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Yao Y, Wang X, Zhao B, Mo J, Guo Z, Yang B, Li Z, Fan X, Cai D, Sang L, Zheng Z, Shao X, Ai L, Hu W, Zhang C, Zhang K. Hypometabolic patterns are related to post-surgical seizure outcomes in focal cortical dysplasia: A semi-quantitative study. Epilepsia Open 2024; 9:653-664. [PMID: 38265725 PMCID: PMC10984320 DOI: 10.1002/epi4.12903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 12/25/2023] [Accepted: 01/06/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE Fluorine-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) is routinely used for presurgical evaluation in many epilepsy centers. Hypometabolic characteristics have been extensively examined in prior studies, but the metabolic patterns associated with specific pathological types of drug-resistant epilepsy remain to be fully defined. This study was developed to explore the relationship between metabolic patterns or characteristics and surgical outcomes in type I and II focal cortical dysplasia (FCD) patients based on results from a large cohort. METHODS Data from individuals who underwent epilepsy surgery from 2014 to 2019 with a follow-up duration of over 3 years and a pathological classification of type I or II FCD in our hospital were retrospectively analyzed. Hypometabolic patterns were quantitatively identified via statistical parametric mapping (SPM) and qualitatively analyzed via visual examination of PET-MRI co-registration images. Univariate analyses were used to explore the relationship between metabolic patterns and surgical outcomes. RESULTS In total, this study included data from 210 patients. Following SPM calculations, four hypometabolic patterns were defined including unilobar, multi-lobar, and remote patterns as well as cases where no pattern was evident. In type II FCD patients, the unilobar pattern was associated with the best surgical outcomes (p = 0.014). In visual analysis, single gyrus (p = 0.032) and Clear-cut hypometabolism edge (p = 0.040) patterns exhibited better surgery outcomes in the type II FCD group. CONCLUSIONS PET metabolic patterns are well-correlated with the prognosis of type II FCD patients. However, similar correlations were not observed in type I FCD, potentially owing to the complex distribution of the epileptogenic region. PLAIN LANGUAGE SUMMARY In this study, we demonstrated that FDG-PET was a crucial examination for patients with FCD, which was a common cause of epilepsy. We compared the surgical prognosis for patients with different hypometabolism distribution patterns and found that clear and focal abnormal region in PET was correlated with good surgical outcome in type II FCD patients.
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Affiliation(s)
- Yuan Yao
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Xiu Wang
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Baotian Zhao
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Jiajie Mo
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Zhihao Guo
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Bowen Yang
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Zilin Li
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Xiuliang Fan
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Du Cai
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Lin Sang
- Department of NeurosurgeryBeijing FengTai HospitalBeijingChina
| | - Zhong Zheng
- Department of NeurosurgeryBeijing FengTai HospitalBeijingChina
| | - Xiaoqiu Shao
- Department of NeurologyBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Lin Ai
- Department of Nuclear MedicineBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Wenhan Hu
- Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
| | - Chao Zhang
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
| | - Kai Zhang
- Department of NeurosurgeryBeijing TianTan Hospital, Capital Medical UniversityBeijingChina
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Lai YH, Chang SJ. Efforts to improve the surgical outcome for exotropia and investigation of the insertion locations of the extraocular muscles. Kaohsiung J Med Sci 2023; 39:834-841. [PMID: 37341429 DOI: 10.1002/kjm2.12724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/16/2023] [Accepted: 05/31/2023] [Indexed: 06/22/2023] Open
Abstract
In our previous retrospective study, we found that using the strabismus surgery dosages established by western strabismus mentors tends to result in undercorrection of Taiwanese exotropia (XT) patients compared with those in western populations. We also discovered that the location of extraocular muscle (EOM) insertion could vary by ethnicity. In this study, using a generalized estimation equation model, we compared the XT surgery outcome between augmented and original strabismus surgery dosages in Taiwanese patients. We also conducted an observational study to investigate the horizontal EOM insertion location in a Taiwanese population and compared the data with Dr. Apt L.'s study. For Taiwanese XT patients, augmented surgical dosages resulted in significantly better outcome at 6 months and 1 year postoperatively compared with original surgical dosages (p = 0.003 and p < 0.001, respectively). The distance from the lateral recuts muscle (LR) insertion location to the limbus was significantly shorter in Taiwanese than in white Americans (6.5 vs. 6.9 mm, respectively, p = 0.0001). Furthermore, the medial rectus muscle and LR insertion locations differed significantly between males and females (p < 0.001 and p = 0.023, respectively). The patients' sex did not affect the surgery outcome. Augmented surgery doses modified from western strabismus mentors produce better surgery outcome for Taiwanese XT patients. Surgeons may require country-specific guidelines for strabismus surgery dosage. We also demonstrated a simple method for young ophthalmologists to establish their own normograms to improve their surgical success rate. Our study confirms that LR insertion locations differ between Taiwanese and White Americans.
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Affiliation(s)
- Yu-Hung Lai
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shun-Jen Chang
- Department of Kinesiology, Health and Leisure Studies, National University of Kaohsiung, Kaohsiung, Taiwan
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Rodríguez-Calvo PP, Rodríguez-Uña I, Fernández-Vega-Cueto A, Sánchez-Ávila RM, Anitua E, Merayo-Lloves J. Plasma Rich in Growth Factors as an Adjuvant Agent in Non-Penetrating Deep Sclerectomy. J Clin Med 2023; 12:jcm12103604. [PMID: 37240710 DOI: 10.3390/jcm12103604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/11/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The purpose of this study is to evaluate the utility and safety of plasma rich in growth factors immunosafe eye drops (is-ePRGF) in the postoperative treatment of non-penetrating deep sclerectomy (NPDS). METHODS This is a case-control study in patients with open-angle glaucoma. Group one (control) was not treated with is-ePRGF, while group two (is-ePRGF) was treated (four times a day for four months). Postoperative evaluations were performed at one day, one month, three months and six months. The main outcomes were: intraocular pressure (IOP), microcysts in blebs with AS-OCT and the number of hypotensive eye drops. RESULTS Preoperatively, group one (n = 48 eyes) and group two (n = 47 eyes) were similar in age (71.5 ± 10.7 vs. 70.9 ± 10.0 years; p = 0.68), IOP (20.6 ± 10.2 vs. 23.0 ± 9.0 mmHg; p = 0.26) and number of hypotensive drugs (2.7 ± 0.8 vs. 2.8 ± 0.9; p = 0.40). The IOP at six months dropped to 15.0 ± 8.0 mmHg (IOP reduction: -27.2%) and 10.9 ± 4.3 mmHg (IOP reduction: -52.6%) for group one and group two, respectively (p < 0.01). At six months, blebs with microcysts were 62.5% (group one) and 76.7% (group two). Postoperative complications were observed in 12 eyes (25%) for group one and in 5 eyes (11%) for group two (p = 0.06). No specific complications related to the use of is-ePRGF were identified. CONCLUSIONS Topical is-ePRGF seems to reduce IOP and the rate of complications in the medium term after NPDS, so it can be considered as a possible safe adjuvant to achieve surgical success.
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Affiliation(s)
- Pedro P Rodríguez-Calvo
- Instituto Universitario Fernandez-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain
| | - Ignacio Rodríguez-Uña
- Instituto Universitario Fernandez-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain
| | - Andrés Fernández-Vega-Cueto
- Instituto Universitario Fernandez-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain
| | | | - Eduardo Anitua
- Biotechnology Institute (BTI), 01007 Vitoria, Spain
- Regenerative Medicine Laboratory, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), 01007 Vitoria, Spain
| | - Jesús Merayo-Lloves
- Instituto Universitario Fernandez-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain
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Ma M, Zhu F, Fan F, Pan J, Cao H, Zhou Q, Wang D. Relationship between preoperative lymphocyte to monocyte ratio and surgery outcome in type A aortic dissection. Front Surg 2023; 9:1103290. [PMID: 36684141 PMCID: PMC9849739 DOI: 10.3389/fsurg.2022.1103290] [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: 11/20/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Background Lymphocyte-to-monocyte ratio (LMR) is associated with the mortality of cardiovascular diseases. However, the relationship between preoperative LMR and the prognosis of patients with Stanford type A aortic dissection (TAAD) undergoing surgical treatment remains to be determined. Methods We enrolled 879 patients with TAAD undergoing surgical treatment between January 2018 and December 2021. Patients were divided into two groups: the Deceased group and the Survived group. The baseline clinical and operative characteristics of the two groups were compared and analyzed. Results In univariate and multivariate logistic regression analysis, the association between LMR and in-hospital mortality was significant, and LMR (OR = 1.598, 95% CI 1.114-2.485, P = 0.022) remained significant after adjusting for confounders. Conclusion Lower LMR may be independently associated with higher in-hospital mortality in TAAD undergoing surgical treatment.
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Affiliation(s)
- Ming Ma
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China,Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China,Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Feng Zhu
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China,Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China,Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Fudong Fan
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China,Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China,Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Jun Pan
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China,Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China,Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Hailong Cao
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China,Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China,Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Qing Zhou
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China,Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China,Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Dongjin Wang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China,Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China,Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China,Correspondence: Dongjin Wang
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Mastropasqua L, Brescia L, D'Arcangelo F, Nubile M, D'Onofrio G, Totta M, Perna F, Aloia R, Agnifili L. Topical Steroids and Glaucoma Filtration Surgery Outcomes: An In Vivo Confocal Study of the Conjunctiva. J Clin Med 2022; 11. [PMID: 35887722 DOI: 10.3390/jcm11143959] [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: 06/02/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 01/25/2023] Open
Abstract
(1) Background: The purpose of this study is to investigate the effects of topical steroids on conjunctiva in patients undergoing filtration surgery (FS) for glaucoma by using confocal microscopy (CM); (2) Methods: One hundred and four glaucomatous patients were randomized to fluorometholone or lubricants four weeks before FS. CM was performed before treatments and pre-operatively. Dendritic and goblet cell densities (DCD, GCD), stromal meshwork reflectivity (SMR), vascular tortuosity (VT), and intra-ocular pressure (IOP) were the main outcomes. By evaluating treatments and outcomes (12-month success/failure) as categorical variables, patients were grouped into Group 1, 2, 3, or 4 (success/failure with fluorometholone, or lubricants); (3) Results: Twelve-month IOP was reduced in Groups 1 and 3 (p < 0.001). After treatments, DCD and SMR were reduced in Groups 1 and 2 (p < 0.01), and 1 and 3 (p < 0.05), respectively. Pre-operative DCD was lower in the steroid compared to lubricant group (p < 0.001), whereas SMR was lower in successful (1 and 3) compared to failed groups (2 and 4) (p = 0.004). There were no significant differences between the fluorometholone and lubricant groups for success percentages. The number of bleb management procedures and IOP lowering medications were lower in Group 1 compared to Groups 2−4 (p < 0.05); (4) Conclusions: Topical steroids mitigate conjunctival inflammation and lower the stromal density in patients undergoing FS. These modifications lead to less intensive post-operative management.
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Fitzgerald Z, Morita-Sherman M, Hogue O, Joseph B, Alvim MKM, Yasuda CL, Vegh D, Nair D, Burgess R, Bingaman W, Najm I, Kattan MW, Blumcke I, Worrell G, Brinkmann BH, Cendes F, Jehi L. Improving the prediction of epilepsy surgery outcomes using basic scalp EEG findings. Epilepsia 2021; 62:2439-2450. [PMID: 34338324 PMCID: PMC8488002 DOI: 10.1111/epi.17024] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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: 02/19/2021] [Revised: 06/15/2021] [Accepted: 07/15/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aims to evaluate the role of scalp electroencephalography (EEG; ictal and interictal patterns) in predicting resective epilepsy surgery outcomes. We use the data to further develop a nomogram to predict seizure freedom. METHODS We retrospectively reviewed the scalp EEG findings and clinical data of patients who underwent surgical resection at three epilepsy centers. Using both EEG and clinical variables categorized into 13 isolated candidate predictors and 6 interaction terms, we built a multivariable Cox proportional hazards model to predict seizure freedom 2 years after surgery. Harrell's step-down procedure was used to sequentially eliminate the least-informative variables from the model until the change in the concordance index (c-index) with variable removal was less than 0.01. We created a separate model using only clinical variables. Discrimination of the two models was compared to evaluate the role of scalp EEG in seizure-freedom prediction. RESULTS Four hundred seventy patient records were analyzed. Following internal validation, the full Clinical + EEG model achieved an optimism-corrected c-index of 0.65, whereas the c-index of the model without EEG data was 0.59. The presence of focal to bilateral tonic-clonic seizures (FBTCS), high preoperative seizure frequency, absence of hippocampal sclerosis, and presence of nonlocalizable seizures predicted worse outcome. The presence of FBTCS had the largest impact for predicting outcome. The analysis of the models' interactions showed that in patients with unilateral interictal epileptiform discharges (IEDs), temporal lobe surgery cases had a better outcome. In cases with bilateral IEDs, abnormal magnetic resonance imaging (MRI) predicted worse outcomes, and in cases without IEDs, patients with extratemporal epilepsy and abnormal MRI had better outcomes. SIGNIFICANCE This study highlights the value of scalp EEG, particularly the significance of IEDs, in predicting surgical outcome. The nomogram delivers an individualized prediction of postoperative outcome, and provides a unique assessment of the relationship between the outcome and preoperative findings.
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Affiliation(s)
| | | | - Olivia Hogue
- Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Boney Joseph
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Deborah Vegh
- Epilepsy Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Dileep Nair
- Epilepsy Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Richard Burgess
- Epilepsy Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - William Bingaman
- Epilepsy Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Imad Najm
- Epilepsy Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Michael W. Kattan
- Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Ingmar Blumcke
- Institute of Neuropathology, University Hospitals Erlangen, Erlangen, Germany
| | - Gregory Worrell
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Fernando Cendes
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Lara Jehi
- Epilepsy Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Peng J, Li W, Tang J, Li Y, Li X, Wu X, Lu Z, Lin J, Pan Z. Surgical Outcomes of Robotic Resection for Sigmoid and Rectal Cancer: Analysis of 109 Patients From a Single Center in China. Front Surg 2021; 8:696026. [PMID: 34504865 PMCID: PMC8422034 DOI: 10.3389/fsurg.2021.696026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/27/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Robotic colorectal surgery has been increasingly performed in recent years. The safety and feasibility of its application has also been demonstrated worldwide.However, limited studies have presented clinical data for patients with colorectal cancer (CRC) receiving robotic surgery in China. The aim of this study is to present short-term clinical outcomes of robotic surgery and further confirm its safety and feasibility in Chinese CRC patients. Methods: The clinical data of 109 consecutive CRC patients who received robotic surgery at Sun Yat-sen University Cancer Center between June 2016 and May 2019 were retrospectively reviewed. Patient characteristics,tumor traits, treatment details, complications, pathological details, and survival status were evaluated. Results: Among the 109 patients, 35 (32.1%) had sigmoid cancer, and 74 (67.9%) had rectal cancer. Thirty-seven (33.9%) patients underwent neoadjuvant chemoradiotherapy. Ten (9.2%) patients underwent sigmoidectomy, 38 (34.9%) underwent high anterior resection (HAR), 45 (41.3%) underwent low anterior resection (LAR), and 16 (14.7%) underwent abdominoperineal resection (APR). The median surgical procedure time was 270 min (range 120–465 min). Pathologically complete resection was achieved in all patients. There was no postoperative mortality. Complications occurred in 11 (10.1%) patients, including 3 (2.8%) anastomotic leakage, 1 (0.9%) anastomotic bleeding, 1 (0.9%) pelvic hemorrhage, 4 (3.7%) intestinal obstruction, 2 (1.8%) chylous leakage, and 1 (0.9%) delayed wound union. At a median follow-up of 17 months (range 1–37 months), 1 (0.9%) patient developed local recurrence and 5 (4.6%) developed distant metastasis, with one death due to disease progression. Conclusions: Our results suggest that robotic surgery is technically feasible and safe for Chinese CRC patients, especially for rectal cancer patients who received neoadjuvant treatment. A robotic laparoscope with large magnification showed a clear surgical space for pelvic autonomic nerve preservation in cases of mesorectal edema.
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Affiliation(s)
- Jianhong Peng
- State Key Laboratory of Oncology in South China, Department of Colorectal Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Weihao Li
- State Key Laboratory of Oncology in South China, Department of Colorectal Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jinghua Tang
- State Key Laboratory of Oncology in South China, Department of Colorectal Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yuan Li
- State Key Laboratory of Oncology in South China, Department of Colorectal Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xueying Li
- State Key Laboratory of Oncology in South China, Department of Colorectal Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiaojun Wu
- State Key Laboratory of Oncology in South China, Department of Colorectal Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhenhai Lu
- State Key Laboratory of Oncology in South China, Department of Colorectal Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Junzhong Lin
- State Key Laboratory of Oncology in South China, Department of Colorectal Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhizhong Pan
- State Key Laboratory of Oncology in South China, Department of Colorectal Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
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Dandis R, Westeneng JM, Inthout J, Nijhuis-Van der Sanden MWG, Harmelink KE, Teerenstra S, Hoogeboom TJ. Latent Class Analysis to Predict Outcomes of Early High-Intensity Physical Therapy After Total Knee Arthroplasty, Based on Longitudinal Trajectories of Walking Speed. J Orthop Sports Phys Ther 2021; 51:362-71. [PMID: 33971736 DOI: 10.2519/jospt.2021.10299] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To (1) classify patients who are recovering from total knee arthroplasty (TKA) based on walking speed during an early physical therapy program, and (2) assess whether walking-speed trajectory predicts performance on the timed up-and-go (TUG) test. DESIGN Cohort study. METHODS We included 218 patients from a 10-day physical therapy program after TKA. A latent class mixed model was used to classify patients according to their walking-speed trajectory during the program. We assessed the change in TUG test score from pre-TKA to 6 weeks and 1 year after TKA. The association between change in TUG test score and walking-speed trajectory was assessed using multivariable regression. RESULTS There were 2 groups with distinct walking-speed trajectories: a high-gain group (46%) and a low-gain group (54%). There was no significant association between change in TUG test score and walking-speed trajectory after TKA and physical therapy. Function (based on TUG test performance) improved for all patients 1 year after TKA, irrespective of walking-speed trajectory (ie, high or low gain) early in postoperative physical therapy. CONCLUSION Although we distinguished different groups based on functional outcomes during physical therapy, the clinical relevance of classifying patients based on walking speed remains unclear, as it did not predict short- and long-term functional outcomes. J Orthop Sports Phys Ther 2021;51(7):362-371. Epub 10 May 2021. doi:10.2519/jospt.2021.10299.
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Dombroski TCD, Peixoto-Santos JE, Maciel K, Baqui MMA, Velasco TR, Sakamoto AC, Assirati JA, Carlotti CG, Machado HR, Sousa GKD, Hanamura K, Leite JP, Costa da Costa J, Palmini AL, Paglioli E, Neder L, Spreafico R, Shirao T, Garbelli R, Martins AR. Drebrin expression patterns in patients with refractory temporal lobe epilepsy and hippocampal sclerosis. Epilepsia 2020; 61:1581-1594. [PMID: 32662890 DOI: 10.1111/epi.16595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Drebrins are crucial for synaptic function and dendritic spine development, remodeling, and maintenance. In temporal lobe epilepsy (TLE) patients, a significant hippocampal synaptic reorganization occurs, and synaptic reorganization has been associated with hippocampal hyperexcitability. This study aimed to evaluate, in TLE patients, the hippocampal expression of drebrin using immunohistochemistry with DAS2 or M2F6 antibodies that recognize adult (drebrin A) or adult and embryonic (pan-drebrin) isoforms, respectively. METHODS Hippocampal sections from drug-resistant TLE patients with hippocampal sclerosis (HS; TLE, n = 33), of whom 31 presented with type 1 HS and two with type 2 HS, and autopsy control cases (n = 20) were assayed by immunohistochemistry and evaluated for neuron density, and drebrin A and pan-drebrin expression. Double-labeling immunofluorescences were performed to localize drebrin A-positive spines in dendrites (MAP2), and to evaluate whether drebrin colocalizes with inhibitory (GAD65) and excitatory (VGlut1) presynaptic markers. RESULTS Compared to controls, TLE patients had increased pan-drebrin in all hippocampal subfields and increased drebrin A-immunopositive area in all hippocampal subfields but CA1. Drebrin-positive spine density followed the same pattern as total drebrin quantification. Confocal microscopy indicated juxtaposition of drebrin-positive spines with VGlut1-positive puncta, but not with GAD65-positive puncta. Drebrin expression in the dentate gyrus of TLE cases was associated negatively with seizure frequency and positively with verbal memory. TLE patients with lower drebrin-immunopositive area in inner molecular layer (IML) than in outer molecular layer (OML) had a lower seizure frequency than those with higher or comparable drebrin-immunopositive area in IML compared with OML. SIGNIFICANCE Our results suggest that changes in drebrin-positive spines and drebrin expression in the dentate gyrus of TLE patients are associated with lower seizure frequency, more preserved verbal memory, and a better postsurgical outcome.
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Affiliation(s)
| | - Jose Eduardo Peixoto-Santos
- Discipline of Neuroscience, Department of Neurology and Neurosurgery, Paulista Medical School, UNIFESP, São Paulo, Brazil
| | - Karina Maciel
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Munira Muhammad Abdel Baqui
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Tonicarlo Rodrigues Velasco
- Ribeirao Preto Epilepsy Surgery Center, Clinics Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Americo Ceiki Sakamoto
- Ribeirao Preto Epilepsy Surgery Center, Clinics Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - João Alberto Assirati
- Department of Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Carlos Gilberto Carlotti
- Department of Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Hélio Rubens Machado
- Department of Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Gleice Kelly de Sousa
- Graduate Program of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Kenji Hanamura
- Department of Neurobiology and Behavior, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - João Pereira Leite
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Jaderson Costa da Costa
- Department of Internal Medicine, School of Medicine, Epilepsy Surgery Program and Brain Institute, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - André Luiz Palmini
- Department of Internal Medicine, School of Medicine, Epilepsy Surgery Program and Brain Institute, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eliseu Paglioli
- Department of Surgery, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciano Neder
- Department of Pathology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Roberto Spreafico
- Clinical Epileptology and Experimental Neurophysiology Unit, Scientific Institute for Research and Health Care Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Tomoaki Shirao
- Department of Neurobiology and Behavior, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Rita Garbelli
- Clinical Epileptology and Experimental Neurophysiology Unit, Scientific Institute for Research and Health Care Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Antonio Roberto Martins
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Institute for Neuroscience and Behavior, Ribeirão Preto, Brazil
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10
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Gao M, Zhu B, Li P, Zhang G, Chen K, Lv H, Ma R, Zhang L, Fan Y, Kang X. Influence of the IGFBP3-202A/C Gene Polymorphism on Clinical Features and Surgery Outcome in Acromegalic Patients. Front Endocrinol (Lausanne) 2018; 9:751. [PMID: 30619084 PMCID: PMC6297192 DOI: 10.3389/fendo.2018.00751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/27/2018] [Indexed: 12/14/2022] Open
Abstract
Purpose: Excess growth hormone (GH) secretion in acromegaly patients results in increased levels of IGF-1 expression, which causes the clinical manifestations of acromegaly. IGF-1 levels are attenuated by IGFBP3, and a polymorphism in the promoter of IGFBP3 is known to affect the circulating level of IGFBP3 protein. The aim of the study was to evaluate the association of the IGFBP3 gene polymorphism with clinical features and surgery outcomes in acromegaly. We also investigate the difference in IGFBP3 polymorphism between acromegaly and general population. Methods: The study included 102 acromegalic patients and 142 sex- and age-matched healthy controls. The genotyping of IGFBP3 was carried out using the MassARRAY method. Patients were followed up for 4-12 months to estimate the neurosurgical effects. Clinical data were obtained from the medical records. Results: The CC genotype, which is associated with decreased IGFBP3 levels, was less common in acromegaly patients than among the healthy controls; although, this correlation was not significant (P = 0.056). There was no association of the IGFBP3 gene polymorphism with glucose, lipid, phosphorus, blood urea nitrogen, creatinine or uric acid levels. Additionally, there was no association between tumor size, texture, or hemorrhage/cyst, except there was a trend that more patients with the C allele (P = 0.054) needed additional treatment post-operation than did patients carrying the A allele (OR 1.985, 95% CI 0.983-4.008). Moreover, higher IGF-1 values after treatment were observed in patients carrying the C allele (P = 0.012 and P = 0.014 according to the additive model and dominant model, respectively). Conclusion: Polymorphisms in IGFBP3 may not influence metabolic parameters or pituitary tumor characteristics in acromegalic patients, but they may be associated with the hormone levels and surgery effects.
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Affiliation(s)
- Ming Gao
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents and Clinical Research, Beijing, China
| | - Bin Zhu
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ping Li
- Department of Endocrinology, Yuncheng Central Hospital, Shanxi Medical University, Yuncheng, China
| | - Guojun Zhang
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents and Clinical Research, Beijing, China
| | - Kelin Chen
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents and Clinical Research, Beijing, China
| | - Hong Lv
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents and Clinical Research, Beijing, China
| | - Ruimin Ma
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents and Clinical Research, Beijing, China
| | - Limin Zhang
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents and Clinical Research, Beijing, China
| | - Yubo Fan
- Lab of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xixiong Kang
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents and Clinical Research, Beijing, China
- Lab of Biological Science and Medical Engineering, Beihang University, Beijing, China
- *Correspondence: Xixiong Kang
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11
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Sun Y, Wang X, Che N, Qin H, Liu S, Wu X, Wei M, Cheng H, Yin J. Clinical characteristics and epilepsy outcomes following surgery caused by focal cortical dysplasia (type IIa) in 110 adult epileptic patients. Exp Ther Med 2017; 13:2225-2234. [PMID: 28565831 PMCID: PMC5443177 DOI: 10.3892/etm.2017.4315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 08/09/2015] [Accepted: 10/21/2016] [Indexed: 11/09/2022] Open
Abstract
The aim of the present study was to investigate the effects of surgical intervention of focal cortical dysplasia (FCD) IIa on the outcome of epilepsy, and to evaluate the prognostic factors of seizure freedom. Patient data from epilepsy surgeries were retrospectively reviewed at the Second Affiliated Hospital of Dalian Medical University between 2007 and 2015. A total of 110 patients with a definite pathological diagnosis of FCD IIa were included. Moreover, the clinical characteristics, seizure outcome and quality of life in adults with FCD IIa were evaluated. The Engel seizure outcome achievements were class I in 72, class II in 20, class III in 11 and class IV in 7 patients. In addition, the Engel seizure outcome was relevant with the resection range of the lesions (P=0.028). The assessments of electrocorticography (ECoG) patterns and magnetic resonance imaging (MRI) are relevant to determining the extent of the resection, which may influence the surgery outcome (P=0.001 and P=0.023). Using multivariate regression analyses, the extent of resection, seizure frequency, preoperative ECoG and location of resection were the most important risk factors for seizure recurrence. The results of quality of life in epilepsy-10 scoring revealed that the quality of life improved significantly following surgery (P<0.01). Moreover, surgical intervention, EcoG, MRI positioning and complete resection helped to have improved seizure control, relief of anxiety and quality of life. All these observations strongly recommend an early consideration of epilepsy surgery in FCD IIa patients.
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Affiliation(s)
- Yuqiang Sun
- Department of Neurosurgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116044, P.R. China.,Department of Neurosurgery, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
| | - Xiaofeng Wang
- Department of Neurosurgery, Weinan Central Hospital, Weinan, Shaanxi 714000, P.R. China
| | - Ningwei Che
- Department of Neurosurgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Huamin Qin
- Department of Pathology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Shuping Liu
- Department of Neurosurgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Xinling Wu
- Department of Psychology, Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Minghai Wei
- Department of Neurosurgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Huakun Cheng
- Department of Neurosurgery, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
| | - Jian Yin
- Department of Neurosurgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116044, P.R. China
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12
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Signorelli C, Bonanzinga T, Grassi A, Lopomo N, Zaffagnini S, Marcacci M. Predictive mathematical modeling of knee static laxity after ACL reconstruction: in vivo analysis. Comput Methods Biomech Biomed Engin 2016; 19:1610-7. [PMID: 27123692 DOI: 10.1080/10255842.2016.1176152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/21/2022]
Abstract
Previous studies did not take into consideration such large variety of surgery variables which describe the performed anterior cruciate ligament (ACL) reconstruction and the interaction among them in the definition of postoperative outcome. Seventeen patients who underwent navigated Single Bundle plus Lateral Plasty ACL reconstruction were enrolled in the study. Static laxity was evaluated as the value of anterior/posterior displacement at 30° and at 90° of flexion, internal/external rotation at 30° and 90° of knee flexion, varus/valgus test at 0° and 30° of flexion. The evaluated surgical variables were analyzed through a multivariate analysis defining the following models: AP30estimate, AP90estimate, IE30estimate, IE90estimate, VV0estimate, VV30estimate. Surgical variables has been defined as the angles between the tibial tunnel and the three planes, the lengths of the tunnel and the relationship between native footprints and tunnels. An analogous characterization was performed for the femoral side. Performance and significance of the defined models have been quantified by the correlation ratio (η(2)) and the corresponding p-value (*p < 0.050). The analyzed models resulted to be statistically significant (p < 0.05) for prediction of postoperative static laxity values. The only exception was the AP90estimate model. The η(2) ranged from 0.568 (IE90estimate) to 0.995 (IE30estimate). The orientation of the tibial tunnel resulted to be the most important surgical variable for the performed laxity estimation. Mathematical models for postoperative knee laxity is a useful tool to evaluate the effects of different surgical variables on the postoperative outcome.
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Affiliation(s)
- C Signorelli
- a Istituto Ortopedico Rizzoli , Laboratorio di Biomeccanica e Innovazione Tecnologica , Bologna , Italy
| | - T Bonanzinga
- a Istituto Ortopedico Rizzoli , Laboratorio di Biomeccanica e Innovazione Tecnologica , Bologna , Italy.,b Istituto Ortopedico Rizzoli, Clinica Ortopedica e Traumatologica II , Bologna , Italy
| | - A Grassi
- a Istituto Ortopedico Rizzoli , Laboratorio di Biomeccanica e Innovazione Tecnologica , Bologna , Italy.,b Istituto Ortopedico Rizzoli, Clinica Ortopedica e Traumatologica II , Bologna , Italy
| | - N Lopomo
- a Istituto Ortopedico Rizzoli , Laboratorio di Biomeccanica e Innovazione Tecnologica , Bologna , Italy.,c Dipartimento di Ingegneria dell'Informazione, Università degli Studi di Brescia , Brescia , Italy
| | - S Zaffagnini
- a Istituto Ortopedico Rizzoli , Laboratorio di Biomeccanica e Innovazione Tecnologica , Bologna , Italy.,b Istituto Ortopedico Rizzoli, Clinica Ortopedica e Traumatologica II , Bologna , Italy
| | - M Marcacci
- a Istituto Ortopedico Rizzoli , Laboratorio di Biomeccanica e Innovazione Tecnologica , Bologna , Italy.,b Istituto Ortopedico Rizzoli, Clinica Ortopedica e Traumatologica II , Bologna , Italy
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Abstract
OBJECTIVE Many people are convinced that lunar phases influence their lives - despite the fact that a lot of studies have shown that this belief is wrong. In this article, we investigate the effect of lunar phases on acute post-surgical pain and on treatment-related side effects. We hypothesize that there is no influence. METHODS The data for the study were collected in 2010 and 2011 in 10 international hospitals participating in the research project PAIN OUT. Hospitalized patients were asked for their pain after surgery and pain treatment side effects using numerical ratings scales from 0 to 10. We applied Kurskal-Wallis H-tests to find out if the four moon phases show significant differences in 14 outcome variables. Afterwards, we adjusted for age, gender and three tracer surgeries. RESULTS A total of 12,224 patient data sets were assessed. For most variables and sub-groups, there is no lunar effect on the observed outcome variables. The only items that show statistically significant differences are pain interference with sleep (p = 0.01) and drowsiness (p = 0.01). The only sub-groups that show statistically significant connections to lunar phases in some variables are men (7 out of 14 variables significant) and elderly people (4 out of 14 variables significant). DISCUSSION Even in the statistically significant sub-groups, the differences are small and only show up in some variables. We conclude that lunar phases have no effect on post-surgical pain or its side effects. The hypothesis holds. Thus, there is no reason for patients to postpone surgeries or to fear surgeries on any given date.
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Affiliation(s)
- Marcus Komann
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Claudia Weinmann
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Winfried Meissner
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
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