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Habib M, Amjad MB, Abbas M, Chaudhary MA. Gastric Trichobezoars in paediatric population– A series of six cases and literature review. Ann Med Surg (Lond) 2022; 84:104906. [DOI: 10.1016/j.amsu.2022.104906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/05/2022] [Accepted: 11/06/2022] [Indexed: 11/15/2022] Open
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202
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Shah H, Chisena E, Nguyen B, Tristram D, Bialowas C. Successful management of mucormycosis infection secondary to motor vehicle accident in a healthy adolescent: A case report. Med Mycol Case Rep 2022; 38:36-40. [DOI: 10.1016/j.mmcr.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/16/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022] Open
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203
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Selokar N, Vidyalakshmi R, Thiviya P, Sinija VRN, Hema V. Assessment of nutritional quality of
non‐conventional
millet malt enriched bar. J FOOD PROCESS PRES 2022. [DOI: 10.1111/jfpp.17271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Nupur Selokar
- Food Processing Business Incubation Centre National Institute of Food Technology Entrepreneurship and Management, (NIFTEM‐T) Thanjavur India
| | - Rajagopal Vidyalakshmi
- Food Safety and Quality Testing National Institute of Food Technology Entrepreneurship and Management, (NIFTEM‐T) Thanjavur India
| | - Perumal Thiviya
- Food Processing Business Incubation Centre National Institute of Food Technology Entrepreneurship and Management, (NIFTEM‐T) Thanjavur India
| | | | - Vincent Hema
- Centre of Excellence in Grain Science National Institute of Food Technology Entrepreneurship and Management, (NIFTEM‐T) Thanjavur India
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204
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Bak M, Jaffry K, Tan PY. A rare presentation of appendicitis contained within an incisional hernia post loop ileostomy reversal - A case report. Int J Surg Case Rep 2022; 101:107814. [PMID: 36462234 PMCID: PMC9712665 DOI: 10.1016/j.ijscr.2022.107814] [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: 10/29/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Appendicitis within an incisional hernia is rare, with current literature describing a small number of cases, occurring through a variety of surgical incisions. We describe a case of appendicitis contained within an incisional hernia following reversal of a loop ileostomy, on a background of previous sigmoid cancer resection. This is the second such case we were able to identify on literature review. CASE PRESENTATION A 45 year old man presented with one day of migratory abdominal pain, predominantly focused at a tender, irreducible lump in his right lower quadrant, underlying the scar from previous reversal of loop ileostomy. CT on admission revealed an incisional hernia, containing an inflamed appendiceal tip. He underwent an uncomplicated laparoscopic appendicectomy and primary suture closure of the hernia defect, and was discharged the following day. Acute appendicitis was confirmed on histopathology. DISCUSSION Placement of a defunctioning ileostomy is common in the management of colonic cancers, and incisional hernias are a common complication. It is however rare for an appendix to be contained within a hernia sac, and even rarer for appendicitis to develop in this setting. As a result, the presentation of this condition may mimic that of an incarcerated or strangulated incisional hernia, with pre-operative diagnosis typically relying on diagnostic imaging. CONCLUSION Incisional hernia appendicitis is rare and presents a diagnostic challenge. Early recognition of this dual pathology is necessary to allow for prompt surgical management of both the appendicitis and hernia, as well as guiding the approach for hernia repair.
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Affiliation(s)
- Marek Bak
- Department of General Surgery, Monash Health, Melbourne, Victoria, Australia,Corresponding author at: Monash Health, 246 Clayton Road, Clayton, Victoria 3168, Australia.
| | - Kumail Jaffry
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Pee Yau Tan
- Department of General Surgery, Monash Health, Melbourne, Victoria, Australia
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205
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Scherschinski L, Jubran JH, Shaftel KA, Furey CG, Farhadi DS, Benner D, Hendricks BK, Smith KA. Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Management of Low-Grade Gliomas and Radiation Necrosis: A Single-Institution Case Series. Brain Sci 2022; 12:brainsci12121627. [PMID: 36552087 PMCID: PMC9775146 DOI: 10.3390/brainsci12121627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/10/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Laser interstitial thermal therapy (LITT) has emerged as a minimally invasive treatment modality for ablation of low-grade glioma (LGG) and radiation necrosis (RN). OBJECTIVE To evaluate the efficacy, safety, and survival outcomes of patients with radiographically presumed recurrent or newly diagnosed LGG and RN treated with LITT. METHODS The neuro-oncological database of a quaternary center was reviewed for all patients who underwent LITT for management of LGG between 1 January 2013 and 31 December 2020. Clinical data including demographics, lesion characteristics, and clinical and radiographic outcomes were collected. Kaplan-Meier analyses comprised overall survival (OS) and progression-free survival (PFS). RESULTS Nine patients (7 men, 2 women; mean [SD] age 50 [16] years) were included. Patients underwent LITT at a mean (SD) of 11.6 (8.5) years after diagnosis. Two (22%) patients had new lesions on radiographic imaging without prior treatment. In the other 7 patients, all (78%) had surgical resection, 6 (67%) had intensity-modulated radiation therapy and chemotherapy, respectively, and 4 (44%) had stereotactic radiosurgery. Two (22%) patients had lesions that were wild-type IDH1 status. Volumetric assessment of preoperative T1-weighted contrast-enhancing and T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences yielded mean (SD) lesion volumes of 4.1 (6.5) cm3 and 26.7 (27.9) cm3, respectively. Three (33%) patients had evidence of radiographic progression after LITT. The pooled median (IQR) PFS for the cohort was 52 (56) months, median (IQR) OS after diagnosis was 183 (72) months, and median (IQR) OS after LITT was 52 (60) months. At the time of the study, 2 (22%) patients were deceased. CONCLUSIONS LITT is a safe and effective treatment option for management of LGG and RN, however, there may be increased risk of permanent complications with treatment of deep-seated subcortical lesions.
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Affiliation(s)
- Lea Scherschinski
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA
- Department of Neurosurgery, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- Correspondence: ; Tel.: +1-602-693-5883
| | - Jubran H. Jubran
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Kelly A. Shaftel
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Charuta G. Furey
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Dara S. Farhadi
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Dimitri Benner
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Benjamin K. Hendricks
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Kris A. Smith
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA
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Shah H, Carstensen T, Kmeid M, Bialowas C. Cutaneous Blastomycosis Presenting as a Nonhealing Wound in the Northeast United States: A Case Report. INT J LOW EXTR WOUND 2022:15347346221140782. [PMID: 36426539 DOI: 10.1177/15347346221140782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Primary cutaneous blastomycosis is a rare presentation of infection caused by direct inoculation of a wound. We present a 61-year-old male with an extensive history of wound dehiscence and wound care noncompliance after a bite from a brown recluse spider on the left thigh while on vacation in Cape Cod in September of 2020. After antibiotic therapy and culture, treatment involved debridement, split thickness skin grafting, strict wound vacuum-assisted closure care, and oral itraconazole. This brief demonstrates a case of blastomycosis arising from trauma in a non-endemic region for infection and serves as an example of successful management of the longstanding wound.
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Affiliation(s)
| | - Teresa Carstensen
- Division of Plastic & Reconstructive Surgery, 138207Albany Medical Center, Albany, NY, USA
| | - Michel Kmeid
- Department of Pathology, 138207Albany Medical Center, Albany, NY, USA
| | - Christie Bialowas
- Division of Plastic & Reconstructive Surgery, 138207Albany Medical Center, Albany, NY, USA
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207
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Agyemang K, Rose A, Olukoya O, Brown J, St George EJ. Spontaneous obliteration of brain arteriovenous malformations: illustrative cases. J Neurosurg Case Lessons 2022; 4:CASE22309. [PMID: 36411546 PMCID: PMC9678798 DOI: 10.3171/case22309] [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] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/06/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Spontaneous angiographic obliteration of a brain arteriovenous malformation (AVM) is considered a rare outcome, with most cases in the literature related to prior hemorrhage in small brain AVMs. The authors present a prospective, single center, consecutive case series. The clinical course and radiographic features of four cases with spontaneous obliteration of brain AVM were analyzed. OBSERVATIONS The median age of patients in this series was 47.6 years, with an equal gender split. The median maximum brain AVM diameter was 2 cm. The median time to spontaneous obliteration was 26 months, with hemorrhage preceding this in three out of four cases and a prolonged latency in the only case with a nidus size larger than 3 cm and no hemorrhage. LESSONS The present study provides additional information to allow clinicians to counsel patients about the rare outcomes of conservative management. This work extends our understanding of when this phenomenon can occur by reporting on the differences associated with spontaneous obliteration of larger AVMs.
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Affiliation(s)
- Kevin Agyemang
- Neurosurgical Department, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom; and ,School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Anna Rose
- School of Medicine, University of Glasgow, Scotland, United Kingdom
| | | | - Jennifer Brown
- Neurosurgical Department, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom; and
| | - Edward Jerome St George
- Neurosurgical Department, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom; and ,School of Medicine, University of Glasgow, Scotland, United Kingdom
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208
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Mulenga K, Kazuma SME, Nonde J, Mbewe C, Volodymyr P, Musowoya J. Retroperitoneal paraganglioma in a young patient presenting with hypertensive crisis and transient loss of sight; a rare case report and literature review. Int J Surg Case Rep 2022; 101:107781. [PMID: 36413895 PMCID: PMC9678955 DOI: 10.1016/j.ijscr.2022.107781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Catecholamine secreting tumors are a rare type of neuroendocrine tumors whose embryological origin is neural crest cells. 80 % to 90 % arise from the chromaffin cells of adrenal medulla while 10 % to 20 % arise from sympathetic and parasympathetic ganglia. Paragangliomas can be symptomatic due to excess catecholamine secretion or can be asymptomatic. Definitive treatment of paragangliomas is surgical resection. CASE A 16 yr old male who presented with right iliac fossa pain and hypertension associated with headache and transient loss of sight. Contrasted CT scan of the abdomen revealed a para-aortic retroperitoneal mass, 24 h urine Normetanephrines were significantly elevated. Pre-operative patient preparation included administration of alpha blockers then later beta blockers with adequate hydration. Intra operative blood pressure elevation during tumor manipulation managed with intravenous beta blockers. Post operatively patient required no inotropic support or anti hypertensives. Histopathology revealed features suggestive of a paraganglioma and immunohistochemistry s100 (+) Chromogranin A (+). DISCUSSION Functional paragangliomas are manifested by symptoms that result from catecholamine hypersecretion. Biochemical confirmation and functional localization of the tumors is recommended. Definitive management is surgical resection with a pre requisite of adequate patient preparation which includes blood pressure control and volume replacement. CONCLUSION Tumor localisation and adequate patient preparation with alpha blockers and adequate hydration is an important prerequisite to surgical resection.
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Affiliation(s)
- Kasonde Mulenga
- Department of General Surgery, Ndola Teaching Hospital, Postal agency Ndola, Zambia,Corresponding author.
| | | | - James Nonde
- Department of Emergency Medicine, Ndola Teaching Hospital, Postal agency Ndola, Zambia
| | - Chitani Mbewe
- Department of Radiology, Ndola Teaching Hospital, postal agency Ndola, Zambia
| | - Petrenko Volodymyr
- Department of Pathology, Ndola Teaching Hospital, Postal agency Ndola, Zambia
| | - Joseph Musowoya
- Department of General Surgery, Ndola Teaching Hospital, Postal agency Ndola, Zambia
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209
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Nana P, Dakis K, Spanos K, Tsolaki V, Karavidas N, Zakynthinos G, Kouvelos G, Giannoukas A, Matsagkas M. COVID-19 related peripheral arterial thrombotic events in intensive care unit and non-intensive care unit patients: A retrospective case series. Vascular 2022:17085381221140159. [PMID: 36395575 PMCID: PMC9679328 DOI: 10.1177/17085381221140159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
OBJECTIVES COVID-19 associated arterial thrombosis has been attributed to multiple inflammation and coagulation mechanisms. The aim of this study was to report the experience of a tertiary center on COVID-19 patients managed for acute peripheral arterial thrombosis. METHODS A single-center case series was conducted, including retrospectively collected data from all COVID-19 patients presenting arterial thrombosis, from March 2020 to February 2022. Intensive care unit (ICU) and non-ICU cases were included. The primary outcomes were mortality, successful revascularization, and amputation at 30 days. RESULTS Twenty patients presented peripheral arterial thrombosis (90% males, mean age 65 years (16-82 years)). Eighteen were diagnosed with the Delta variant and none was previously vaccinated. All cases presented acute lower limb ischemia; in 20% with bilateral involvement. Nine patients were hospitalized in the ward while 11 in the ICU. From the non-ICU cases, five presented Rutherford IIb and four cases, Rutherford's IIa ischemia. Six cases underwent revascularization (67%). Two of them were finally amputated (33%) and two died during hospitalization (33%). Two revascularizations were considered successful (33%). The ICU group presented mainly with Rutherford's III ischemia (54.5%). The mortality in the ICU cohort was 72.7%. Only one patient underwent successful revascularization and two were amputated in this subgroup. Early mortality was 50% for the total cohort while the type of management was not related to mortality. CONCLUSIONS Covid-19 related arterial thrombosis in non-vaccinated population is associated with 50% early mortality; increased up to 72% in the ICU patients. The amputation rate was 20% while only 40% of the revascularizations were considered successful.
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Affiliation(s)
- Petroula Nana
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Konstantinos Dakis
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Konstantinos Spanos
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Vasiliki Tsolaki
- Intensive Care Unit, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Nikitas Karavidas
- Intensive Care Unit, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - George Zakynthinos
- Intensive Care Unit, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - George Kouvelos
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Athanasios Giannoukas
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Miltiadis Matsagkas
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Tahir M, Zedan M, Bellamkonda V, Dyess DL, Wei EX. Primary Malignant Peripheral Nerve Sheath Tumor of the Breast: A Rare Case Report and Review of Literature. Cureus 2022; 14:e31586. [DOI: 10.7759/cureus.31586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
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211
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Rasulić L, Nikolić Ž, Lepić M, Savić A, Vitošević F, Novaković N, Radojević S, Mićić A, Lepić S, Mandić-Rajčević S. Useful functional recovery and quality of life after surgical treatment of peroneal nerve injuries. Front Surg 2022; 9:1005483. [PMID: 36451682 PMCID: PMC9702062 DOI: 10.3389/fsurg.2022.1005483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/03/2022] [Indexed: 08/30/2023] Open
Abstract
Closed injuries to the peroneal nerve recover spontaneously in about a third of patients, but surgery may be needed in the remaining 2/3. The recovery after surgery is not always satisfactory and the patients may need an orthosis or a walking aid to cope with regular daily activities. This study aimed to evaluate the useful functional recovery and quality of life (QoL) in surgically treated patients with peroneal nerve (PN) injuries. The study involved 51 patients who have undergone surgical treatment due to PN injury in our department, within a 15-year period (2006-2020). Thirty patients (59%) were treated with neurolysis, 12 (23%) with nerve repair techniques, and 9 (18%) with tendon transfer (TT). Neurolysis is employed in the least extensive nerve injuries when nerve continuity is preserved and yields a motor recovery ratio of almost 80%. Nerve repairs were followed by 58.33% of patients achieving M3+ recovery, while 41.66% recovered to the useful functional state (M4 or M5) With the use of TTs, all patients recovered to the M3+, while 66.7% recovered to M4. All our results correspond to the results of previous studies. No statistically significant differences were found regarding the QoL of the groups. There is an apparent advantage of neurolysis, over nerve repair, over TT procedure, both in terms of useful functional recovery, and foot-drop-related QoL. However, when involving all aspects of QoL, these advantages diminish. The individual approach leads to optimal results in all groups of patients.
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Affiliation(s)
- Lukas Rasulić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Živan Nikolić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Plastic Surgery and Burns, Military Medical Academy, Belgrade, Serbia
| | - Milan Lepić
- Clinic for Neurosurgery, Military Medical Academy, Belgrade, Serbia
| | - Andrija Savić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Filip Vitošević
- Center for Radiology and MRI, Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Nenad Novaković
- Clinic for Neurosurgery, Military Medical Academy, Belgrade, Serbia
- Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | | | - Aleksa Mićić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Sanja Lepić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Hygiene, Military Medical Academy, Belgrade, Serbia
| | - Stefan Mandić-Rajčević
- School of Public Health and Health Management and Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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212
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Lim J, Baig AA, Aguirre AO, Cappuzzo JM, Vakharia K, Rho K, Waqas M, Monteiro A, Fretz TJ, Levy EI, Siddiqui AH. Use of drug-eluting, balloon-expandable resolute onyx coronary stent as a novel treatment strategy for vertebral artery ostial stenosis: Case series. Interv Neuroradiol 2022:15910199221138138. [PMID: 36357368 DOI: 10.1177/15910199221138138] [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] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Vertebral artery (VA) ostial stenosis is notoriously difficult to treat using bare-metal stents owing to high rates of restenosis and stent kinking and breakage. We investigated the safety and effectiveness of treatment with a drug-eluting, balloon-expandable coronary stent (Resolute Onyx, Medtronic). METHODS Our prospectively maintained database was retrospectively searched for consecutive patients diagnosed with VA ostial stenosis who underwent Resolute Onyx stenting with/without angioplasty between January 1, 2015 and January 1, 2022. Patient demographics and clinical and radiographic presentations were recorded. Occlusion location, stenosis severity, contralateral disease, devices used, and intraprocedural and postprocedural complications were noted. Outcomes were assessed based on new or recurrent stroke, transient ischemic attack (TIA), or intracranial hemorrhage (ICH). Patients were followed up clinically and with radiographic imaging for in-stent stenosis. RESULTS Twenty-six patients were included in our study (21 men [80.8%]; mean age 70.3 ± 9.8 years). Symptomatic patients presented with TIA (11/26, 42.3%) and stroke (10/26; 38.5%). Mean stenosis in the study cohort was 74.9 ± 13.0%. One (3.8%) intraprocedural complication was encountered whereby the stent failed to open despite several attempts and was exchanged with a new one without issues. No in-hospital postprocedure stroke, TIA, or mortality was reported. During a mean 16.2 ± 13.6 months' follow up, two patients developed symptomatic in-stent restenosis that was treated with balloon angioplasty. CONCLUSIONS We report the first case series of Resolute Onyx drug-eluting stenting including 30-day postprocedure stroke/TIA rates and clinical/radiographic follow up and demonstrate safe and effective treatment of symptomatic and asymptomatic VA ostial stenosis.
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Affiliation(s)
- Jaims Lim
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, 23564Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
| | - Ammad A Baig
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, 23564Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
| | - Alexander O Aguirre
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Justin M Cappuzzo
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, 23564Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
| | - Kunal Vakharia
- Department of Neurosurgery and Brain Repair, 7831University of South Florida, Tampa, Florida, USA
| | - Kyungduk Rho
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, 23564Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
| | - Muhammad Waqas
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, 23564Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
| | - Andre Monteiro
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, 23564Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
| | - Thomas J Fretz
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Elad I Levy
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, 23564Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
- Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York, USA
- Jacobs Institute, Buffalo, New York, USA
| | - Adnan H Siddiqui
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, 23564Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
- Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York, USA
- Jacobs Institute, Buffalo, New York, USA
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213
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Al-juboori AN, Al Hail A, Emam SS. Congenital bilateral adult choanal atresia: Transnasal endoscopic coblation assisted correction. Otolaryngology Case Reports 2022. [DOI: 10.1016/j.xocr.2022.100489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Soliman MAR, Ruggiero N, Aguirre AO, Kuo CC, Khawar WI, Khan A, Jowdy PK, Starling RV, Mullin JP, Pollina J. Prone Transpsoas Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spine Disease: Case Series With an Operative Video Using Fluoroscopy-Based Instrument Tracking Guidance. Oper Neurosurg (Hagerstown) 2022; 23:382-388. [PMID: 36227242 DOI: 10.1227/ons.0000000000000368] [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: 01/21/2022] [Accepted: 05/26/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Lateral lumbar interbody fusion has inherent limitations, such as the necessity to reposition the patient. To overcome this limitation, the prone transpsoas (PTP) approach for lateral lumbar interbody fusion has been developed. OBJECTIVE To report clinical and radiographic outcome measures of a series of patients who underwent PTP at our hospital. METHODS A retrospective chart review was conducted to identify patients who underwent PTP for degenerative lumbar spine disease between September 2019 and August 2021. A thorough analysis of clinical and radiographic outcome measures for these patients was conducted. RESULTS Our search resulted in the identification of 15 consecutive patients. Four patients were operated using the assistance of fluoroscopy-based instrument tracking. Overall, the mean follow-up duration was 11.9 ± 7.9 months. Radiographically, the PTP approach resulted in significant postoperative improvement of lumbar lordosis ( P = .03) and pelvic incidence minus lumbar lordosis ( P < .005). No significant difference was found postoperatively in other regional sagittal alignment parameters, including pelvic tilt, sacral slope, or pelvic incidence. Clinically, the patients' Oswestry Disability Indices ( P = .002) and Short Form Survey-12 Physical Scores improved significantly ( P = .01). The estimated mean blood loss for patients who underwent the PTP procedure was 137.7 ± 96.4 mL, the mean operative time was 212.5 ± 77.1 minutes, and the mean hospital stay was 2.7 ± 1.4 days. One patient each had superficial wound infection, transient paralytic ileus, transient pulmonary embolism, transient urinary retention, or required revision lumbar surgery. CONCLUSION This study demonstrates that the PTP approach is associated with significant improvement in radiographic and clinical outcomes.
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Affiliation(s)
- Mohamed A R Soliman
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
- Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nicco Ruggiero
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
| | - Alexander O Aguirre
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
| | - Cathleen C Kuo
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
| | - Wasiq I Khawar
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - Asham Khan
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - Patrick K Jowdy
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - Robert V Starling
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - Jeffrey P Mullin
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - John Pollina
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
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215
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Estrella EP, Montales TD. Nerve Transfers for Elbow Reconstruction in Upper and Extended Upper-Type Brachial Plexus Injuries: A Case Series. Oper Neurosurg (Hagerstown) 2022; 23:367-373. [PMID: 36227251 DOI: 10.1227/ons.0000000000000369] [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: 10/11/2021] [Accepted: 05/14/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Nerve transfers for elbow flexion in brachial plexus injuries have been used with increasing frequency because of the higher rate of success and acceptable morbidity. This is especially true in upper and extended upper-type brachial plexus injuries. OBJECTIVE To present the clinical outcomes of nerve transfers for elbow flexion in patients with upper and extended upper-type brachial plexus injuries. METHODS A retrospective cohort review was done on all patients with upper and extended upper-type brachial plexus injuries from 2006 to 2017, who underwent nerve transfers for the restoration of elbow flexion. Outcome variables include Filipino version of the disability of the arm, shoulder, and hand (FIL-DASH) score, elbow flexion strength and range of motion, and pain. All statistical significance was set at P < .05. RESULTS Fifty-six patients with nerve transfers to restore elbow flexion were included. There was a significant improvement in FIL-DASH scores in 28 patients after the nerve transfer procedure. Patients with C56 nerve root injuries and those with more than 2 years' follow-up have a higher percentage of regaining ≥M4 elbow flexion strength. Those with double nerve transfers had a higher percentage of ≥M4 elbow flexion strength, greater range of elbow flexion, and better FIL-DASH scores compared with single nerve transfers, but this did not reach statistical significance. CONCLUSION Nerve transfer procedures improve FIL-DASH scores in upper and upper-type brachial plexus injuries. After nerve transfer, stronger elbow flexion can be expected in patients with C56 injuries, and those with longer follow-up.
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Affiliation(s)
- Emmanuel P Estrella
- Institute of Clinical Epidemiology, ASTRO Study Group, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Microsurgery Unit, Department of Orthopedics, University of the Philippines, Manila Philippine General Hospital, Manila, Philippines
| | - Tristram D Montales
- Microsurgery Unit, Department of Orthopedics, University of the Philippines, Manila Philippine General Hospital, Manila, Philippines
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216
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Bubeníková A, Skalický P, Beneš V. Partial medial clinoidectomy with optic canal roof drilling for clipping of ophthalmic artery aneurysms: how I do it. Acta Neurochir (Wien) 2022; 164:2893-8. [PMID: 36104634 DOI: 10.1007/s00701-022-05352-1] [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: 05/31/2022] [Accepted: 08/21/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Clipping of ophthalmic artery (OA) aneurysms present one of the treatment strategies for long-term disease management. Existing surgical techniques primarily require extra/intradural removal of the anterior clinoid process, carrying a higher risk of infection, damage to surrounding structures or technical complications. METHODS We present the technique of minimally invasive partial medial clinoidectomy with the unroofing of the optic canal for surgical clipping of OA aneurysms, and besides its pros and cons, we also discuss proper technical indications. CONCLUSION The partial medial clinoidectomy improves manoeuvrability around the paraclinoid region, provides better protection for adjacent structures and renders excellent treatment outcome.
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217
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(Sitaula) R, Maskey HMS, Chaudhary S, Jha S. Scleritis as the harbinger of Granulomatosis with polyangiitis. Ann Med Surg (Lond) 2022; 84:104908. [DOI: 10.1016/j.amsu.2022.104908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 11/04/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022] Open
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218
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Yulia DE, Soeharto DA. One year follow-up of intravitreal bevacizumab injection in Aggressive Retinopathy of Prematurity at Indonesian national referral hospital: Case series. Ann Med Surg (Lond) 2022. [DOI: 10.1016/j.amsu.2022.104853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/22/2022] [Accepted: 10/30/2022] [Indexed: 11/08/2022] Open
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219
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McGrath LB, Gadjradj PS, Hussain I, Takoushian E, Kirnaz S, Goldberg JL, Sommer F, Navarro-Ramirez R, Mykolajtchuk C, Ng AZ, Basilious M, Medary B, Härtl R. Ten-Step 3-Dimensional-Navigated Single-Stage Lateral Surgery With Microtubular Decompression: A Case Series. Oper Neurosurg (Hagerstown) 2022; 23:406-412. [PMID: 36227239 DOI: 10.1227/ons.0000000000000366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/14/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Single-stage lateral lumbar interbody fusion is a safe and effective procedure that relies on indirect decompression and fusion to treat various lumbar pathologies. This technique, however, has an overall 9% rate of indirect decompression failure, which may require additional surgery to achieve adequate direct decompression. To address this concern, we modified this technique by adding a minimally invasive, direct tubular decompression in lateral position when indicated. No study has described the technical nuances of incorporating a microtubular decompression into the single-stage lateral lumbar interbody fusion workflow (SSLLIF+). OBJECTIVE To report on the procedural steps and clinical outcomes of the SSLLIF+. METHODS In this retrospective case series of prospectively collected data, we present the detailed surgical approach of the SSLLIF+ with a single-center case series over a 5-year period. Surgical and clinical outcomes are presented. RESULTS A total of 7 patients underwent a SSLLIF+ with a total of 18 levels fused and 7 levels decompressed. The SSLLIF+ was successfully performed in all cases without the occurrence of intraoperative complications in this case series. There was 1 revision after 20 months of follow-up because of adjacent segment disease. There was no need for further direct decompression in a delayed fashion. CONCLUSION SSLLIF with direct microtubular decompression in lateral position is a safe and effective procedure in patients where indirect decompression alone may not achieve the surgical goal. Adherence to minimally invasive spine surgery principles and thoughtful patient selection facilitate the successful management of these patients while demonstrating short hospital stay and low-risk of perioperative complications.
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Affiliation(s)
- Lynn B McGrath
- Department of Neurological Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York, USA
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Dewi IR, Maimunah U. Antiviral use in liver function abnormalities and Covid-19 patients: Serial cases. Ann Med Surg (Lond) 2022. [PMID: 36411832 PMCID: PMC9652095 DOI: 10.1016/j.amsu.2022.104876] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/05/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Some SARS-CoV-2 patients have liver function abnormalities due to anti-viral drug effects. Methods The design of this study was a case series reported using retrospectives. Data collection was carried out from December 2020 to February 2021. All participants were diagnosed with SAR-CoV-2 and received an anti-viral drug which identified liver function abnormalities. Results The patients’ average age was 54.56 ± 14.46 years old. Most patients experienced shortness of breath and cough, with hypertension as the accompanying comorbid. Increased AST and ALT were found in one patient who used Lopinavir-Ritonavir. The increase was 1.0 times to 2.0 times the expected value. Increased CRP, D-dimer and procalcitonin were also found, with a mean of 12.27 ± 15,34, 1861.29 ± 1828.85 and 1.54 ± 2.84, respectively. One of the patients in the Lopinavir-Ritonavir group died while receiving treatment. Conclusion SAR-CoV-2 is one of the risk factors that cause liver function abnormalities supported by anti-viral drugs that cause liver work to increase.
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221
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Larni Y, Mohsenifar H, Ghandhari H, Salehi R. The effectiveness of Schroth exercises added to the brace on the postural control of adolescents with idiopathic scoliosis: Case series. Ann Med Surg (Lond) 2022; 84:104893. [DOI: 10.1016/j.amsu.2022.104893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/10/2022] [Accepted: 11/07/2022] [Indexed: 11/15/2022] Open
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222
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Sapkota P, Tamang A, Bhandari S, Singh Y, Shrestha RB, Karmacharya RM, Vaidya S, Bhatt S. Anticoagulation failure in pulmonary thromboembolism in COVID-19 pneumonia despite prolonged anticoagulation: A case series. Ann Med Surg (Lond) 2022; 84:104929. [PMID: 36439890 PMCID: PMC9675080 DOI: 10.1016/j.amsu.2022.104929] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/09/2022] [Accepted: 11/13/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Moderate to severely ill patients diagnosed with Coronavirus disease 2019 (COVID-19) pneumonia develop a series of complications and less frequently, we might witness cases of Pulmonary Thromboembolism (PE)-refractory to the standard treatment with Low Molecular Weight Heparin (LMWH). The aim of this case series is to report the presentation and management of pulmonary thromboembolism secondary to COVID-19 pneumonia. Method We report a case series of seven cases aged 40–70 who were presented in Dhulikhel Hospital with COVID-19 symptoms in different stages. The case details were extracted from their medical reports of the hospital. The written informed ethical consents were obtained from all the cases and their voluntary participation was assured. Outcome The cases in the case series admitted with COVID-19 pneumonia, after diagnostic investigation (Chest x-ray, HRCT, CTPA) were suggestive of COVID-19 Pneumonia with ARDS and pulmonary thromboembolism. The cases received rivaroxaban, a newer anticoagulant-15 mg twice daily for 21 days and after discharge, they were asked to continue once daily doses for 9 weeks. Significant improvement was witnessed, with the presence of additional intervention including rehabilitative chest exercises. Conclusion Pulmonary thromboembolism secondary to COVID-19 pneumonia is a life-threatening condition. Rivaroxaban is seen to be very effective in the management of this condition when an anticoagulation failure occurs even after the therapeutic dose of low molecular weight heparin. Future studies may require more scientific investigations to prevent complications even in the early stages of COVID-19.
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Affiliation(s)
- Prakash Sapkota
- Department of Internal Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal
| | - Ashish Tamang
- Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal
- Corresponding author.
| | - Sadikshya Bhandari
- Department of Internal Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal
| | - Yadvinder Singh
- Department of Internal Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal
| | - Rohit Bhasink Shrestha
- Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal
| | - Robin Man Karmacharya
- Cardiothoracic and Vascular Surgery Unit, Department of Surgery, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal
| | - Satish Vaidya
- Cardiothoracic and Vascular Surgery Unit, Department of Surgery, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal
| | - Swechha Bhatt
- Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal
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Park YG, Choi S, Kim BS, Lee SJ, Kim DY, Lim C. Tension band wiring versus suture anchor technique in patellar inferior pole fracture: Novel double row suture anchor technique. Ann Med Surg (Lond) 2022; 84:104822. [DOI: 10.1016/j.amsu.2022.104822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/23/2022] [Accepted: 10/30/2022] [Indexed: 11/07/2022] Open
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224
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Javeed S, Dibble CF, Greenberg JK, Zhang JK, Khalifeh JM, Park Y, Wilson TJ, Zager EL, Faraji AH, Mahan MA, Yang LJ, Midha R, Juknis N, Ray WZ. Upper Limb Nerve Transfer Surgery in Patients With Tetraplegia. JAMA Netw Open 2022; 5:e2243890. [PMID: 36441549 PMCID: PMC9706368 DOI: 10.1001/jamanetworkopen.2022.43890] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IMPORTANCE Cervical spinal cord injury (SCI) causes devastating loss of upper extremity function and independence. Nerve transfers are a promising approach to reanimate upper limbs; however, there remains a paucity of high-quality evidence supporting a clinical benefit for patients with tetraplegia. OBJECTIVE To evaluate the clinical utility of nerve transfers for reanimation of upper limb function in tetraplegia. DESIGN, SETTING, AND PARTICIPANTS In this prospective case series, adults with cervical SCI and upper extremity paralysis whose recovery plateaued were enrolled between September 1, 2015, and January 31, 2019. Data analysis was performed from August 2021 to February 2022. INTERVENTIONS Nerve transfers to reanimate upper extremity motor function with target reinnervation of elbow extension and hand grasp, pinch, and/or release. MAIN OUTCOMES AND MEASURES The primary outcome was motor strength measured by Medical Research Council (MRC) grades 0 to 5. Secondary outcomes included Sollerman Hand Function Test (SHFT); Michigan Hand Outcome Questionnaire (MHQ); Disabilities of Arm, Shoulder, and Hand (DASH); and 36-Item Short Form Health Survey (SF-36) physical component summary (PCS) and mental component summary (MCS) scores. Outcomes were assessed up to 48 months postoperatively. RESULTS Twenty-two patients with tetraplegia (median age, 36 years [range, 18-76 years]; 21 male [95%]) underwent 60 nerve transfers on 35 upper limbs at a median time of 21 months (range, 6-142 months) after SCI. At final follow-up, upper limb motor strength improved significantly: median MRC grades were 3 (IQR, 2.5-4; P = .01) for triceps, with 70% of upper limbs gaining an MRC grade of 3 or higher for elbow extension; 4 (IQR, 2-4; P < .001) for finger extensors, with 79% of hands gaining an MRC grade of 3 or higher for finger extension; and 2 (IQR, 1-3; P < .001) for finger flexors, with 52% of hands gaining an MRC grade of 3 or higher for finger flexion. The secondary outcomes of SHFT, MHQ, DASH, and SF36-PCS scores improved beyond the established minimal clinically important difference. Both early (<12 months) and delayed (≥12 months) nerve transfers after SCI achieved comparable motor outcomes. Continual improvement in motor strength was observed in the finger flexors and extensors across the entire duration of follow-up. CONCLUSIONS AND RELEVANCE In this prospective case series, nerve transfer surgery was associated with improvement of upper limb motor strength and functional independence in patients with tetraplegia. Nerve transfer is a promising intervention feasible in both subacute and chronic SCI.
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Affiliation(s)
- Saad Javeed
- Department of Neurological Surgery, Washington University, St Louis, Missouri
| | | | - Jacob K. Greenberg
- Department of Neurological Surgery, Washington University, St Louis, Missouri
| | - Justin K. Zhang
- Department of Neurological Surgery, Washington University, St Louis, Missouri
| | - Jawad M. Khalifeh
- Department of Neurological Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Thomas J. Wilson
- Department of Neurosurgery, Stanford University, Stanford, California
| | - Eric L. Zager
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia
| | - Amir H. Faraji
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas
| | - Mark A. Mahan
- Department of Neurosurgery, Clinical Neurosciences Center, The University of Utah, Salt Lake City
| | - Lynda J. Yang
- Department of Neurological Surgery, University of Michigan School of Medicine, Ann Arbor
| | - Rajiv Midha
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Neringa Juknis
- Physical Medicine and Rehabilitation, Washington University, St Louis, Missouri
| | - Wilson Z. Ray
- Department of Neurological Surgery, Washington University, St Louis, Missouri
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Ramdani H, Benelhosni K, Billah NM, Nassar I. Chest CT in covid-19 pneumonia's follow-up: A 30 patients case series. Ann Med Surg (Lond) 2022; 84:104835. [PMID: 36373105 PMCID: PMC9637543 DOI: 10.1016/j.amsu.2022.104835] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/29/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022] Open
Abstract
Background Lung abnormalities do not fully resolve in all Covid-19 survivors and may progress to fibrosis. Understanding post-COVID lung changes helps identify patients susceptible of post-COVID-19 sequelae. We analyzed scannographic residual lung abnormalities and the full resolution percentage on intermediate- and long-term follow-up (3 months or more). Methods Data from 30 RT-PCR positive COVID-19 patients undergoing at least one follow-up chest CT at Ibn Sina Hospital, with a minimal time interval of 3 months between the RT-PCR and the CT performance were gathered retrospectively. The following elements were analyzed: (1) lung opacities, (2) distribution, (3) dominant lung opacity, (4) Sub-pleural bands, (5) Interlobular septal thickening, (6) Vascular dilatation, (7) Bronchiectasis, (8) Honey combing, (9) Architectural distortion, (10) mosaic attenuation, and (11) Additional findings: Enlarged lymph nodes, Pleural and Pericardial fluid. To evaluate the degree of lung opacification, a score founded on visual evaluation of the lung involvement's percentage was employed. Patients were then subdivided into two categories: (1) no residual opacities and (2) remaining pulmonary opacities. Outcomes 30 patients were enrolled. The age ranged between 40 and 87 years. CT was indicated for symptoms or functional impairment. The time range between the positive RT-PCR and Follow-up CT varied between 3 and 12 months. CT severity score ranged between o and 23. Residual lung opacities were present in 24 cases (80%). The dominant lung opacities were Ground glass (46.7%), and linear/curvilinear opacities (23.3%). Signs of fibrosis were present in 9 patients (30%). Conclusion CT abnormalities following Covid-19 pneumonia's prevalence varies based on the extent of the original lung affection and the time gap since the acute phase. Residual anomalies' effects on respiratory physiology, symptoms, and quality of living are unknown. Maintained monitoring of COVID-19 survivors with clinical examination, iterative pulmonary function tests, and HRCT is advised.
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226
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Sidow NO, Hassan MS. Intravenous immunoglobulin treatment with prognosis for the first six months of Guillain–Barré Syndrome in Somalia: Case series. Ann Med Surg (Lond) 2022; 84:104816. [DOI: 10.1016/j.amsu.2022.104816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/20/2022] [Accepted: 10/30/2022] [Indexed: 11/08/2022] Open
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227
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Grüter AA, Oudkerk SF. Spontaneous iliac vein rupture showed by femoral contrast bolus: A case report. Radiol Case Rep 2022; 18:135-137. [PMID: 36340224 PMCID: PMC9626363 DOI: 10.1016/j.radcr.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction: Spontaneous iliac vein rupture (SIVR) is an uncommon disease with less than sixty cases reported before. This disease often requires surgical intervention. SIVR has never been imaged in the literature. This report shows how to image this diagnosis. Case report: A 71-year-old female was diagnosed with SIVR with the use of CT venography. Endovascular repair with 2 endografts and a sinus XL stent was performed. Postoperatively, the patient developed abdominal compartment syndrome and a large part of the intestines had to be removed because of ischemia. Discussion: This is the first report that shows SIVR before and after endovascular treatment with the use of CT venography by injecting a contrast bolus in the femoral vein. This information is of high interest for a broad range of clinicians to show or exclude a venous abdominal bleeding in an early stage.
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Affiliation(s)
- Alexander A.J. Grüter
- Department of Surgery, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands,Corresponding author.
| | - Sytse F. Oudkerk
- Department of Radiology, Noordwest Hospital, Alkmaar, The Netherlands
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Awadalkreem F, Khalifa N, Ahmad AG, Suliman AM, Osman M. Oral rehabilitation of maxillofacial trauma using fixed corticobasal implant-supported prostheses: A case series. Int J Surg Case Rep 2022; 100:107769. [PMID: 36302317 PMCID: PMC9615311 DOI: 10.1016/j.ijscr.2022.107769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/23/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction Maxillofacial trauma is associated with severe loss of soft and hard tissues that lead to aesthetic and functional disfigurements, adverse psychological impacts on the patient's general and oral health, and decreased quality of life. Therefore, treatment of maxillofacial trauma is challenging. Presentation of case We present three patients with maxillofacial trauma owing to road traffic accidents that were rehabilitated by immediate use of loaded fixed corticobasal implant-supported prostheses with follow-up periods of 6, 5, and 7 years. All treated patients had a 100 % implant survival rate, healthy peri-implant tissues, stable prosthesis with significant improvement in mastication and phonation, and high patient satisfaction. Discussion Rehabilitation of patients with intensive maxillofacial trauma requires a multidisciplinary approach to ensure the standard of care during treatment. The described treatment eliminates the need for bone grafting, reduces susceptibility to grafting complications, shortens treatment time, and provides the patient with a fixed prosthesis with predictable success, excellent implant survival, healthy peri-implant tissue, improved prosthetic stability, and high satisfaction rates. Conclusion Corticobasal implant-supported prostheses are a feasible treatment modality to rehabilitate patients with maxillofacial trauma with high success and survival rates and patient satisfaction. Treatment of maxillofacial trauma requires a multidisciplinary approach. Hard and soft tissue loss complicates treatment. Corticobasal implants do not require bone grafting and reduce treatment time. They help achieve satisfactory peri-implant health and patient satisfaction. Corticobasal implant-supported prostheses are a feasible treatment modality.
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Affiliation(s)
- Fadia Awadalkreem
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates,Corresponding author.
| | - Nadia Khalifa
- Department of Preventive and Restorative Dentistry, University of Sharjah/Faculty of Dental Medicine, Sharjah, United Arab Emirates
| | - Abdelnasir G. Ahmad
- International University of Africa, Oral and Maxillofacial Surgery Department, Khartoum, Sudan
| | - Ahmed Mohamed Suliman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Motaz Osman
- Implant Department, Khartoum Teaching Dental Hospital, Federal Ministry of Heath, Khartoum, Sudan
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Giuzio F, Giuliani A, Massariello DN, Mele L, Saturnino C, Brongo S. Surgical treatment of undifferentiated soft tissue sarcoma in a young 17-year-old woman: A case report. Int J Surg Case Rep 2022; 100:107766. [PMID: 36334549 PMCID: PMC9638776 DOI: 10.1016/j.ijscr.2022.107766] [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: 08/25/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
This case report describes the clinical case of a 17-year-old woman with an undifferentiated soft tissue sarcoma in the left supratrocanteric area. The young woman came for observation at our plastic surgery hospital with a large vascular mass visible on her left side which also made walking difficult. Our patient reports the onset of the mass about two months earlier and its growth very quickly. In this case report, we will analyze the demolitive and reconstructive surgical procedures in order to guarantee our patient radical surgery and the possibility of continuing radiotherapy and any specific chemotherapy to avoid the risk of relapse and metastasis over time.
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Affiliation(s)
- Federica Giuzio
- Department of Sciences, University of Basilicata, Potenza, Italy,U.O.S.D. of Plastic Surgery A.O.R “San Carlo”, Potenza, Basilicata, Italy,Corresponding author at: Department of Sciences, University of Basilicata, Potenza, Italy.
| | - Antonio Giuliani
- U.O.C. of General and Emergency Surgery A.O.R. “San Carlo”, Potenza, Basilicata, Italy
| | | | - Luigi Mele
- Department of Experimental Medicine, University of Campania “L. Vanvitelli” Naples, Italy
| | | | - Sergio Brongo
- Department of Plastic Surgery, University of Salerno, Campania, Italy
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Banchini F, Luzietti E, Romboli A, Palmieri G, Conti L, Capelli P. Could the top-down right hemicolectomy be an easier alternative to the classic medial-to-lateral approach in obese patients? A case report with video example. Int J Surg Case Rep 2022; 100:107752. [PMID: 36257139 DOI: 10.1016/j.ijscr.2022.107752] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/21/2022] Open
Abstract
Laparoscopic right hemicolectomy is performed only in 25% of cases in recent survey The medial-to-lateral and the bottom-to-up are the most frequent approaches used to perform surgery Top-to-down right hemicolectomy is an infrequent approach Obesity is an evident aspect complicating surgical dissection Top-to Down dissection could be an opportunity to use as alternative approach when classical dissection becomes intricate
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231
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Dakuyo R, Konaté K, Sanou A, Kaboré K, Sama H, Bazié D, Diao M, Dicko MH, Morales-quintana L. Comparison of Proximate and Phytonutrient Compositions of Cashew Nuts and Apples from Different Geographical Areas of Burkina Faso. BioMed Research International 2022; 2022:1-12. [PMID: 36267836 PMCID: PMC9578815 DOI: 10.1155/2022/1800091] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 09/23/2022] [Indexed: 11/18/2022]
Abstract
The cashew plant is an allogamous plant that produces two types of fruits: the nut and the cashew apple. The present study was conducted to perform a comparison of proximate and phytonutrient compositions of cashew (Anacardium occidentale L.) nuts and apples from different geographical areas of Burkina Faso. For this purpose, 60 samples of apples and kernels were collected from the three main cashew cultivation areas. The nutritional potential of cashew nuts and apples produced was evaluated to enhance their food processing. Protein, carbohydrates, lipids, dietary fibers, ascorbic acid, tannins, anthocyanins, chlorophyll, lycopene, and β-carotene contents were assessed. The results revealed high contents of lipids (
g/100 gDW), proteins (
g/100 gDW), and starch (
g/100 g DW) in almonds. Apples, on the other hand, are rich in lipids, ascorbic acid (
mg/100 g), soluble sugars (
mg/100 g,), and pigments (lycopene, anthocyanin, β-carotene, and chlorophyll). In summary, almonds may be suitable as a source of lipids and related products. Apples can be used as natural antioxidants and produce juices. All of these data are important clues for cashew by-product processing. These results obtained provide a scientific basis for their food and economical valorization of cashew fruits.
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232
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Theodoraki K, Vezakis A, Massaras D, Louta A, Arkadopoulos N, Smyrniotis V. Splenic Artery Ligation: An Ontable Bail-Out Strategy for Small-for-Size Remnants after Major Hepatectomy: A Retrospective Study. J Pers Med 2022; 12:1687. [PMID: 36294827 DOI: 10.3390/jpm12101687] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022] Open
Abstract
It has been reported that the prevention of acute portal overpressure in small-for-size liver grafts leads to better postoperative outcomes. Accordingly, we aimed to investigate the feasibility of the technique of splenic artery ligation in a case series of thirteen patients subjected to major liver resections with evidence of small-for-size syndrome and whether the maneuver results in the reduction of portal venous pressure and flow. The technique was successful in ten patients, with splenic artery ligation alleviating portal hypertension significantly. Three patients required the performance of a portocaval shunt for the attenuation of portal hypertension. Portal inflow modulation via splenic artery ligation is a technically simple technique that can prove useful in the context of major hepatectomies as well as in liver transplantations and the early evaluation and modification of portal venous pressure post hepatectomy can be used as a practical tool to guide the effect of the intervention.
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233
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Sukamto AR, Sembiring YE, Akbar E, Limanto DH. Technical aspect in renal artery embolization in renal tumors: A case series. Int J Surg Case Rep 2022; 100:107724. [PMID: 36244149 DOI: 10.1016/j.ijscr.2022.107724] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction Renal artery embolization aims to reduce blood loss during surgery. Various embolizing agents are available, each of which has its own indications appropriate for various vascular anatomy and renal pathology. Presentation of case We report three cases of renal artery embolization prior to surgical nephrectomy using vascular plug and other embolizing agents. In two cases, complete blood flow occlusion was achieved with minimal blood loss during the subsequent surgery. One case only achieved reduced blood flow, but subsequent nephrectomy and patient recovery was successful. Discussion Renal artery embolization prior to malignant mass resection is a well-known, potentially beneficial procedure. The rationale that supports this procedure is clear, but its reported outcome in the literature is still inconclusive. It is important to understand its benefits, complications, and pitfalls to achieve better outcome. Conclusion In our cases, renal artery embolization provided satisfactory reduction in bleeding during nephrectomy, and therefore has the potential to be employed as a standard procedure for future surgeries. Arterial embolization in renal pathology currently has no clinical guidelines The use of vascular plug in renal vascular pathology is feasible Careful consideration is needed regarding the choice of renal arterial embolization
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Corsini Campioli C, O’Horo JC, Lahr BD, Wilson WR, DeSimone DC, Baddour LM, Van Gompel JJ, Sohail MR. Predictors of Treatment Failure in Patients With Pyogenic Brain Abscess. World Neurosurg X 2022; 16:100134. [PMID: 36061125 PMCID: PMC9437902 DOI: 10.1016/j.wnsx.2022.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Cristina Corsini Campioli
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
- To whom correspondence should be addressed: Cristina Corsini Campioli, M.D.
| | - John C. O’Horo
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
- Division of Pulmonary and Critical Care, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Brian D. Lahr
- Division of Clinical Trials and Biostatistics, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Walter R. Wilson
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
- Department of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Daniel C. DeSimone
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
- Department of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Larry M. Baddour
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
- Department of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Jamie J. Van Gompel
- Departments of Otolaryngology-Head and Neck Surgery and Neurologic Surgery, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - M. Rizwan Sohail
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
- Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
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Zairi M, Mohseni AA, Msakni A, Jaber C, Mensia K, Saied W, Bouchoucha S, Boussetta R, Nessib MN. Acute hematogenous osteomyelitis in children: Management of pandiaphysitis with extensive bone destruction: A case series of thirteen child. Ann Med Surg (Lond) 2022; 82:104578. [PMID: 36268342 PMCID: PMC9577533 DOI: 10.1016/j.amsu.2022.104578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/29/2022] [Accepted: 09/04/2022] [Indexed: 11/29/2022] Open
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236
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Katoof FM, jasim HA. Rare findings in ectopic breast tissue: A case study of 7 patients. International Journal of Surgery Open 2022. [DOI: 10.1016/j.ijso.2022.100572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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237
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Shrestha AL, Mishra A. Breast abscess in two Nepalese newborns: An unusual series. Ann Med Surg (Lond) 2022; 82:104774. [PMID: 36268300 PMCID: PMC9577873 DOI: 10.1016/j.amsu.2022.104774] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 11/27/2022] Open
Abstract
Background Breast abscess in newborns is an exceedingly rare pyogenic inflammation that usually starts as mastitis neonatorum. Although mastitis can respond to antibiotic therapy in the initial stages, once advanced into a purulent collection, decompression may be indicated either in the form of needle aspiration or even surgical drainage. We present two newborns with breast abscesses managed surgically with successful outcomes. Case presentation Case 1: A 13-day-old boy presented with swelling and redness over the left breast for a day. Local examination revealed a warm, indurated swelling with redness and fluctuation. Needle aspiration confirmed pus. Intravenous (IV) antibiotics were started right away followed by pus drainage, the culture of which yielded Methicillin-Sensitive Staphylococcus aureus (MSSA). Regular wound care subsequently resulted in complete recovery. Case 2: A 15-day-old boy presented with swelling, redness and milky discharge from the right breast for two days. The swelling was erythematous, tender and indurated but not cystic or fluctuant. Ultrasonogram was suggestive of an abscess. Once again, IV antibiotics were administered followed by drainage. Pus yielded MSSA. Following regular wound dressings, satisfactory healing was achieved. Conclusion Neonatal mastitis and breast abscess are uncommon. Early recognition followed by appropriate antibiotic therapy and drainage of the abscess is the mainstay of treatment. Neonatal mastitis and breast abscess are fairly uncommon. Breast abscess, an exceedingly rare pyogenic inflammation, starts as mastitis neonatorum. Clinical improvement is aided by adequate antibiotic coverage and needle aspiration or surgical drainage of pus. Prompt recognition and management are paramount to avoid complications. Newborns with breast abscesses are managed surgically with successful outcomes.
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238
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Miyasaka M, Kawarada Y, Yamamura Y, Kitashiro S, Okushiba S, Hirano S. Inguinal single-port approach of endoscopic component separation for abdominal wall defects: A case series. Ann Med Surg (Lond) 2022; 82:104611. [PMID: 36268298 PMCID: PMC9577530 DOI: 10.1016/j.amsu.2022.104611] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 11/27/2022] Open
Abstract
Background The component separation (CS) technique is widely used for abdominal wall defects, particularly in infected wounds. CS is associated with many wound complications due to subcutaneous blood flow disturbance. Endoscopic component separation (ECS) has fewer wound complications compared to CS and has been performed recently. However, there are various port required placements for ECS, and this technique requires proficiency. One approach for ECS is the inguinal single-port approach, which can be performed from an inguinal incision similar to that used in open surgery for inguinal hernias. Case presentation We performed ECS with an inguinal single-port approach in three older adults. All patients had abdominal wall defects with infection at the central abdominal wound site. A 2–3-cm incision was created in the middle of the inguinal ligament, and a single-port surgical device with two 5-mm trocars was placed in the incision. The external oblique muscle was separated from the internal oblique muscle, and the external oblique aponeurosis was released. The muscle flap of the abdominal wall was moved to the central line. Tension-free abdominal wall closure was possible using a one-handed approach. Conclusions ECS, which has fewer wound complications, requires proficiency. This procedure is a simple and easy-to-perform procedure using an inguinal incision that surgeons are familiar with. Component separation is associated with wound complications. Endoscopic component separation has fewer complications, but is not easy to approach. Inguinal single port approach for endoscopic component separation technique is easy.
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239
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Al Mousa A, Kitaz MN, Brimo Alsaman MZ, Rezkallah V, Ghabreau L, Al-Hadid I. Renal primitive neuroectodermal tumor. The first case series from Syria. Ann Med Surg (Lond) 2022; 82:104740. [PMID: 36268368 PMCID: PMC9577866 DOI: 10.1016/j.amsu.2022.104740] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/12/2022] [Accepted: 09/18/2022] [Indexed: 11/29/2022] Open
Abstract
Primitive neuroectodermal tumor (PNET) mainly arises from soft tissues of the extremities such as humerus, femur, C tibia. It rarely arises from kidney; less than 200 cases have been reported in the literature. The clinical presentation and radiography findings are not specific. Here we first report two cases of renal primitive neuroectodermal tumor in Syria. the first patient was 26-year-old- female that presented to urology clinic complaining of right flank pain. Ultrasonography of the abdomen showed a large mixed heterogeneous mass in the right kidney with no hemorrhage or calcification and MSCT of abdomen and pelvis demonstrate a mixed well-demarcated heterogeneous mass measuring (74*117) mm in the right kidney right radical nephrectomy was performed. The second patient 19-year-old-male presented with left flank pain. Ultrasonography of the abdomen showed mixed large mass involving the left kidney, with unmarked border. The CT of the abdomen and pelvis demonstrating a (30*110*90) mm left renal mass and periaortic lymphadenopathy measuring (45*28) mm. The patient underwent Left radical nephrectomy with periaortic lymphadenectomy dissection. The final diagnosis for both cases was Renal PNET based on microscopic and immunohistochemistry examination. In patient with suspected renal mass in the radiographic images, the diagnosis of renal primitive neuroectodermal tumor should be kept in the mind despite its rarity. The final diagnosis is done by histopathological study in association with immunohistochemical examination. Here we will first report two cases of renal PNET in Syria. The diagnosis of renal primitive neuroectodermal tumor should be kept in the mind despite its rarity. The final diagnosis is done by histopathological study in association with immunohistochemical examination.
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Affiliation(s)
- Ahmad Al Mousa
- Department of Urology, Aleppo University Hospital, Aleppo, Syria
| | | | | | - Vairy Rezkallah
- Department of Pathology, Aleppo University Hospital, Aleppo, Syria
| | - Lina Ghabreau
- Department of Pathology, Aleppo University Hospital, Aleppo, Syria
| | - Ibrahim Al-Hadid
- Department of Urology, Aleppo University Hospital, Aleppo, Syria
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Jahromi BR, Dashti R, Rustemi O, Silva JM, Srinivasan VM, Tulamo R, Kozyrev DA, Jauhiainen S, Magnuson PU, Arce M, Kaukovalta H, Schwartz C, Numminen J, Sarpaneva S, Hirvelä V, Lawton MT, Tanikawa R, Niemelä M, Hernesniemi J. Slow-Closing Clip for the Treatment of Nonsaccular Vertebrobasilar Aneurysms: A Retrospective Case Series. World Neurosurg 2022; 168:e645-e665. [DOI: 10.1016/j.wneu.2022.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022]
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241
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Mouni O, Idrissi A, Bouziane M, Ahid S, Sair K. Impact of the COVID-19 pandemic on digestive cancer staging, a case series. Ann Med Surg (Lond) 2022; 82:104471. [PMID: 36059595 PMCID: PMC9419999 DOI: 10.1016/j.amsu.2022.104471] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Method Results Conclusion This is study assesses the impact of The COVID-19 pandemic on the diagnosis delay in digestive cancers and its impact on their staging. A three-year study that includes 165 patients, 1 year before the COVID-19 pandemic and two years during. The pandemic had a statistically significant impact on the staging of the tumor but no impact on the short-term outcome of the patients. The first study of its kind in Morocco.
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242
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Endo K, Morishima K, Koizumi M, Sasanuma H, Sakuma Y, Lefor AK, Sata N. Lateral retroperitoneal adrenalectomy: Comparison of introduction and education periods of a new surgical procedure in a teaching hospital. A retrospective case series study. International Journal of Surgery Open 2022. [DOI: 10.1016/j.ijso.2022.100550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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243
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Zairi M, Msakni A, Mohseni AA, Othmen A, Mensia K, Saied W, Bouchoucha S, Boussetta R, Nessib MN. Calcaneal lengthening osteotomy in the management of idiopathic flatfoot in children: cCase series of twenty-one feet. Int J Surg Case Rep 2022; 99:107634. [PMID: 36099766 PMCID: PMC9568701 DOI: 10.1016/j.ijscr.2022.107634] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Flatfoot is a frequent reason for consultation in pediatric orthopedics. The calcaneal lengthening osteotomy according to the EVANS technique is a therapeutic alternative. The objective of this work was to evaluate the short and medium term clinical and radiological results of calcaneal lengthening osteotomy in children with idiopathic flat foot valgus. Methods This study concerned 12 children and 15 ft treated surgically by calcaneal lengthening osteotomy by an orthopedic surgeon in a pediatric orthopedic surgery center. The evaluation of the results was clinical according AOFAS score and radiological. Results The deformity was reducible in all of our patients. The mean preoperative AOFAS score was 61, postoperatively 90. The overall result was excellent in 11 cases (11 ft) and good in 4 cases. The postoperative radiological result was close to normal values. Conclusion Calcaneal lengthening osteotomy is a reliable and recommended technique for the correction of symptomatic idiopathic flatfoot. Level of evidence: IV, Case series. Flatfoot is a frequent reason for consultation in pediatric orthopedics. Orthopedic management was recommended up to 9 years old. Knowing how to choose the feet to be operated on is important. Calcaneal lengthening osteotomy is a reliable and recommended technique for the correction of symptomatic idiopathic flatfoot.
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Putri Susilo AF, Tjandraprawira KD, Bayu P, Bayuaji H. Disorders of sex development (DSD) 46.XY due to type 2 5-α reductase deficiency in three siblings: Case report from a low-resource setting. Ann Med Surg (Lond) 2022; 82:104577. [PMID: 36268297 PMCID: PMC9577524 DOI: 10.1016/j.amsu.2022.104577] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/31/2022] [Accepted: 09/04/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction and Importance Disorders of Sexual Development (DSD) is a rare autosomal recessive genetic condition significantly affecting patients' lives in various aspects, particularly psychosocially. Type 2 5-α reductase is a cause of DSD 46,XY. It is rare to find multiple DSDs in the same family. Patients may present with amenorrhea and ambiguous genitalia. This case report is aimed to highlight the genetic aspects of the disease, the challenges to diagnostics and the various management options for the patients. Methods Case series of three siblings with DSD 46, XY with relevant discussion. Outcomes Three sisters, aged nineteen, seventeen, and fifteen years old came with an identical complaint of late menarche. Their physical examinations revealed elementary breast development and little axillary hair. The external genitals consisted of vulva, major and minor labia. Clitoromegaly was present with short (<5 cm) vagina. No female internal genital was found but undescended testes were palpable. Presences of testes was confirmed via ultrasound. Laboratory results showed reduced estradiol, highly increased follicle stimulating hormone (FSH), normal male testosterone levels and increased testosterone-dihydrotestosterone ratio (T/DHT >20). Karyotype was 46,XY. Diagnoses of DSD 46, XY due to type 2 5-α reductase deficiency were established. Patient 1 chose female as the gender of choice whilst patients 2 and 3 chose male. All patients are due for corrective surgery along with psychotherapy and psychoeducation. Conclusion DSD 46, XY due to type 2 5-α reductase deficiency is a rare autosomal recessive genetic disorder requiring comprehensive diagnostics and holistic management to improve patient quality of life. Disorder of sexual development (46,XY) due to type 2 5-α reductase deficiency is rare. It requires a multidisciplinary team involving a battery of tests, imaging and genetic tests, e.g. karyotyping. Informed consent and collaboration with other disciplines are pivotal for holistic management.
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Quoc LT, Thanh HNT, Le Khanh T, Trung DT. The role of acupuncture in pain and swelling control for postoperative tibial fracture treatment. Int J Surg Case Rep 2022; 99:107600. [PMID: 36116306 PMCID: PMC9568740 DOI: 10.1016/j.ijscr.2022.107600] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background Currently, intramedullary nailing for tibial fractures has very good postoperative treatment results. Combining the advantages of traditional medicine and modern medicine is a comprehensive treatment method that brings the best benefits to the patient. Methods The study method was a controlled clinical trial. The study included 60 patients with a definitive diagnosis of tibial fracture who underwent intramedullary nailing surgery. These patients were divided into 2 groups: with and without electroacupuncture treatment. Results Electro-acupuncture had a significant analgesic effect in 24–48 h after surgery: After 24 h or electro-acupuncture, the pain difference in the study group and the control groups was 3.03 ± 1.25 and 2.46 ± 1.33, respectively (p < 0.05). The VAS score difference between day 1 and day 2 in the study group and the control group was 0.61 ± 0.71 and 0.59 ± 0.67, respectively (p < 0.05). At 48 h postoperatively, the circumference of the calf on the fractured side in the study group and the control group was 36.1 ± 2.1 and 37.3 ± 2.2 cm, respectively (p < 0.05). At 72 h postoperatively, the circumference of the calf in the study group and the control group was 35.9 ± 2.6 and 37.6 ± 2.8 cm, respectively (p < 0.05). The effect of electro-acupuncture on bone healing did not differ between the study group and the control group (p > 0.05). During 7 days of using the treatment regimen, there were 3.3 % of patients with dizziness, 3.3 % of patients with vomiting/nausea, 3.3 % of patients with bleeding at the injection site. There was no difference in blood pressure, pulse rate, hematological indexes and biochemical indexes of patients before and after using the treatment regimen. Conclusion Electro-acupuncture has a significant analgesic effect 24 h–48 h after surgery. The effect of electroacupuncture on bone healing was not different between the two groups. Electroacupuncture is a safe, effective method with few side effects. Combining the advantages of traditional medicine and modern medicine is a comprehensive treatment method that brings the best benefits to the patient. This study was conducted to evaluate the effect of supporting pain relief and bone healing of electroacupuncture on patients after intramedullary nailing for tibial fractures, and to monitor the undesirable effects of the treatment regimen. Sixty patients with tibial fracture undergoing intramedullary nailing surgery were divided into 2 groups, with and without postoperative acupuncture treatment. Electro-acupuncture has a significant analgesic effect in 24-48 hours after surgery. The effect of electroacupuncture on bone healing was not different between the two groups. Electro-acupuncture is a safe, effective method with few side effects.
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Affiliation(s)
| | | | | | - Dung Tran Trung
- Department of Orthopaedic Surgery, Vin University, Hanoi, Viet Nam; Orthopaedic and Sports Medicine Center, Vinmec Healthcare System, Viet Nam.
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Wang AY, Liu P, Balonov K, Riesenburger R, Kryzanski J. Use of Spinal Anesthesia in Lower Thoracic Spine Surgery: A Case Series. Oper Neurosurg (Hagerstown) 2022; 23:298-303. [PMID: 36106935 PMCID: PMC10586860 DOI: 10.1227/ons.0000000000000325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/16/2022] [Accepted: 04/25/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Spinal anesthesia is a safe and effective alternative to general anesthesia for patients undergoing lumbar spine surgery, and numerous reports have demonstrated its advantages. To the best of our knowledge, no group has specifically reported on the use of spinal anesthesia in thoracic-level spine surgeries because there is a hypothetical risk of injuring the conus medullaris at these levels. With the advantages of spinal anesthesia and the desire for many elderly patients to avoid general anesthesia, our group has uniquely explored the use of this modality on select patients with thoracic pathology requiring surgical intervention. OBJECTIVE To investigate the feasibility of performing thoracic-level spinal surgeries under spinal anesthesia and report our experience with 3 patients. METHODS A retrospective chart review of medical records was undertaken, involving clinical notes, operative notes, and anesthesia records. RESULTS Three spinal stenosis patients underwent thoracic laminectomy under spinal anesthesia. Two surgeries were performed at the T11-T12 level and 1 at the T12-L1 level. The average age was 82 years, average American Society of Anesthesiologists score was 3.3, and 1 identified as female. Two cases used hyperbaric 0.75% bupivacaine dissolved in dextrose, and 1 used isobaric 0.5% bupivacaine dissolved in water. CONCLUSION Spinal anesthesia is feasible for thoracic-level spine procedures, even in elderly patients with comorbidities. We describe our cases and technique for safely achieving a thoracic level of analgesia, as well as discuss recommendations, adverse events, and considerations for the use of spinal anesthesia during lower thoracic-level spine operations.
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Affiliation(s)
- Andy Y. Wang
- Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts, USA;
| | - Penny Liu
- Department of Anesthesiology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Konstantin Balonov
- Department of Anesthesiology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Ron Riesenburger
- Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts, USA;
| | - James Kryzanski
- Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts, USA;
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Cloney MB, Hopkins B, Shlobin NA, Kelsten M, Goergen J, Driscoll C, Svet M, Ordon M, Koski T, Dahdaleh NS. Surgical Site Infection in the Intensive Care Setting After Posterior Spinal Fusion: A Case Series Highlighting the Microbial Profile, Risk Factors, and the Importance of Comorbid Disease Burden. Oper Neurosurg (Hagerstown) 2022; 23:312-317. [PMID: 36103357 DOI: 10.1227/ons.0000000000000341] [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: 08/19/2021] [Accepted: 05/05/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Most posterior spinal fusion (PSF) patients do not require admission to an intensive care unit (ICU), and those who do may represent an underinvestigated, high-risk subpopulation. OBJECTIVE To identify the microbial profile of and risk factors for surgical site infection (SSI) in PSF patients admitted to the ICU postoperatively. METHODS We examined 3965 consecutive PSF patients treated at our institution between 2000 and 2015 and collected demographic, clinical, and procedural data. Comorbid disease burden was quantified using the Charlson Comorbidity Index (CCI). We performed multivariable logistic regression to identify risk factors for SSI, readmission, and reoperation. RESULTS Anemia, more levels fused, cervical surgery, and cerebrospinal fluid leak were positively associated with ICU admission, and minimally invasive surgery was negatively associated. The median time to infection was equivalent for ICU patients and non-ICU patients, and microbial culture results were similar between groups. Higher CCI and undergoing a staged procedure were associated with readmission, reoperation, and SSI. When stratified by CCI into quintiles, SSI rates show a strong linear correlation with CCI ( P = .0171, R = 0.941), with a 3-fold higher odds of SSI in the highest risk group than the lowest (odds ratio = 3.15 [1.19, 8.07], P = .032). CONCLUSION Procedural characteristics drive the decision to admit to the ICU postoperatively. Patients admitted to the ICU have higher rates of SSI but no difference in the timing of or microorganisms that lead to those infections. Comorbid disease burden drives SSI in this population, with a 3-fold greater odds of SSI for high-risk patients than low-risk patients.
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Affiliation(s)
- Michael Brendan Cloney
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Benjamin Hopkins
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Max Kelsten
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jack Goergen
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Conor Driscoll
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Mark Svet
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Matthew Ordon
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tyler Koski
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nader S Dahdaleh
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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248
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Cakwira H, Mukengere M, Lucien B, Aborode AT, Sironge L, Michael MV, Akilimali A. The clinical characteristics of perineal tears: A study carried out on 14 pregnant women in a tertiary center: Case series. Ann Med Surg (Lond) 2022; 82:104432. [PMID: 36268344 PMCID: PMC9577417 DOI: 10.1016/j.amsu.2022.104432] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/03/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background The sheer quality of the female genital tract is not always respected at the time of childbirth because no protocol for the management of perineal tears exists in our services these days. The management remains dependent on a gynecologist and obstetrician. The study aimed to describe the characteristics of perineal tears. Methods Our cross-sectional, retrospective, and descriptive study focused on patients admitted for childbirth and hospitalized in the obstetrics department of the Saint Luc Tertiary Clinic for a period from March 2021 to March 2022. During this period, we recorded 111 deliveries with 14 perineal tears. Results A total of 111 deliveries were recorded with a 12.6% frequency of perineal tears. 64.3% of women aged between 26 and 35 and 71.4% of primiparous women were affected by perineal tears. For delivery, 64.3% of births were eutocic deliveries, with 42.9% of children born with a birth weight greater than 4 kg, and the cephalic presentation delivered 86% of children. For degrees of perineal tears, 64.3% of patients had first-degree perineal tears. For postpartum treatment of perineal tears, analgesics help calm the pain, and antibiotic therapy has been considered. For fourth and third-degree tears, episiotomy was performed as a surgical procedure. Conclusion Perineal tears are the trauma often encountered in obstetrics; the first few suffer from it essentially. The high birth weight of children is often the cause. They require immediate management to prevent or avoid infections. Women have a very complex anatomy, hence the high risk of trauma or tears of the perineum that are often unavoidable during childbirth. Young primiparous women are the most vulnerable to perineal tears with a very high prevalence. The high weight and cephalic presentation of children at delivery are the factors causing perineal tears in women. Vaginal delivery and the number of foetuses has an impact on the integrity of the perineum. During childbirth, perineal tears should be brought to the attention of obstetric providers to avoid complications for the woman.
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Hajri A, Fatine A, Eddaoudi Y, Rifki El Jay S, Boufettal R, Erreguibi D, Chehab F. Epidemiology, incidence and treatment of rectal cancer in young women case serie about 11 cases (case series). Ann Med Surg (Lond) 2022; 82:104693. [PMID: 36268414 PMCID: PMC9577628 DOI: 10.1016/j.amsu.2022.104693] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/04/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Rectal cancer constitutes, by its frequency and its gravity, a real concern of the public health in the world, it represents the eighth most frequent cancer. Its incidence is increasing in young people and in particular in women, in whom it remains a rare disease known for its poor prognosis. The objective of our work is to highlight the epidemiological characteristics of rectal cancer in patients under 40 years of age, determine its incidence and outline the different therapeutic means. Materials and methods Our work is a retrospective study with a descriptive aim on a series of 11 female patients aged less than 40 years, operated for rectal cancer in the department of digestive cancer surgery and liver transplantation Casablanca Morocco, over a period of 7 years from January 2013 to December 2019. Results The average age of our patients was 34.8 years. The average diagnostic delay was 10 months. The most frequent clinical sign was rectorrhagia (90.9% of cases). On rectal examination, the tumor was inaccessible in 18.8% of cases and externalized in 9.09% of cases. It was located in the lower rectum in 36.36% of cases, the same for the middle rectum. Rectoscopy showed that the majority of tumors were circumferential (36.36%). The budding ulcerative aspect was the most frequently found with 7 cases or 63.63%. The histological study showed the predominance of lieberkühnian adenocarcinoma (63.63%). Thoracic-abdominal-pelvic CT scan showed liver metastases in only one patient (9.09%). Pelvic MRI showed invasion of the mesorectum in 5 cases (45.45%) and of the internal sphincter in 3 cases (27.27%). All our patients underwent laparotomy. Curative surgery was performed in 8 patients and 3 patients had palliative surgery. Preoperative radiotherapy was performed in 81.81% of cases. The evolution was marked by 27.27% of locoregional recurrences. The operative mortality was nil in our series. Conclusion Detection of patients with precancerous conditions, screening for cancer in subjects at risk (familial recto-colic cancer, familial recto-colonic polyposis and ulcerative colitis), suspicion of cancer in the presence of any proctological sign, early diagnosis and curative surgical resection preceded by radiotherapy are the means that can improve the prognosis of rectal cancer in young women. Rectal cancer constitutes, by its frequency and its gravity, a real concern of the public health in the world. It represents the eighth most frequent cancer. Its incidence is increasing in young people and in particular in women, in whom it remains a rare disease known for its poor prognosis.
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Affiliation(s)
| | | | - Yassine Eddaoudi
- Corresponding author. Surgical department of cancerology and liver transplantation University hospital center Casablanca Morocco, Faculty of Medicine and Pharmacy, Hassan II University, Morocco.
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Raygor KP, Garcia J, Rutledge C, Tonetti DA, Raper DMS, Abla AA. The Lateral Supraorbital Craniotomy Approach for Anterior Circulation Aneurysms: A Modern Surgical Case Series in the Endovascular Era. World Neurosurg 2022; 166:e799-807. [PMID: 35926698 DOI: 10.1016/j.wneu.2022.07.107] [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: 05/28/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The lateral supraorbital (LSO) approach is a minimally invasive modification of the standard pterional approach to anterior circulation aneurysms. This study aimed to describe a dual-trained cerebrovascular neurosurgeon's first 18-month experience with the LSO approach, including decision-making criteria and lessons learned. METHODS This retrospective case series analyzed 50 consecutive patients treated with LSO craniotomy for aneurysm clipping by a single surgeon. Aneurysms were separated into 3 categories by location: internal carotid artery, anterior communicating artery, and middle cerebral artery. Surgical characteristics were evaluated for differences by location and rupture status. RESULTS Aneurysm clipping via LSO was performed on 57 aneurysms in 50 patients. Fixed retraction was employed less often in patients with internal carotid artery aneurysms than in patients with anterior communicating artery, middle cerebral artery, or multiple aneurysms (10% vs. 68.2%, 45.5%, and 42.9, P = 0.02). Of patients, 26 (52%) presented with subarachnoid hemorrhage; the majority of patients (92.3%) had Hunt and Hess grade I-III. No differences were noted in intraoperative rupture rates, fixed retractor use, operative duration, or estimated blood loss by rupture status. Adverse events included permanent frontalis nerve palsy in 1 patient (2%), temporalis atrophy in 1 patient, and transient aphasia in 1 patient. No postoperative hematomas or strokes were observed. CONCLUSIONS The LSO approach can safely and effectively treat anterior circulation aneurysms and should be considered a viable minimally invasive option for aneurysm clipping. Further studies comparing the LSO approach with other cranial approaches are needed.
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