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Pre-operative steroid

Alexandria F Jaksha, Erik K Weitzel, Adrienne M Laury
Rhinosinusitis affects a significant portion of the US population, and its management imposes a substantial burden on the healthcare system. The treatment of chronic rhinosinusitis includes initial medical management prior to consideration of surgical intervention. However, if surgery does become necessary, several factors must be considered in order to optimize outcomes. This review evaluates surgical patient selection, perioperative medical management, and the extent of operative intervention, with the goal of improving surgical results, decreasing the need for revision surgery, and enhancing the patient's quality of life...
2016: F1000Research
S H Lee, H J Ahn, S M Yeon, M Yang, J A Kim, D M Jung, J H Park
Atrial fibrillation is the most frequent arrhythmia after thoracic surgery and is associated with increased hospital costs, morbidity and mortality. In this study, we aimed to identify potentially modifiable risk factors for postoperative atrial fibrillation following lung resection surgery and to suggest possible measures to reduce risk. We retrospectively reviewed the medical records of 4731 patients who underwent lobectomy or more major lung resection over a 6-year period. Patients who developed atrial fibrillation postoperatively and required treatment were included in the postoperative atrial fibrillation group, while the remaining patients were assigned to the non-postoperative atrial fibrillation group...
September 26, 2016: Anaesthesia
V V Ramesh Chandra, B C M Prasad, C Krishna Mohan, T C Kalawat, V Satyanarayana, A Y Lakshmi
BACKGROUND: Low back pain is caused by a variety of conditions. When conventional imaging failed, single-photon emission computed tomography (SPECT) was superior to scintigraphy in identifying the pathology. Injection therapies are often helpful in treating the pathology. AIM: To determine the cause of chronic low backache in individuals with normal conventional imaging (radiographs, computed tomography and magnetic resonance imaging), to determine the specific pathology using scintigraphic studies and diagnostic blocks; and, to treat the individuals with various spinal injection techniques and determine their efficacy...
September 2016: Neurology India
Geraint J Sunderland, Michael D Jenkinson, Rasheed Zakaria
The diagnosis of brain metastases is associated with a poor prognosis reflecting uncontrolled primary disease that has spread to the relative sanctuary of the central nervous system. 20 % of brain metastases occur in the posterior fossa and are associated with significant morbidity. The risk of acute hydrocephalus and potential for sudden death means these metastases are often dealt with as emergency cases. This approach means a full pre-operative assessment and staging of underlying disease may be neglected and a proportion of patients undergo comparatively high risk surgery with little or no survival benefit...
September 12, 2016: Journal of Neuro-oncology
Federico Ricci, Antonio Calabrese, Cecilia De Felici, Filippo Missiroli, Marco Pileri, Federico Regine
PURPOSE: To report the outcome of 5 consecutive cases of presumed, noninfectious endopththalmitis following intravitreal injection of bevacizumab (IVB). METHODS: Ten pre-loaded syringes of bevacizumab (1.25 mg/50 µL) furnished by a compounding pharmacy were injected intravitreally. Treatments were performed in the operating room by the same surgeon on 2 consecutive days. RESULTS: Of 10 eyes, 5 showed moderate to severe ocular inflammation within a few days of injection...
2016: Digital Journal of Ophthalmology: DJO
Laura Prieto-García, Miguel Pericacho, Sandra M Sancho-Martínez, Ángel Sánchez, Carlos Martínez-Salgado, José Miguel López-Novoa, Francisco J López-Hernández
Pre-renal acute kidney injury (AKI) results from glomerular haemodynamic alterations leading to reduced glomerular filtration rate (GFR) with no parenchymal compromise. Renin-angiotensin system inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor antagonists (ARAs), non-steroidal anti-inflammatory drugs (NSAIDs) and diuretics, are highly prescribed drugs that are frequently administered together. Double and triple associations have been correlated with increased pre-renal AKI incidence, termed "double whammy" and "triple whammy", respectively...
August 1, 2016: Pharmacology & Therapeutics
Jessica W Lo, Catey Bunce, David Charteris, Philip Banerjee, Rachel Phillips, Victoria R Cornelius
BACKGROUND: Open globe ocular trauma complicated by intraocular scarring (proliferative vitreoretinopathy) is a relatively rare, blinding, but potentially treatable condition for which, at present, surgery is often unsatisfactory and visual results frequently poor. To date, no pharmacological adjuncts to surgery have been proven to be effective. The aim of the Adjunctive Steroid Combination in Ocular Trauma (ASCOT) randomised controlled trial is to determine whether adjunctive steroid (triamcinolone acetonide), given at the time of surgery, can improve the outcome of vitreoretinal surgery in patients with open globe ocular trauma...
2016: Trials
Philip J Banerjee, Victoria R Cornelius, Rachel Phillips, Jessica W Lo, Catey Bunce, Joanna Kelly, Caroline Murphy, Rhiannon Tudor Edwards, Elizabeth L Robertson, David G Charteris
BACKGROUND: Eyes sustaining open globe trauma are at high risk of severe visual impairment. Ocular injuries which result in visual loss invariably affect the posterior segment of the eye, and prevention of visual loss involves posterior segment (vitreoretinal) surgery. Despite improvements in vitreoretinal surgical techniques, outcomes in these patients remain unsatisfactory, and development of the intraocular scarring response proliferative vitreoretinopathy is the leading cause. Proliferative vitreoretinopathy is the most common cause of recurrent retinal detachment in these eyes; it is reported to occur in up to 45 % of cases...
2016: Trials
Neha Sood, Kaniksha Desai, Ana-Maria Chindris, Jason Lewis, Tri A Dinh
Steroid cell tumor not otherwise specified (NOS) is a rare subtype of sex cord stromal tumor of the ovary and contributes less than 0.1% of all ovarian neoplasms. The majority of tumors occur in pre-menopausal women (mean age: 43 years), in which 56-77% of patients present with virilization due to excess testosterone. An 80-year-old woman with worsening alopecia and excessive growth of coarse hair on abdomen and genital area was found to have elevated serum testosterone level (462 ng/mL). Radiologic studies were consistent with bilateral adrenal adenomas...
June 28, 2016: Rare Tumors
H Hakan Poyrazoğlu, Zeynel Duman, Şerafettin Demir, M Kemal Avşar, Atakan Atalay, Bahattin Çiftçi, İhsan Bayraktar, Funda Tor
BACKGROUND: Cardiopulmonary bypass is known to cause inflammatory events. Inflammation occurs due to many known important biological processes. Numerous mechanisms are known to be responsible for the development of inflammatory processes. Currently, there are many defined mediators as a tumor necrosis factor-α (TNF-α) playing an active role in this process. AIMS: This research was to investigate the effects of pre-operative steroid use on inflammatory mediator TNF-α and on time to extubation postoperatively in ventricular septal defect patients undergoing cardiopulmonary bypass surgery...
March 2016: Balkan Medical Journal
Erika Betancourt, Jonathan Wachtel, Michalis Michaelos, Michael Haggerty, Jessica Conforti, Mary F Kritzer
Parkinson's disease (PD) is well known for motor deficits such as bradykinesia. However, patients often experience additional deficits in working memory, behavioral selection, decision-making and other executive functions. Like other features of PD, the incidence and severity of these cognitive symptoms differ in males and females. However, preclinical models have not been used to systematically investigate the roles that sex or sex hormones may play in these complex signs. To address this, we used a Barnes maze spatial memory paradigm to compare the effects of a bilateral nigrostriatal dopamine lesion model of early PD on cognitive behaviors in adult male and female rats and in adult male rats that were gonadectomized or gonadectomized and supplemented with testosterone or estradiol...
May 25, 2016: Neuroscience
Sailaja Bondalapati, Avinash Pathengay, Jay Chhablani
BACKGROUND: To report the outcomes of external drainage of subretinal fluid (SRF) in exudative retinal detachment secondary to central serous chorioretinopathy (CSCR). METHODS: Retrospective observational analysis of six eyes with exudative retinal detachment secondary to CSCR who underwent external drainage of SRF between 2004 and 2014 was performed. Collected data included demographics, steroid usage, surgical details, and visual acuity preoperatively and postoperative visual acuity and clinical examination data were collected...
December 2015: Eye Science
Deepti V Prashar, Deepti Pahwa, Vimal Kalia, Govind Jindal, Rupinder Kaur
AIM AND OBJECTIVES: This study evaluated the efficacy of oral methylprednisolone and diclofenac sodium on post-operative sequelae after third molar surgery. SETTINGS AND DESIGN: A randomized double-blind clinical trial was conducted (with institutional and university approval for dissertation) to evaluate the effect of methylprednisolone with diclofenac sodium (group A) as compared with diclofenac sodium and placebo (group B) on three variables: Pain, swelling and trismus, after third molar surgery...
January 2016: Indian Journal of Dentistry
Theodore D Koreckij, Abigail A Davidson, Kevin C Baker, Daniel K Park
STUDY DESIGN: A retrospective case-control study. OBJECTIVE: The aim of this study was to determine the effect of retropharyngeal steroids on postoperative dysphagia scores and clinical outcomes following multilevel anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: Dysphagia is a well-known complication following ACDF surgery and increased rates of dysphagia are seen with increased levels of surgery. Retropharyngeal steroids have been shown to decrease painful swallowing and prevertebral soft tissue (PSTS) swelling in 1- and 2-level anterior cervical surgery...
May 2016: Spine
Jourdan M Cancienne, Brian C Werner, Varun Puvanesarajah, Hamid Hassanzadeh, Anuj Singla, Frank H Shen, Adam L Shimer
STUDY DESIGN: Retrospective database analysis. OBJECTIVE: To determine if any association exists between preoperative cervical epidural steroid injections (CESI) at various time intervals before anterior cervical discectomy and fusion (ACDF) or posterior cervical fusion (PCF) and the incidence of postoperative infection. SUMMARY OF BACKGROUND DATA: While infectious complications following CESI are uncommon, the association between preoperative CESI and post-operative infection following ACDF or PCF has yet to be evaluated in the current literature...
April 23, 2016: Spine
Jeung Hui Pyo, Hyuk Lee, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J Kim
BACKGROUND/AIMS: The aim of this study was to compare the clinical effects of preoperative and postoperative dexamethasone on pain after endoscopic submucosal dissection (ESD) for early gastric neoplasm. METHODS: Forty patients with early gastric neoplasm who were scheduled for ESD were randomized into two groups according to the timing of steroid administration: preoperative ("pre", n=20) and postoperative ("post", n=20) steroid administration. The pre group received 0...
July 15, 2016: Gut and Liver
J G Seow, Y R Lim, V G Shelat
PURPOSE: Perforated peptic ulcer (PPU) is a common surgical emergency and treatment involves omental patch repair (PR). Gastric resection (GR) is reserved for difficult pathologies. We audit the outcomes of GR at our institution and evaluate the pre-operative factors predicting the need for GR. METHODS: This is a single-institution, retrospective study of patients with PPU who underwent surgery from 2004 to 2012. Demographics, clinical presentation and intra-operative findings were studied to identify factors predicting the need for GR in PPU...
April 13, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Patrick D Munson
OBJECTIVES: To determine if children with recurrent croup (RC) and persistent laryngomalacia (LM) clinically improve after supraglottoplasty (SGP). MATERIAL AND METHODS: Retrospective chart review cohort at tertiary care children's hospital consisting of patients diagnosed with LM and RC that underwent SGP from July 2011 to August 2014. Clinical history, demographics, clinical outcomes, and operative complications were reviewed. Specifically, the episodes of croup requiring systemic steroids were compared pre- and post-SGP with statistical analysis...
May 2016: International Journal of Pediatric Otorhinolaryngology
Manabu Komori, Yutaka Yamamoto, Yuichiro Yaguchi, Tetsuo Ikezono, Hiromi Kojima
CONCLUSION: Approximately 50% of patients with sPLF based on the clinical diagnosis criteria were definitively diagnosed with CTP-positive sPLF. These results suggest that early surgery within 7 days of the disease onset contributes to improvements in the therapeutic response of hearing loss. OBJECTIVES/HYPOTHESIS: Idiopathic spontaneous perilymph fistula (sPLF) cannot be diagnosed reliably. It is speculated that this condition occurs in patients with vertigo-accompanied acute sensorineural hearing loss that progresses rapidly in spite of steroid therapy...
September 2016: Acta Oto-laryngologica
Nadine Khawaja, Tara Renton
Acute trigeminal pain is a common presentation in the dental surgery, with a reported 22% of the US adult population experiencing orofacial pain more than once during a 6-month period. This article discusses the mechanisms underlying the pain experience, diagnosis and subsequent management of acute trigeminal pain, encompassing pre-, peri- and post-operative analgesia. The dental team spend most of their working lives managing patients and acute pain. The patient may present to the clinician in existing pain, which may often provide a diagnostic challenge...
June 2015: Dental Update
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