP from January 2017 through December 2021 in this case series. We extracted referral information, final diagnosis, management, and outcome measures including estimated blood loss (EBL), secondary procedures and treatment complications. RESULTS Of 57 cases referred for suspected CSEPs, 23 (40%) had confirmed diagnoses; one additional case was diagnosed during clinic evaluation for early pregnancy loss. Most (n=50 [88%]) referrals occurred in the last 2 years of the 5-year study period. Of 24 confirmed CSEP cases, 8 were pregnancy losses at the time of diagnosis. Fourteen cases were ≤50 days gestation or gestational size (7 [50%] pregnancy losses) and 10 >50 days gestation (range 39-66 days). We treated all 14 patients ≤50 days primarily with suction aspiration under ultrasound guidance in an operating room with no complications and EBL of 14±10 mL. Of the ten patients >50 days (maximum 66 days), 7 were managed with primary aspiration of which 5 were uncomplicated. We treated one patient (57 days) had primary intrauterine double-catheter balloon with immediate hemorrhage requiring uterine artery embolization followed by an uncomplicated suction aspiration. CONCLUSION Patients with confirmed CSEPs at 50 days or less gestation or gestational size can likely be primarily treated with suction aspiration with low risk for significant adverse outcomes. Treatment success and complications are directly related to gestational age at treatment.
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Affiliation(s)
- Brenda T Wu
- Department of Obstetrics and Gynecology; University of California, Davis; Sacramento, CA, USA
| | - Zoe Feld
- Department of Obstetrics and Gynecology; University of California, Davis; Sacramento, CA, USA
| | - Mitchell D Creinin
- Department of Obstetrics and Gynecology; University of California, Davis; Sacramento, CA, USA.
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146
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Salem MM, Ravindran K, Hoang AN, Doron O, Esparza R, Raper D, Jankowitz BT, Tanweer O, Lopes D, Langer D, Nossek E, Burkhardt JK. Sonolucent Cranioplasty in Extracranial to Intracranial Bypass Surgery: Early Multicenter Experience of 44 Cases. Oper Neurosurg (Hagerstown) 2023:01787389-990000000-00655. [PMID: 36929760 DOI: 10.1227/ons.0000000000000674] [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: 06/23/2022] [Accepted: 01/10/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND The new sonolucent cranioplasty implant (clear polymethyl methacrylate, PMMA) adds functionality besides surgical reconstruction. One possible application uses the transcranioplasty ultrasound (TCUS) technique after PMMA cranioplasty to assess graft patency of extracranial-intracranial (EC-IC) bypass procedures. OBJECTIVE To report our early multicenter experience. METHODS This is a multicenter analysis of consecutive EC-IC bypass patients from 5 US centers (2019-2022) with closure postbypass using PMMA implant. RESULTS Forty-four patients (median age 53 years, 68.2% females) were included. The most common indication for bypass was Moyamoya disease/syndrome (77.3%), and superficial temporal artery to middle cerebral artery bypass was the most common procedure (79.5%). Pretreatment modified Rankin Scales of 0 and 1 to 2 were noted in 11.4% and 59.1% of patients, respectively. Intraoperative imaging for bypass patency involved a combination of modalities; Doppler was the most used modality (90.9%) followed by indocyanine green and catheter angiography (86.4% and 61.4%, respectively). Qualitative TCUS assessment of graft patency was feasible in all cases. Postoperative inpatient TCUS confirmation of bypass patency was recorded in 56.8% of the cases, and outpatient TCUS surveillance was recorded in 47.7%. There were no cases of bypass failure necessitating retreatment. Similarly, no implant-related complications were encountered in the cohort. Major complications requiring additional surgery occurred in 2 patients (4.6%) including epidural hematoma requiring evacuation (2.3%) and postoperative surgical site infection (2.3%) that was believed to be unrelated to the implant. CONCLUSION This multicenter study supports safety and feasibility of using sonolucent PMMA implant in EC-IC bypass surgery with the goal of monitoring bypass patency using TCUS.
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Affiliation(s)
- Mohamed M Salem
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Krishnan Ravindran
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA
| | - Alex Nguyen Hoang
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Omer Doron
- Department of Neurosurgery, Lenox Hill Hospital, New York City, New York, USA
| | - Rogelio Esparza
- Department of Neurosurgery, New York University School of Medicine, New York, New York, USA
| | - Daniel Raper
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Brian T Jankowitz
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Omar Tanweer
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Demetrius Lopes
- Department of Neurosurgery, Advocate Aurora Health System, Chicago, Illinois, USA
| | - David Langer
- Department of Neurosurgery, Lenox Hill Hospital, New York City, New York, USA
| | - Erez Nossek
- Department of Neurosurgery, New York University School of Medicine, New York, New York, USA
| | - Jan-Karl Burkhardt
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
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Joosten JJ, Slooter MD, van den Elzen RM, Bloemen PR, Laméris W, de Bruin DM, Bemelman WA, Hompes R. Understanding fluorescence time curves during ileal pouch-anal anastomosis with or without vascular ligation. Surg Endosc 2023:10.1007/s00464-023-09921-y. [PMID: 36917344 DOI: 10.1007/s00464-023-09921-y] [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: 12/21/2022] [Accepted: 01/28/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Intraoperative indocyanine green fluorescence angiography (ICG-FA) may be of added value during pouch surgery, in particular after vascular ligations as lengthening maneuver. The aim was to determine quantitative perfusion parameters within the efferent/afferent loop and explore the impact of vascular ligation. Perfusion parameters were also compared in patients with and without anastomotic leakage (AL). METHODS All consenting patients that underwent FA-guided ileal pouch-anal anastomosis (IPAA) between July 2020 and December 2021 were included. After intravenous bolus injection of 0.1 mg/kg ICG, the near-infrared camera (Stryker Aim 1688) registered the fluorescence intensity over time. Quantitative analysis of ICG-FA from standardized regions of interests on the pouch was performed using software. Fluorescence parameters were extracted for inflow (T0, Tmax, Fmax, slope, Time-to-peak) and outflow (T90% and T80%). Change of management related to FA findings and AL rates were recorded. RESULTS Twenty-one patients were included, three patients (14%) required vascular ligation to obtain additional length, by ligating terminal ileal branches in two and the ileocolic artery (ICA) in one patient. In nine patients the ICA was already ligated during subtotal colectomy. ICG-FA triggered a change of management in 19% of patients (n = 4/21), all of them had impaired vascular supply (ligated ileocolic/ terminal ileal branches). Overall, patients with intact vascular supply had similar perfusion patterns for the afferent and efferent loop. Pouches with ICA ligation had longer Tmax in both afferent as efferent loop than pouches with intact ICA (afferent 51 and efferent 53 versus 41 and 43 s respectively). Mean slope of the efferent loop diminished in ICA ligated patients 1.5(IQR 0.8-4.4) versus 2.2 (1.3-3.6) in ICA intact patients. CONCLUSION Quantitative analysis of ICG-FA perfusion during IPAA is feasible and reflects the ligation of the supplying vessels.
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Affiliation(s)
- J J Joosten
- Department of Surgery, Amsterdam University Medical Centres (UMC), Academic Medical Centre (AMC), Postbox 22660, 1100 DD, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.,Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M D Slooter
- Department of Radiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.,Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R M van den Elzen
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.,Department of Biomedical Engineering, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.,Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - P R Bloemen
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.,Department of Biomedical Engineering, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.,Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - W Laméris
- Department of Surgery, Amsterdam University Medical Centres (UMC), Academic Medical Centre (AMC), Postbox 22660, 1100 DD, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.,Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - D M de Bruin
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.,Department of Biomedical Engineering, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.,Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - W A Bemelman
- Department of Surgery, Amsterdam University Medical Centres (UMC), Academic Medical Centre (AMC), Postbox 22660, 1100 DD, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.,Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R Hompes
- Department of Surgery, Amsterdam University Medical Centres (UMC), Academic Medical Centre (AMC), Postbox 22660, 1100 DD, Amsterdam, The Netherlands. .,Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands. .,Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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148
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Osterbur Badhey ML, Li S, Alimena S, Johnson NR, Bartz D. Allergic and Infectious complications of Etonogestrel Implant Placements: A Case Series. Contraception 2023; 122:109994. [PMID: 36871621 DOI: 10.1016/j.contraception.2023.109994] [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: 09/19/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 03/07/2023]
Abstract
Patients rarely experience complications at time of Etonogestrel subdermal contraceptive implant placement. Few case reports describe infection or allergy as a complication at time of implant insertion. In this case series, we discuss three infections and one allergic reaction following Etonogestrel implant placement, review 6 previous case reports of 8 cases of infection or allergy and discuss management of these complications. We highlight differential diagnosis when encountering a placement complication, considerations of dermatologic conditions when placing Etonogestrel implants, and discuss when to consider removal of the implant when a complication occurs.
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Affiliation(s)
- Marika L Osterbur Badhey
- Integrated Residency Program in OBGYN, Massachusetts General Hospital/Brigham and Women's Hospital Brigham and Women's Hospital, Boston, MA, USA
| | - Sue Li
- Integrated Residency Program in OBGYN, Massachusetts General Hospital/Brigham and Women's Hospital Brigham and Women's Hospital, Boston, MA, USA
| | - Stephanie Alimena
- Integrated Residency Program in OBGYN, Massachusetts General Hospital/Brigham and Women's Hospital Brigham and Women's Hospital, Boston, MA, USA
| | - Natasha R Johnson
- Department of Obstetrics and Gynecology, Division of Women's Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Deborah Bartz
- Department of Obstetrics and Gynecology, Division of Women's Health, Brigham and Women's Hospital, Boston, MA, USA.
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149
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Longatti P, Feletti A, Basaldella L, Boaro A, Sala F, Fiorindi A. The Roof of the 4th Ventricle Seen From Inside: Endoscopic Anatomic Illustration-A Case Series. Oper Neurosurg (Hagerstown) 2023:01787389-990000000-00643. [PMID: 36867083 DOI: 10.1227/ons.0000000000000669] [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: 10/29/2022] [Accepted: 01/04/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The anatomy of the roof of the fourth ventricle has been illustrated in many laboratory investigations, but in vivo reports of the roof anatomy and its variants are still lacking. OBJECTIVE To describe the topographical anatomy of the roof of the fourth ventricle explored through a transaqueductal approach that overcomes cerebrospinal fluid depletion, displaying in vivo anatomic images possibly quite close to normal physiological conditions. METHODS We critically reviewed the intraoperative video recordings of our 838 neuroendoscopic procedures, selecting 27 cases of transaqueductal navigation that provided good quality image details of the anatomy of the roof of the fourth ventricle. Twenty-six patients affected by different forms of hydrocephalus were therefore categorized into three groups: Group A: blockage of the aqueduct-aqueductoplasty, Group B: communicating hydrocephalus, and Group C: tetraventricular obstructive hydrocephalus. RESULTS Group A has shown what the roof of a normal fourth ventricle really looks like albeit the structures seemed overcrowded because of the narrow space. Images from groups B and C paradoxically allowed a more distinct identification of the roof structures flattened by ventricular dilation, making them more comparable with the topography traced on the laboratory microsurgical studies. CONCLUSION Endoscopic in vivo videos and images provided a novel anatomic view and an in vivo redefinition of the real topography of the roof of the fourth ventricle. The relevant role of cerebrospinal fluid was defined and outlined, as well as the effects of hydrocephalic dilation on some structures on the roof of the fourth ventricle.
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Affiliation(s)
| | - Alberto Feletti
- Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, Verona, Italy
| | - Luca Basaldella
- Unit of Neurosurgery, Neuro-cardio-vascular Department, Azienda AULSS2 Marca Trevigiana, Treviso, Italy
| | - Alessandro Boaro
- Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, Verona, Italy
| | - Francesco Sala
- Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, Verona, Italy
| | - Alessandro Fiorindi
- Neurosurgical Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Spedali Civili, University of Brescia, Brescia, Italy
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Huseynov E, Aliyev V, Coban G. Bile Leakage From the Luschka Duct After Laparoscopic Sleeve Gastrectomy and Cholecystectomy: A Case Report. Cureus 2023; 15:e35684. [PMID: 37009350 PMCID: PMC10065306 DOI: 10.7759/cureus.35684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/06/2023] Open
Abstract
Bile leakage may develop as a result of traumatic or iatrogenic injuries of bile ducts during laparoscopic cholecystectomy (LC). The frequency of Luschka duct injuries during LC is extremely rare. In this case, we present a case of bile leakage due to Luschka duct injury during sleeve gastrectomy (SG) and LC. The leakage was not noticed during the surgery, and on postoperative day 2, bilious drainage was seen from the drain. Magnetic resonance imaging (MRI) was helpful to determine Luschka duct injury. Biliary leakage resolved after endoscopic retrograde cholangiopancreatography (ERCP) with stent placement.
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