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Preoperative hypertension

Wen-Zhi Li, Xiang Wan, Long Li, Bin Xu, Zhong Wang
We encountered 2 patients (a 33-year-old woman and a 66-year-old man) with an aldosterone-producing adenoma (APA) and a left accessory spleen. The patients' primary symptoms were hypertension and hypokalemia, and both had elevated serum aldosterone levels. Preoperative computed tomography a left suprarenal retroperitoneal mass and laparoscopic left adrenalectomy was performed in both cases. The postoperative microscopic examination revealed splenic tissue. Both patients experienced relief of their hypertension and hypokalemia, with an uneventful recovery...
August 16, 2018: Urology Journal
Fu-Hua Lin, Xiang-Heng Zhang, Ji Zhang, Zhen-Qiang He, Hao Duan, Chao Ke, Ke Sai, Xiao-Bing Jiang, Fuad Al-Nahari, Shao-Yan Xi, Yong-Gao Mou
BACKGROUND: Surgical procedures are critical in making a conclusive histopathological diagnosis of primary central nervous system lymphoma (PCNSL), which typically presents contrast-enhancing lesions in magnetic resonance imaging (MRI). The fluorescein sodium-guided technique could enhance tumor visibility. We reported a series of patients with PCNSL underwent fluorescein sodium-guided surgical procedures. PATIENTS AND METHODS: 12 patients clinically considered brain tumors underwent fluorescein sodium-guided surgery in Sun Yat-sen University Cancer Center from March 2016 to July 2017...
August 16, 2018: Journal of Neuro-oncology
Benjamin Dk Leong, Ariffin A Zainal, Hussein Hanif, Hafizan M Tajri, Naresh Govindarajantran, Kumaraguru Pillay, Kia L Tan, Ahmad Faidzal Othman
Objective : Native fistula creation for hemodialysis in patients who have exhausted all their superficial veins presents a challenge to vascular practice. We review our experience in transposed basilic vein fistula (BVT) creation and its usage for hemodialysis. Materials and Methods : We analyzed the hospital operative registry from January 2009 till June 2012 to identify the total number of BVT created in our center. Medical records of all patients were traced, and patients were interviewed using a standard proforma...
June 25, 2018: Annals of Vascular Diseases
Donata Ringaitiene, Lina Puodziukaite, Vaidas Vicka, Dalia Gineityte, Mindaugas Serpytis, Jurate Sipylaite
OBJECTIVE: To determine whether bioelectrical impedance-derived phase angle (PA) can be a predictor of red blood cell (RBC) transfusion in patients undergoing cardiac surgery. DESIGN: An observational retrospective study of prospectively collected data. SETTING: Single center, tertiary referral university hospital. PARTICIPANTS: The study sample comprised 642 adult patients undergoing elective cardiac surgery. INTERVENTIONS: Patient demographic and clinical variables were collected...
July 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Marcos Guilherme Cunha Cruvinel, Fabiano Soares Carneiro, Roberto Cardoso Bessa Junior
OBJECTIVE: The aim of this report is to exemplify the role of the use of bedside ultrasound by the anesthesiologist, offering an individualized approach to the specific condition of the patient, without unnecessary postponement of femur fracture surgical repair in the elderly. CASE REPORT: Female patient, 86 years old, hypertensive, victim of trochanteric fracture of the femur, taken to the operating room after being released by cardiology. Bedside ultrasound allowed the identification of aortic stenosis, left ventricular hypertrophy, carotid stenosis, and signs of hypovolemia...
August 13, 2018: Revista Brasileira de Anestesiologia
R Gudaityte, K Adamonis, A Maleckas
BACKGROUND: Laparoscopic gastric greater curvature plication (LGGCP) is a novel bariatric procedure. Few studies have presented intermediate or long-term results. The aim of this prospective study was to investigate intermediate results and factors associated with failure to achieve satisfactory weight loss after LGGCP. METHODS: Between October 2011 and November 2013, 61 patients underwent LGGCP and were followed up to 36 months after operation. Demographics, comorbidities, complications, and percentage of excess body mass index loss (%EBMIL) were analyzed...
August 15, 2018: Obesity Surgery
V Larouche, N Garfield, E Mitmaker
Pheochromocytomas are rare adrenal neoplasms characterized by excess secretion of catecholamines. We describe the case of a 65-year-old man, known for hypertension, with no family history of hereditary pheochromocytoma syndromes. He reported a two-year history of flushing, systolic blood pressure surges to 200 mmHg, headaches, tremors, and syncope. His initial workup revealed elevated 24h urine catecholamines and metanephrines. An adrenal MRI in March 2017 showed a large 7.6 cm heterogeneous right adrenal lesion...
2018: Case Reports in Endocrinology
Shuhei Ishiyama, Junji Shiode, Masao Yoshioka, Junichirou Nasu, Akiko Fujiwara, Mamoru Itoh, Masakuni Fujii, Shusuke Saitoh, Mitsuhiro Kanetoh, Hisanori Oka
Rectal varices are ectopic varices that occur in patients with portal hypertension and cause abrupt gastrointestinal bleeding. Endoscopic variceal ligation is a minimally invasive treatment used for patients with bleeding from rectal varices. Endoscopic treatment of colorectal tumors accompanied by rectal varices has been rarely reported. It is very important to control bleeding during treatment. The patient was a 76-year-old man who had a chief complaint of bloody stools. A flat-elevated-type neoplastic lesion measuring about 20 mm was found above the rectal varices...
August 14, 2018: Clinical Journal of Gastroenterology
Benjamin Degeorge, Louis Dagneaux, Julien Andrin, Cyril Lazerges, Bertrand Coulet, Michel Chammas
BACKGROUND: No surgical management is better than another regarding functional recovery for trapeziometacarpal joint osteoarthritis. Metacarpophalangeal (MCP) hyperextension, directly due to the shortening of thumb height, appears to be a factor of poor prognosis. HYPOTHESIS: MCP hyperextension can be corrected by implantation of a trapeziometacarpal prosthesis (TMP), as opposed to trapeziectomy and ligamentoplasty (TL), and pinch strength is greater with TMP in this indication...
August 11, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Kuan-Ting Wu, Chung-Yang Chen, Bradley Chen, Jun-Wen Wang, Po-Chun Lin, Shih-Hsiang Yen
Background: Etiology of acute kidney disease (AKD) after total knee arthroplasty (TKA) was considered as multifactorial. However, the role of early postoperative volume supplement in AKD rate has not been investigated. The purpose of this study was to evaluate the incidence and risk factors of AKD in patients with early volume supplement following TKA. Methods: This was a retrospective study with 458 patients who underwent unilateral TKA. All the patients received 6% tetrastarch, 7...
2018: BioMed Research International
Masao Takeda, Koichi Yamamoto, Hiroshi Akasaka, Hiromi Rakugi, Mitsuhide Naruse, Yoshiyu Takeda, Isao Kurihara, Hiroshi Itoh, Hironobu Umakoshi, Mika Tsuiki, Takamasa Ichijo, Takuyuki Katabami, Norio Wada, Yui Shibayama, Takanobu Yoshimoto, Yoshihiro Ogawa, Junji Kawashima, Masakatsu Sone, Nobuya Inagaki, Katsutoshi Takahashi, Megumi Fujita, Minemori Watanabe, Yuichi Matsuda, Hiroki Kobayashi, Hirotaka Shibata, Kohei Kamemura, Michio Otsuki, Yuichi Fujii, Atsushi Ogo, Shintaro Okamura, Shozo Miyauchi, Toshihiko Yanase, Tomoko Suzuki, Takashi Kawamura
Context: Primary aldosteronism (PA) in the elderly has increased in importance in association with population aging. Objective: To investigate the characteristics and outcomes of elderly PA patients undergoing aldosteronectomy. Patients and methods: Using a database of PA patients who underwent adrenal venous sampling (AVS), elderly patients (≥65 years old) were compared to non-elderly patients (<65) in terms of characteristics, subtype classification in ACTH-stimulated AVS, and outcomes after adrenalectomy...
August 6, 2018: Journal of Clinical Endocrinology and Metabolism
David Muchuweti, Edwin G Muguti, Bothwell A Mbuwayesango, Simbarashe Gift Mungazi, Rudo Makunike-Mutasa
INTRODUCTION: Pheochromocytomas are catecholamine producing tumours which arise from chromaffin cells within the adrenal medulla. Patients with these tumours commonly present with a triad of headache, palpitations and hypertension. CASE PRESENTATION: We present a case of a 37-year-old male patient who presented with dull left sided abdominal pain and discomfort for 6 weeks. A preoperative Computed tomography (CT) scan showed a huge left suprarenal tumour but urinary vanillylmandelic acid (VMA) were negative...
August 1, 2018: International Journal of Surgery Case Reports
Eric H Zhao, Kalin Nishimori, Jacob Brady, Sana H Siddiqui, Jean Anderson Eloy, Soly Baredes, Richard Chan W Park
OBJECTIVES/HYPOTHESIS: Evaluate risk factors for unplanned reoperation following free flap surgery of the head and neck. STUDY DESIGN: Retrospective database review. METHODS: The National Surgical Quality Improvement Program database was queried for free flap surgeries of the head and neck between 2010 and 2014. Bivariate and multivariate analyses were performed to compare perioperative variables and postoperative complications in patients with and without unplanned reoperation...
August 10, 2018: Laryngoscope
Zitao Zhang, Zhen Wang, Yan Zhang, Xusheng Qiu, Yixin Chen
Sufficient drainage is very important for preventing wound complications after open reduction and internal fixation (ORIF) of calcaneal fractures. However, the drainage amount varies among patients. The objective of this study was to identify factors associated with increased postoperative drainage after ORIF of calcaneal fractures.A retrospective study including 87 patients with 92 calcaneal fractures in our hospital was performed. Patients were divided into 2 groups based on whether they had increased drainage, which was defined as a total drainage of ≥340 mL (50th percentile)...
August 2018: Medicine (Baltimore)
Charles Marcus, Prasanna Santhanam, Matthew J Kruse, Mehrbod S Javadi, Lilja B Solnes, Steven P Rowe
The aim of the present study was to evaluate the incidence of undiagnosed pulmonary arterial dilatation using the gated computed tomography (CT) images acquired in patients with an otherwise normal Tc-sestamibi single-photon-emission CT (SPECT)/CT myocardial perfusion study.This was a retrospective review of 200 consecutive patients (100 men, mean age 58.7 years) who underwent a myocardial perfusion Tc-sestamibi SPECT/CT study with normal perfusion and with gated CT images acquired for coronary calcium scoring...
August 2018: Medicine (Baltimore)
Dany-Michel Marcadet, Bruno Pavy, Gilles Bosser, Frédérique Claudot, Sonia Corone, Hervé Douard, Marie-Christine Iliou, Bénédicte Vergès-Patois, Pascal Amedro, Thierry Le Tourneau, Caroline Cueff, Taniela Avedian, Alain Cohen Solal, François Carré
The exercise test is performed routinely in cardiology; its main indication is the diagnosis of myocardial ischemia, evaluated along with the subject's pretest probability and cardiovascular risk level. Other criteria, such as analysis of repolarization, must be taken into consideration during the interpretation of an exercise test, to improve its predictive value. An exercise test is also indicated for many other cardiac diseases (e.g. rhythm and conduction disorders, severe asymptomatic aortic stenosis, hypertrophic cardiomyopathy, peripheral artery disease, hypertension)...
August 6, 2018: Archives of Cardiovascular Diseases
Gustavo Rubio, John K Karwowski, Hilene DeAmorim, Lee J Goldstein, Arash Bornak
INTRODUCTION: and objective: Prolonged hemodynamic instability after carotid artery stenting (CAS) has been associated with increased incidence of stroke and other major adverse events. The objective of this study is to determine the factors associated with hypotension following CAS. In particular, this study evaluates whether involvement of the carotid bifurcation/bulb and degree of calcification can predict postoperative hypotension. METHODS: A retrospective review of 90 CAS performed in 88 patients at a single tertiary center was performed...
August 6, 2018: Annals of Vascular Surgery
Michelle Philip, Bartley Thornburg
Extrahepatic abdominal surgery in patients with portal hypertension is associated with a high rate of perioperative complications and death due to the increased risk of liver failure, perioperative bleeding, and ascites. One proposed method to facilitate surgery in these patients is with preoperative placement of a transjugular intrahepatic portosystemic shunt (TIPS). By decompressing the portal circulation, this presurgical measure would theoretically decrease the potential for bleeding and improve the ability to control ascites in the perioperative and postoperative period...
August 2018: Seminars in Interventional Radiology
Victoria Young, Shankar Rajeswaran
Interventional radiology's role in the management of portal hypertension in the pediatric population differs from the management of adult portal hypertension. In the pediatric population, portal hypertension is frequently secondary to thrombosis and cavernous transformation of the extrahepatic portion of the portal vein. Transjugular intrahepatic portosystemic shunt can be utilized to manage portal hypertension in children with intrinsic liver disease that results in cirrhosis and portal hypertension, and is often used as a bridge to transplant...
August 2018: Seminars in Interventional Radiology
Kang-Yung Peng, Huang-Ming Chang, Yu-Feng Lin, Chieh-Kai Chan, Chia-Hui Chang, Shih-Chieh Jeff Chueh, Shao-Yu Yang, Kuo-How Huang, Yen-Hung Lin, Vin-Cent Wu, Kwan-Dun Wu
Context: The aberrant expressions or alternations of microRNA (miRNA) in the pathogenesis of aldosterone-producing adenomas (APA) are still largely unknown. Objective: We investigated the role of microRNA-203 (miR-203; screened from microRNA microarray) and elucidated its effects on the Wnt/β-catenin pathway in regards to aldosterone production and cell proliferation in APA. Methods: miR-203 expression was up- or down-regulated by transfecting miR-203-mimics or inhibitors respectively into primary APA cells and human adrenocortical cell line HAC15...
August 1, 2018: Journal of Clinical Endocrinology and Metabolism
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